[Laboratory diagnosis of an imported case of visceral leishmaniasis in Henan Province].

OBJECTIVE: To analyze the epidemiological and clinical data of an imported case of visceral leishmaniasis in Henan Province, and explore the method of laboratory diagnosis of kala-azar. METHODS: The epidemiological and clinical data of an imported visceral leishmaniasis patient were analyzed. Leishmania donovani bodies in bone marrow smears were observed microscopically. The antibody was detected by using rK39 dipstick test strips. Two pairs of specific primers, K13A-K13B and LITSR-L5.8S, were used to amplify kinetoplast DNA and internal transcribed spacer of rDNA of the parasite, respectively. RESULTS: The patient had been in the epidemic area of visceral leishmaniasis, and had symptoms such as irregular fever, splenomegaly, pancytopenia, and inversed ratio of albumin and globulin. The amastigotes of L. donovani were found in the bone marrow smears, and rK39 test strip was positive, and the PCR products of K13A-K13B and LITSR-L5.8S were 87 bp and 285 bp respectively. The similarities of the two fragment sequences to the corresponding sequences of L. donovani were 94% and 100%, respectively. CONCLUSIONS: The case is diagnosed as visceral leishmaniasis according to the epidemiological data, clinical manifestations and laboratory test results of the patient, and the pathogen is L. donovani.

[Investigation on human intestinal parasitic diseases in ecological regions of Qinba Mountains in Henan Province in 2015].

OBJECTIVE: To understand and analyze the epidemic status of human intestinal parasitic diseases in the ecological region of the Qinba Mountains in Henan Province, so as to provide the evidence for the control of the diseases in this region. METHODS: According to the methods of National Survey Scheme on Major Human Parasitic Diseases, 26 survey spots were selected in 8 counties (cities) in ecological regions of Qinba Mountains in Henan Province in 2015. After collecting the human fecal samples, the eggs of intestinal helminthes were detected with the modified Kato-Katz thick smear method, the species of Ancylostoma of the hookworm egg-positive samples were identified with the tube fecal culture method, the eggs of Enterobius vermicularis were detected by using the adhesive tape method in children aged 3 to 6 years, and the cyst and trophozoite of intestinal protozoa were examined by iodine staining. The infections of intestinal parasites in different populations and the related influencing factors were analyzed. RESULTS: Totally 6 706 residents were recruited in this study, 8 kinds of parasites were found including 3 species of helminthes and 5 species of protozoans. The overall infection rate of intestinal parasites was 3.39%, covering 2.92% for helminthes and 0.49% for protozoans. The infection rate of E. vermicularis in children aged 3 to 6 years was 3.93%. The 3 identified helminthes were Ascaris lumbricoides, E. vermicularis, and Dicrocoelium dendriticum, with the highest infection rate of E. vermicularis (2.68%, χ2 = 306.362, P < 0.05). The 5 identified protozoans were Entamoeba hartmani, E. coli, Endolimax nana, Giardia lamblia, and Blastocystis hominis, and the infection rate of E. nana was the highest (χ2 = 23.842, P < 0.05). Among the 8 counties (cities), the highest infection rate of helminthes, mainly with Enterobius infection, existed in Ruyang County, and the infection rate of protozoans in Xin'an County was the highest, mainly with E. nana infection. There was a significant difference in the infection rates of helminthes and protozoans among the 8 counties (cities) (helminthes: χ2 = 357.525, P < 0.05; protozoans: χ2 = 38.795, P < 0.05). There was no significant difference in the helminth infection rate between males and females ( χ2 = 0.034, P > 0.05), but the protozoan infection rate of the males was higher than that of the females ( χ2 = 12.946, P < 0.05). The helminth infection rate of the 0-9 years old group was the highest ( χ2 = 62.600, P < 0.05), up to 6.60%, mainly with E. vermicularis infection. There was no significant difference in the infection rate of intestinal parasites among nationalities ( χ2 = 0.212, P > 0.05). The helminth infection rate of preschool children was the highest and up to 8.43%, mainly with E. vermicularis infection. The infection of A. lumbricoides was mainly happened among farmers, with the infection rate of 0.31%. There was a significant difference in the helminth infection rate among different occupations (χ2 = 84.333, P < 0.05). The intestinal parasites infection rate of the illiterate population was the highest and up to 7.63%, there was a significant difference among the populations with different educational levels (χ2 = 72.013, P < 0.05). The helminth infection rate of plain areas was higher than that of valley and hill ( χ2 = 11.690, P < 0.05). The helminth infection rate of people with low-income was the highest and up to 10.32% (χ2 = 244.999, P < 0.05). The protozoan infection rate of people with middle-income was the highest, who had the annual per capita net income of 6 000 to 7 999 Yuan ( χ2 = 24.749, P < 0.05). The helminth infection rate of people drinking well water was much higher than that of people drinking tap water (χ2 = 62.255, P < 0.05). The protozoan infection rate of people without insect repellent was higher than that of people with insect repellent (χ2 = 5.235, P < 0.05). CONCLUSIONS: The infection rates of human intestinal parasites in the ecological region of the Qinba Mountains in Henan Province have decreased sharply. E. vermicularis infection in children should be the main point of prevention and treatment of parasitic diseases in the future.

[Investigation and analysis of overseas imported malaria prevalence in Henan Province from 2012 to 2014].

OBJECTIVE: To understand the epidemic characteristics of imported malaria in Henan Province from 2012 to 2014, so as to provide the evidence for proposing the reasonable suggestions for imported malaria prevention and control. METHODS: The data of imported malaria were collected and the epidemic characteristics were analyzed in Henan Province from 2012 to 2014. RESULTS: A total of 569 imported malaria cases were reported in Henan Province from 2012 to 2014, including 445 cases of falciparum malaria, 48 cases of vivax malaria, 61 cases of ovale malaria, 14 cases of quartan malaria, and 1 case of mixed infection. All the malaria cases were confirmed in laboratory. During the three years, the time of higher incidence was in Spring Festival, and May and June, and the cases mainly distributed in Luoyang, Zhengzhou, Puyang, Xinxiang, Anyang, Xuchang and Nanyang cities, accounting for 68.54%. Totally 82.43% of the patients were male youth and middle-aged. Of the 569 patients, 534 (93.85%) returned from Africa and 35 (6.15%) returned from Southeast Asian countries. The average time was 6.22 d and the median was 4 d from the onset to diagnosis. Among 569 cases, 290 (50.97%) were confirmed by different levels of centers for disease prevention and control, and 279 (49.03%) were diagnosed by different levels of medical institutions. CONCLUSIONS: The imported malaria cases have been increased obviously in recent 3 years in Henan Province. Therefore, the health education for the knowledge about malaria prevention and control, and the technician training should be strengthened.

[Analysis of malaria death cases in Henan Province from 2010 to 2015].

OBJECTIVE: To retrospectively overview the malaria death cases reported in Henan Province and analyze the cause of death. METHODS: The data including basic information, epidemiological survey and medical records of malaria death cases in Henan Province from 2010 to 2015 were collected and analyzed. RESULTS: In the six years, a total of 14 malaria patients were dead. All the death patients were adult males and imported from Africa. They had definite histories of living in malaria-epidemic areas and the symptoms of fever. Twelve patients were diagnosed as malaria after at least twice diagnoses. The average time from symptom appearing to correct diagnosis was 6.5 d. The causes of deaths were misdiagnosis and delayed treatment. CONCLUSIONS: The major reasons of malaria death cases in Henan Province are the failure of correct diagnosis and prompt treatment. Health education of malaria prevention and diagnosis and treatment training of malaria should be strengthened in order to improve the public awareness and the diagnosis ability of clinical doctors for malaria, which can prevent the death of imported malaria cases.