Outcomes of antiretroviral treatment for 0-14-year-old children living with HIV in Ganzhou, China, 2006-2023.

BACKGROUND: Studies on antiretroviral therapy (ART) in children living with HIV (CLHIV) are limited due to the small population and low accession rate of ART. METHODS: All 0-14-year-old CLHIV admitted to the Ganzhou Center for Disease Control and Prevention from January 2006 to June 2023 were included retrospectively. The information of treatment regimens, disease progression, and laboratory tests of the patients under ART were used to explore the outcomes and impacts of long-term ART. The normality of all the data was tested by the Shapiro-Wilk test. RESULTS: From 2006 to 2023, 18 CLHIV were reported in Ganzhou. Among them, 11 received ART and were followed up for 60.0 ± 48.4 months. After receiving ART, the median viral load of them decreased from 89,600 copies/ml to 22 copies/ml (P = 0.007), the median CD4+ T cell count increased from 380.7 cells/µL to 661.9 cells/µL (P = 0.028), and the median CD8+ T cell count decreased from 1065.8 cells/µL to 983.3 cells/µL (P = 0.584). The laboratory test results regarding liver function, renal function, blood cell count, and glucolipid metabolism tended to be within normal reference ranges, and the mean height-for-age z-score and weight-for-age z-score increased. However, all the three CLHIV who received cotrimoxazole developed pneumocystis carinii pneumonia, upper respiratory infection, skin lesions, bacterial pneumonia and/or thrush; the mean body-mass-index-for-age z-score decreased from 0.52 to -0.63. CONCLUSION: For CLHIV, ART could effectively inhibit the replication of HIV and improve the immune function of patients. More studies that focus on ART in CLHIV are urgently needed.

[Risk Assessment of Snail Output Via the Mud Balls of Transplanted Seedlings in a Nursery Stock Park in Middle Region of Zhejiang Province].

Objective: To investigate the distribution of snails in a nursery stock park in the middle region of Zhejiang Province and assess the risk of snail output via the mud balls of transplanted seedlings, to provide scientific data for making strategies for snail control. Methods: We selected three species of seedlings including Osmanthus fragrans (a large tree), Camellia sasanqua (a small tree), and Purpus privet (a type of shrub) in a nursery stock park in a snail-positive middle region of Zhejiang Province during 2014-2016 to calculate the areas of regions with snails and the density of living snails. In 30 trees of each species, the distribution of snails within the seedlings ground diameter (radius of investigation, 100 cm for Osmanthus fragrans; 30 cm for Camellia Sasanqua and Purpus Privet) and in different soil layers (surface and superficial layers, 0-3 cm; deep layer, 3-10 cm) was assessed. In addition, the presence of snails in mud balls of 50 trees of Photinia fraseri (a small tree with high density of snails) was investigated to assess the risk of snail output. Results: In the planting areas of Osmanthus fragrans（3 930 m2）, Camellia sasanqua（2 000 m2）, and Purpus privet （1 700 m2）, the areas of snail-positive regions were 200, 900 and 800 m2, respectively, with the density of living snails being 0.08, 0.56 and 0.55/0.1 m2. For Osmanthus fragrans, Camellia sasanqua and Purpus privet, 238, 654 and 645 snails were detected respectively within their seedlings ground diameter, including 159（66.8%）, 461（70.5%） and 376 （58.3%） snails in the surface layer, respectively, which were significantly higher than those in the superficial and deep layers（P＜0.01）. Snails were found in all the 50 trees of Photinia fraseri（3 726 snails, 706 adult snails and 3 020 immature snails, 75 snails/tree on average）. Conclusion: There is a high density of snails in the nursery stock park in the middle region of Zhejiang Province. The snails are distributed mainly in the surface layer, suggesting a risk of snail output through mud balls.

Acute Suppurative Parotitis Treatment by Diode Laser Combined with ER:YAG Laser.

BACKGROUND AND AIM: The diode laser combined with Er:YAG laser is a new treatment modality for acute sialadenitis. A 78-year-old woman with acute suppurative parotitis was treated by traditional probe to the duct orifice with oral antibiotics for 2 weeks. The symptoms and signs did not subside after treatment. The Er:YAG laser was used to reduce severe infection and inflammation and low level laser therapy (LLLT) was applied to relieve pain sensation during incision and drainage. Less scar formation and obstruction was observed after the laser treatments. RESULTS: Purulent secretions from the Stensen duct was noted after milking the parotid gland. The symptoms and signs were significantly relieved after combined laser treatments. The patient experienced no pain during the course of treatment. No recurrence of the symptoms and signs was noted after 1-year follow-up, and the prognosis was very good. CONCLUSION: The hemostatic properties of the diode laser enable better control of the surgical field and faster healing of the wound lesions. The bactericidal effect of Er:YAG lasers has been proved by many researchers, and has been shown to reduce infection and inflammation for better wound healing. The combined laser therapy of diode and Er:YAG lasers is recommended in treating acute sialadenitis.

Development of a rapid dipstick with latex immunochromatographic assay (DLIA) for diagnosis of schistosomiasis japonica.

BACKGROUND: Schistosomiasis japonica (schistosomiasis) is a zoonosis that can seriously affect human health. At present, the immunodiagnostic assays for schistosomiasis detection are time-consuming and require well-trained personnel and special instruments, which can limit their use in the field. Thus, there is a pressing need for a simple and rapid immunoassay to screen patients on a large scale. In this study, we developed a novel rapid dipstick with latex immunochromatographic assay (DLIA) to detect anti-Schisaosoma japonicum antibodies in human serum. RESULTS: Using latex microspheres as a color probe, DLIA was established to test standard positive and negative sera, in comparison with the classical enzyme-linked immunosorbent assay (ELISA). The sensitivity and specificity of DLIA were 95.10% (97/102) and 94.91% (261/275), respectively. The cross-reaction rates with clonorchiosis, intestinal nematodes, Angiostrongylus cantonensis and paragonimiasis were 0, 0, 0 and 42.11% respectively. All the results showed no significant difference to the ELISA. In field tests, 333 human serum samples from an endemic area were tested with DLIA, and compared with ELISA and Kato-Katz method. There was no significant difference between DLIA and ELISA on positive and negative rates of detection; however, significant differences existed between DLIA and Kato-Katz method, and between ELISA and Kato-Katz method. The kappa value between DLIA and ELISA was 0.90. CONCLUSIONS: This is the first study in which DLIA was used to detect anti-Schistosoma japonicum antibody. The results show that DLIA is a simple, rapid, convenient, sensitive and specific assay for the diagnosis of schistosomiasis and is therefore very suitable for large-scale field applications and clinical detection.

[Recent investigation and treatment of 1 060 advanced schistosomiasis cases in Zhejiang Province].

OBJECTIVE: To understand the current status of advanced schistosomiasis patients, deliver medical treatment, and improve the case management in Zhejiang Province. METHODS: The cases previously diagnosed or suspected as advanced schistosomiasis in the province were the subjects of the investigation. Questionnairing (demographical information, disease history, etc.), clinical examination (ascites syndrome, abdominal palpation), laboratory examination (blood biochemistry, anti-Schistosoma japonicum antibody, eggs), and ultrasonography of the abdomen were used confirming the diagnosis. Treatment was given to the patients. RESULTS: There were 1 060 advanced schistosomiasis patients in 32 counties of 7 prefectures in the province. Majority of them distributed in water network regions, and lived with poor economic conditions. The average age of the patients was (66.3 +/- 9.3), with 89.3% ranged from 50 to 80 years old. Clinically 71.3% of the cases were with splenomegaly, 27.6% with ascites, 0.9% cases of multiple granuloma in the colon and 0.2% cases with dwarfism. 1 023 patients (96.5%) had received medical treatments. 69.4% of the cases had serious complications with advanced schistosomiasis and 52.5% had concurrently disorders in other systems. 71.1% of the patients had subjective symptoms and 65.2% had hepatosplenomegaly with hepatic fibrosis and dysfunction. The serum positive rate of anti-S. japonicum antibody was 15.7%. Stool hatching test and microscopy revealed no eggs in fecal samples, but 24 out of 38 cases were found metamorphic eggs by rectal biopsy. Three years' medical treatment improved the clinical conditions in 74.3% of the cases. CONCLUSION: Situation of the advanced schistosomiasis patients is quite critical. Treatment and care are urgently needed especially for those aged 50 to 80 years old. [

[Establishment and application of rapid dipstick of latex immunochromatographic assay for the diagnosis of schistosomiasis].

OBJECTIVE: To establish a simple and fast diagnostic assay for schistosomiasis. METHODS: Based on the immunochromatographic technique and the principle of indirect assay of ELISA, using soluble egg antigen (SEA) of Schistosoma japonicum and mouse anti-human monoclonal antibody labelled with red latex as color developing agents, a latex immunochromatographic assay (DLIA) was developed. Serum samples from 69 schistosomiasis patients were detected by DLIA. Tested were also 264 sera from healthy people, 15 sera from clonorchiasis patients, 8 sera from patients with angiostrongyliasis cantonensis, 11 sera from patients with intestinal nematode infection and 19 sera from paragonimiasis patients. ELISA was used as a parallel control. RESULTS: The sensitivity for detecting schistosomiasis antibodies with DLIA and ELISA was 94.2% (65/69) and 95.7% (66/69), respectively (chi2=0.15, P>0.05). The specificity in examining healthy persons was 97.4% (257/264) and 94.7% (250/264), respectively (chi2=2.43, P>0.05). No cross reaction was found with the sera of clonorchiasis, intestinal nematode infection and angiostrongyliasis. The cross reaction rate with paragonimiasis of the two assays was 42.1% (8/19) and 47.4% (9/19), respectively (chi2=0.11, P>0.05). CONCLUSION: DLIA is a simple, fast, sensitive and specific assay for the diagnosis of schistosomiasis.

[Observation on the change of anti-S. japonicum antibody level in population migrated from outside embankment to new town].

OBJECTIVE: To detect the change of the anti-S. japonicum antibody level after people migrated from outside embankment to newly established town. METHODS: Three pilot spots were established for the investigation: one spot that both inhabitancy and cultivation disuse (A), one spot that only inhabitancy disuse but farming continued (B) and the third one served as control (C). DIGFA and ELISA were used to detect the antibody level in the populations from 2002 to 2005. RESULTS: The positive rate of anti-S. japonicum antibody declined significantly from 6.63% to 3.52% by DIGFA and from 7.26% to 3.71% by ELISA at spot A (chi2=5.2625, P<0.05; chi2=6.3296, P<0.05, respectively). There was no significant difference on the positive rate of antibody in spots B and C. The average A450 value of ELISA in the three spots was statistically analyzed by One-Way ANOVA. It was only in spot B that the average A450 value declined from 0.182 in 2003 to 0.147 in 2005 (P<0.01). CONCLUSION: The anti-S. japonicum antibody level in human population has decreased at certain degree after they migrated from outside embankment to new town.

[Development of a PCR assay for detecting Schistosoma japonicum-infected Oncomelania hupensis].

OBJECTIVE: To establish a sensitive and specific PCR assay for detecting Schistosoma japonicum-infected Oncomelania hupensis. METHODS: Based on 18S-rRNA gene of S. japonicum, a PCR assay for detecting Oncomelania snails infected with S. japonicum was established. The PCR product was sequenced, and the sensitivity, cross-reaction and mass detection experiments of PCR assay were performed. RESULTS: The location of PCR product for detecting Oncomelania snails infected with S. japonicum was similar to the target DNA, with a length of 469 bp and the same sequence as the target DNA. It was registered in GenBank (Accession No. DQ442999). There was no PCR product for detecting uninfected snail. Experiments showed that the minimum DNA concentration of S. japoncium miracidium to be detected was 40 pg/Rpl. DNA from snail infected with single-tail cercaria could not be detected. The maximum dilution concentration of infected snail DNA pooled with uninfected snail DNA that could be detected was 1:640. CONCLUSION: The PCR assay for detecting S. japonicum-infected Oncomelania snails shows high sensitivity, specificity and effect of mass detection.

Evaluation on the applied value of the dot immunogold filtration assay (DIGFA) for rapid detection of anti-Schistosoma japonicum antibody.

The dot immunogold filtration assay (DIGFA) is a rapid technique for the detection of anti-Schistosoma japonicum antibody. Its sensitivity with regard to sera obtained from patients with acute or chronic schistosomiasis was shown to be 100 and 96.9%, respectively. The specificity when using sera of people living in an area non-endemic for schistosomiasis japonica was 100%. Cross-reaction rates for paragonimiasis and clonorchiasis patients were 14.3% and 0%, respectively. Parallel serum tests of 1091 residents from an area endemic for S. japonicum by means of DIGFA, enzyme-linked immunosorbent assay and indirect haemagglutination test resulted in positive rates of 9.3%, 11.5% and 11.0%, respectively. Thus, there was a high level of agreement between the sets of results (P>0.05). In conclusion, DIGFA holds considerable promise for rapid and accurate diagnosis of S. japonicum, as it does not require any specific instruments and can be applied with ease. DIGFA has therefore several advantages over conventional diagnostic approaches and is useful not only for screening and sero-epidemiological surveys in the field, but also in clinical settings.

[A sampling survey on the distribution of Oncomelania snails in Zhejiang Province].

OBJECTIVE: To find out current distribution of Oncomelania snails and Schistosoma infection in snails in Zhejiang Province, so as to improve the project of schistosomiasis control. METHODS: Investigation spots were selected by stratified cluster sampling method, 100 villages of 34 counties were selected from 7106 villages of 55 counties as survey spots. Synchronously systematic and environmental samplings were used for the survey. Snails were dissected to determine the infection status and spots with sham snails were set to assess the quality of the survey. RESULTS: The result showed that snails were found in 223 strips, 1572 frames and 73,300 m2 area in 32 villages of 21 counties. Snails were found in an area covering 72,640 m2 in 29 villages of 18 counties in hilly region, which accounted for 99.1% of total snail habitats. The significantly larger area with snails was revealed in hilly region than that in water network region (t = 3.04, P < 0.01). 1st, 2nd strata occupied 71,680 m2 snail area, which accounted for 97.8% of total snail area, much higher than that in the 3rd stratum (t = 3.71 , P < 0.01). Snail habitats in the irrigation ditches and canals accounted for 62.6% of total snail area, significantly higher than that of farmland (t = 3.02, P < 0.01). No snails were found infected among 7892 living snails by dissection. The theory value of snail area in Zhejiang Province was 1,361,940 m2. CONCLUSION: It is estimated that the snail-ridden area is about 1,500,000-2,000,000 m2 in the Province, mostly found in the villages of hilly region with a record of snail habitats during the recent 4 years and the primary environment of the snail areas were ditches and canals. No infected snails were found from the survey.