[Epidemic situation and diagnosis and treatment of severe falciparum malaria in Nantong City].

OBJECTIVE: To retrospectively analyze the epidemic situation and diagnosis and treatment of severe falciparum malaria in Nantong City, summarize the causes of severe falciparum malaria, and evaluate the effect of diagnosis and treatment, so as to provide the evidence for formulating the practical treatment measures for this disease. METHODS: All the data of falciparum malaria cases in Nantong City from 2009 to 2016 were collected and analyzed for the onset time, diagnosis process and treatment of the disease. RESULTS: A total of 359 malaria cases, including 289 falciparum malaria cases, were reported in Nantong City from 2009 to 2016, including 26 severe falciparum malaria cases. All the severe falciparum malaria cases were imported from Africa, including 57.70% of cases (15/26) from Angola. All of them were male labor exporting personnel. The incidence of malaria was not obviously seasonal. The average time from onset to definite diagnosis was 5.2 days, and 11 cases were diagnosed 5 days after the onset. All the 26 cases were cured by anti-malaria treatment and symptomatic treatment, and there was no death. CONCLUSIONS: Severe falciparum malaria seriously harm the people's health and its clinical manifestations are complicated. Therefore, the training of medical staff and health education in residents, especially in labor exporting personnel, should be further strengthened.

[Study on Oncomelania hupensis snails infected with Schistosoma japonicum miracidia under different conditions in snail-existent non-endemic areas of schistosomiasis in Nantong City].

OBJECTIVE: To understand the forming cause of the Oncomelania hupensis snail-existent non-endemic areas of schistosomiasis (SENEAS), and to verify the conclusion of previous studies, so as to provide the evidence for schistosomiasis monitoring in such areas in Nantong City, Jiangsu Province. METHODS: The controlled field tests were carried out to observe the O. hupensis snails artificially infected by schistosome miracidia in SENEAS. The influence of the soil from SENEAS and the endemic areas on O. hupensis snails artificially infected by miracidia were observed. RESULTS: All the experimental snails could be infected by schistosome miracidia except the smooth-shell snails from Tangyuan Village in the controlled field test environment of SENEAS or the endemic areas. The infection rates of the smooth-shell snails were lower than those of the ribbed-shell snails, but there were no statistically significant differences. The mortality rates of the smooth-shell snails were higher than those of the ribbed - shell snails, which were statistically significant (χ2Xindian = 135.118, χ2Shuangdian = 122.836, χ2Baipu =154.436, χ2Dingyan = 138.288, χ2Control = 151.923, all P < 0.01). There were no significant differences in the infection rates of snails between each test group of the soil from SENEAS and the endemic areas (χ2Rugao = 0.071, χ2Rudong = 0.216, both P > 0.05). Also there was no significant difference between each test group and the control group without soil (χ2 = 7.148, P > 0.05). CONCLUSIONS: It is likely to form the spread of schistosomiasis in SENEAS in Nantong City with sufficient amount of infection source of schistosomiasis imported. It is still necessary to implement the surveillance of schistosomiasis and O. hupensis snails in Nantong City.

[Investigation on current situation of malaria blood examinations in township-level hospitals of Nantong City].

OBJECTIVE: To understand the quality of malaria blood examinations in township-level hospitals, so as to provide the evidence for continuing the malaria blood examinations in the stage of post-malaria elimination. METHODS: A total of 64 township hospitals were investigated and 640 negative malaria blood slides were scored individually according to 10 indicators in "Malaria Elimination Technical Scheme" in 2013 and 2014. The single and multiple indicators were calculated, and the work of blood examinations and situation of technicians were investigated. The data of malaria blood examinations and patient discovery in township hospitals of Nantong City were collected and analyzed during the period of 2011-2014. RESULTS: For the single indicator, 29.5% of the thick blood films did not reach the standard, and 35.8% of thin blood films did not reach the standard. For the multiple indicators, blood slides with more than 4 indicators below the standard (poor quality) accounted for 32.5%. From malaria blood examinations and malaria situation, the number of slides was 194 635 during the period of 2011-2014, and there were no local vivax malaria casesin 4 consecutive years from 2011 to 2014, and local malaria has been effectively controlled in Nantong City. For health facilities where malaria patients initially presented, the township and village level accounted for 16.3%, and county and higher level accounted for 83.7%. CONCLUSIONS: The quality of malaria blood examinations in township level hospitals of Nantong City is not high and the microscopic examination has a relatively low efficiency in the discovery of malaria cases. A new model for malaria blood examinations needs to be further explored.

[Epidemic situation of malaria and progress of malaria elimination in Nantong City from 2008 to 2014].

OBJECTIVE: To analyze the epidemic status and progress of malaria elimination in Nantong City, so as to provide evidences for adjusting the control measures and guiding the work of malaria elimination. METHODS: The data about the epidemic situation of malaria and malaria elimination in Nantong City from 2008 to 2014 were collected and analyzed by the method of descriptive epidemiology. RESULTS: From 2008 to 2014, a total of 305 malaria cases were reported in Nantong City, with an annual average incidence of 0.57/100 000. Among all the cases, 26 (8.52%) were local tertian malaria cases and 279 (91.48%) were imported cases; 276 cases (90.49%) were male and most of them were young adults, and those aged in 20-59 accounted for 91.48% (279/305). There were cases reported in each month, with no obvious seasonality. The imported cases were mainly distributed in Hai'an County (80 cases), Haimen City (71 cases) and Tongzhou District (41 cases), and the total percentage of them was 68.82% among all the imported malaria cases in Nantong City. There were no local malaria cases reported in Nantong City since 2011. Qidong City, Rudong County, Chongchuan District, Development Zone and Gangzha District have reached the criteria of malaria elimination in Jiangsu Province. CONCLUSIONS: From 2008 to 2014, the malaria cases in Nantong City are mainly imported cases, the number of local cases has decreased significantly, and there has been no local infected cases reported in the continuous 4 years of 2011-2014. Totally 5 counties (cities, districts) among the 9 have reached the criteria of malaria elimination in Jiangsu City. In the future, the control of imported malaria should still be strengthened, and the work of malaria elimination should still be promoted.