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BACKGROUND: The co-infection of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) and tuberculosis (TB) poses a significant clinical challenge and is a major global public health issue. This study aims to elucidate the disease burden of HIV-TB co-infection in global, regions and countries, providing critical information for policy decisions to curb the HIV-TB epidemic. METHODS: The ecological time-series study used data from the Global Burden of Disease (GBD) Study 2021. The data encompass the numbers of incidence, prevalence, mortality, and disability-adjusted life year (DALY), as well as age-standardized incidence rate (ASIR), prevalence rate (ASPR), mortality rate (ASMR), and DALY rate for HIV-infected drug-susceptible tuberculosis (HIV-DS-TB), HIV-infected multidrug-resistant tuberculosis (HIV-MDR-TB), and HIV-infected extensively drug-resistant tuberculosis (HIV-XDR-TB) from 1990 to 2021. from 1990 to 2021. The estimated annual percentage change (EAPC) of rates, with 95% confidence intervals (CIs), was calculated. RESULTS: In 2021, the global ASIR for HIV-DS-TB was 11.59 per 100,000 population (95% UI: 0.37-13.05 per 100,000 population), 0.55 per 100,000 population (95% UI: 0.38-0.81 per 100,000 population), for HIV-MDR-TB, and 0.02 per 100,000 population (95% UI: 0.01-0.03 per 100,000 population) for HIV-XDR-TB. The EAPC for the ASIR of HIV-MDR-TB and HIV-XDR-TB from 1990 to 2021 were 4.71 (95% CI: 1.92-7.59) and 13.63 (95% CI: 9.44-18.01), respectively. The global ASMR for HIV-DS-TB was 2.22 per 100,000 population (95% UI: 1.73-2.74 per 100,000 population), 0.21 per 100,000 population (95% UI: 0.09-0.39 per 100,000 population) for HIV-MDR-TB, and 0.01 per 100,000 population (95% UI: 0.00-0.03 per 100,000 population) for HIV-XDR-TB in 2021. The EAPC for the ASMR of HIV-MDR-TB and HIV-XDR-TB from 1990 to 2021 were 4.78 (95% CI: 1.32-8.32) and 10.00 (95% CI: 6.09-14.05), respectively. CONCLUSIONS: The findings indicate that enhancing diagnostic and treatment strategies, strengthening healthcare infrastructure, increasing access to quality medical care, and improving public health education are essential to combat HIV-TB co-infection.
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Coinfecção , Carga Global da Doença , Infecções por HIV , Tuberculose , Humanos , Coinfecção/epidemiologia , Infecções por HIV/epidemiologia , Infecções por HIV/complicações , Tuberculose/epidemiologia , Carga Global da Doença/tendências , Incidência , Prevalência , Saúde Global/estatística & dados numéricos , Feminino , Masculino , Adulto , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologiaRESUMO
Haemaphysalis ticks are pathogenic vectors that threaten human and animal health and were identified in Chongming, the third largest island in China. To understand the distribution of these ticks and determine their potential invasion risk, this study aimed to identify the habitat suitability of the dominant tick H. flava based on natural environmental factors. Geographic information system (GIS) images were combined with sample points from tick investigations to map the spatial distribution of H. flava. Data on 19 bioclimatic variables, environmental variables, and satellite-based landscapes of Chongming Island were retrieved to create a landcover map related to natural environmental determinants of H. flava. These data included 38 sites associated with the vectors to construct species distribution models with MaxEnt, a model based on the maximum entropy principle, and to predict habitat suitability for H. flava on Chongming Island in 2050 and 2070 under different climate scenarios. The model performed well in predicting the H. flava distribution, with a training area under the curve of 0.84 and a test area under the curve of 0.73. A habitat suitability map of the whole study area was created for H. flava. The resulting map and natural environment analysis highlighted the importance of the normalized difference vegetation index and precipitation in the driest month for the bioecology of H. flava, with 141.61 km2 (11.77%), 282.94 km2 (23.35%), and 405.30 km2 (33.69%) of highly, moderately, and poorly suitable habitats, respectively. The distribution decreased by 135.55 km2 and 138.82 km2 in 2050 and 2070, respectively, under the shared socioeconomic pathway (SSP) 1.2.6 climate change scenario. However, under SSP 5.8.5, the total area will decrease by 128.5 km2 in 2050 and increase by 151.64 km2 in 2070. From a One Health perspective, this study provides good knowledge that will guide tick control efforts to prevent the spread of Haemaphysalis ticks or transmission risk of Haemaphysalis-borne infections at the human-animal-environment interface on the island.
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BACKGROUND: Poverty contributes to the transmission of schistosomiasis via multiple pathways, with the insufficiency of appropriate interventions being a crucial factor. The aim of this article is to provide more economical and feasible intervention measures for endemic areas with varying levels of poverty. METHODS: We collected and analyzed the prevalence patterns along with the cost of control measures in 11 counties over the last 20 years in China. Seven machine learning models, including XGBoost, support vector machine, generalized linear model, regression tree, random forest, gradient boosting machine and neural network, were used for developing model and calculate marginal benefits. RESULTS: The XGBoost model had the highest prediction accuracy with an R2 of 0.7308. Results showed that risk surveillance, snail control with molluscicides and treatment were the most effective interventions in controlling schistosomiasis prevalence. The best combination of interventions was interlacing seven interventions, including risk surveillance, treatment, toilet construction, health education, snail control with molluscicides, cattle slaughter and animal chemotherapy. The marginal benefit of risk surveillance is the most effective intervention among nine interventions, which was influenced by the prevalence of schistosomiasis and cost. CONCLUSIONS: In the elimination phase of the national schistosomiasis program, emphasizing risk surveillance holds significant importance in terms of cost-saving.
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Moluscocidas , Esquistossomose , Animais , Bovinos , Esquistossomose/epidemiologia , Esquistossomose/prevenção & controle , Esquistossomose/tratamento farmacológico , Moluscocidas/farmacologia , China/epidemiologia , Caramujos , PrevalênciaRESUMO
Malaria is a major public health threat worldwide, and it was also widely prevalent in the history in China, seriously endangering people's health and affecting socioeconomic development. China was certified malaria elimination in 2021 with unremitting efforts since the founding of the People's Republic of China in 1949. This great achievement has been another milestone in the fight against major infectious diseases following the elimination of smallpox, poliomyelitis, leprosy, filariasis, neonatal tetanus and blinding trachoma in China. This paper briefly introduces the malaria burden dynamics and the corresponding malaria transmission risk stratificantions, as well as systematically reviews the evolution of anti-malaria policies and measures from severe epidemic to elimination in China. Meanwhile, five key lessons in malaria control and elimination in China are also briefly summarized. All of the above provide evidences for promoting global malaria eradication and preventing reestablishment of malaria transmission, finally benefit all individuals still suffering from the scourge of malaria.
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Antimaláricos , Doenças Transmissíveis , Malária , Recém-Nascido , Humanos , Antimaláricos/uso terapêutico , Erradicação de Doenças , Malária/epidemiologia , Malária/prevenção & controle , China/epidemiologiaRESUMO
Most of the new emerging and re-emerging zoonotic virus outbreaks in recent years stem from close interaction with dead or alive infected animals. Since late 2019, the coronavirus disease 2019 (COVID-19) has spread into 221 countries and territories resulting in close to 300 million known infections and 5.4 million deaths in addition to a huge impact on both public health and the world economy. This paper reviews the COVID-19 prevalence in animals, raise concerns about animal welfare and discusses the role of environment in the transmission of COVID-19. Attention is drawn to the One Health concept as it emphasizes the environment in connection with the risk of transmission and establishment of diseases shared between animals and humans. Considering the importance of One Health for an effective response to the dissemination of infections of pandemic character, some unsettled issues with respect to COVID-19 are highlighted.
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COVID-19 , Saúde Única , Animais , Humanos , COVID-19/prevenção & controle , SARS-CoV-2 , Pandemias/prevenção & controle , Saúde PúblicaRESUMO
OBJECTIVE: Acute lung injury (ALI) is a serious respiratory dysfunction caused by pathogen or physical invasion. The strong induced inflammation often causes death. Tanshinone IIA (Tan-IIA) is the major constituent of Salvia miltiorrhiza Bunge and has been shown to display anti-inflammatory effects. The aim of the current study was to investigate the effects of Tan-IIA on ALI. METHODS: A murine model of lipopolysaccharide (LPS)-induced ALI was used. The lungs and serum samples of mice were extracted at 3 days after treatment. ALI-induced inflammatory damages were confirmed from cytokine detections and histomorphology observations. Effects of Tan-IIA were investigated using in vivo and in vitro ALI models. Tan-IIA mechanisms were investigated by performing Western blot and flow cytometry experiments. A wound-healing assay was performed to confirm the Tan-IIA function. RESULTS: The cytokine storm induced by LPS treatment was detected at 3 days after LPS treatment, and alveolar epithelial damage and lymphocyte aggregation were observed. Tan-IIA treatment attenuated the LPS-induced inflammation and reduced the levels of inflammatory cytokines released not only by inhibiting neutrophils, but also by macrophage. Moreover, we found that macrophage activation and polarization after LPS treatment were abrogated after applying the Tan-IIA treatment. An in vitro assay also confirmed that including the Tan-IIA supplement increased the relative amount of the M2 subtype and decreased that of M1. Rebalanced macrophages and Tan-IIA inhibited activations of the nuclear factor-κB and hypoxia-inducible factor pathways. Including Tan-IIA and macrophages also improved alveolar epithelial repair by regulating macrophage polarization. CONCLUSION: This study found that while an LPS-induced cytokine storm exacerbated ALI, including Tan-IIA could prevent ALI-induced inflammation and improve the alveolar epithelial repair, and do so by regulating macrophage polarization.
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Abietanos , Lesão Pulmonar Aguda , Ativação de Macrófagos , Animais , Camundongos , Abietanos/farmacologia , Lesão Pulmonar Aguda/induzido quimicamente , Lesão Pulmonar Aguda/tratamento farmacológico , Síndrome da Liberação de Citocina , Citocinas , Inflamação/tratamento farmacológico , Lipopolissacarídeos/toxicidade , MacrófagosRESUMO
ABSTRACTOn 30 June 2021, China was certified malaria-free by the World Health Organization. In this study, the evolution, performance, outcomes, and impact of China's adaptive strategy and approach for malaria elimination from 2011 to 2020 were analysed using 10-year data. The strategy and approach focused on timely detection and rapid responses to individual cases and foci. Indigenous cases declined from 1,308 in 2011 to 36 in 2015, and the last one was reported from Yunnan Province in April 2016, although thousands of imported cases still occur annually. The "1-3-7" approach was implemented successfully between 2013 and 2020, with 100% of cases reported within 24â h, 94.5% of cases investigated within three days of case reporting, and 93.4% of foci responses performed within seven days. Additionally, 81.6% of patients attended the first healthcare visit within 1-3 days of onset and 58.4% were diagnosed as malaria within three days of onset, in 2017-2020. The adaptive strategy and approach, along with their universal implementation, are most critical in malaria elimination. In addition to strengthening surveillance on drug resistance and vectors and border malaria collaboration, a further adapted three-step strategy and the corresponding "3-3-7" model are recommended to address the risks of re-transmission and death by imported cases after elimination. China's successful practice and lessons learnt through long-term efforts provide a reference for countries moving towards elimination.
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Malária , China/epidemiologia , Humanos , Malária/epidemiologia , Malária/prevenção & controle , Organização Mundial da SaúdeRESUMO
BACKGROUND: Early detection of gait abnormalities is critical for preventing severe injuries in future falls. The timed up and go (TUG) test is a commonly used clinical gait screening test; however, the interpretation of its results is limited to the TUG total time. RESEARCH QUESTION: What is diagnostic accuracy of the low-cost, markerless, automated gait analyzer, with the aid of vision-based artificial intelligence technology, which extract gait spatiotemporal features and screen for abnormal walking patterns through video recordings of the TUG test? METHODS: Our dataset contained retrospective data from outpatients from the Department of Neurology or Rehabilitation of two tertiary hospitals in Shanghai. A panel of three expert neurologists specialized in movement disorders reviewed the gait performance in each TUG video, and labeled them separately, with the most commonly assigned label being used as the reference standard. The gait analyzer performed the AlphaPose algorithm to track the human joint position and calculated the spatiotemporal parameters by filtering and double-threshold signal detection. Gait spatiotemporal features and expert labels were input into machine learning models, and the accuracy of each model was tested with leave-one-out cross-validation (LOOCV). RESULTS: A total of 284 participants were recruited. Among these, 100 were labeled as having abnormal gait performance by experts. The Naive Bayes classifier achieved the best performance with a full-data accuracy of 90.14% and a LOOCV accuracy of 89.08% for screening abnormal gait performance. SIGNIFICANCE: This study is the first to investigate the accuracy of a vision-based intelligent gait analyzer for screening abnormal clinical gait performance. By virtue of a pose estimation algorithm and machine learning models, our intelligent gait analyzer can detect abnormal walking patterns approximate to judgements made by experienced neurologists, which is expected to be a supplementary gait assessment protocol for basic-level doctors in the future.
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Inteligência Artificial , Transtornos dos Movimentos , Teorema de Bayes , China , Marcha , Humanos , Estudos RetrospectivosRESUMO
Background: Sulfadoxine-pyrimethamine (SP) is recommended for intermittent preventive treatment in Africa against Plasmodium falciparum infection. However, increasing SP resistance (SPR) of P. falciparum affects the therapeutic efficacy of SP, and pfdhfr (encoding dihydrofolate reductase) and pfdhps (encoding dihydropteroate synthase) genes are widely used as molecular markers for SPR surveillance. In the present study, we analyzed single nucleotide polymorphisms (SNPs) of pfdhfr and pfdhps in P. falciparum isolated from infected Chinese migrant workers returning from Africa. Methods: In total, 159 blood samples from P. falciparum-infected workers who had returned from Africa to Anhui, Shangdong, and Guangxi provinces were successfully detected and analyzed from 2017 to 2019. The SNPs in pfdhfr and pfdhps were analyzed using nested PCR. The genotypes and linkage disequilibrium (LD) were analyzed using Haploview. Results: High frequencies of the Asn51Ile (N51I), Cys59Arg(C59R), and Ser108Asn(S108N) mutant alleles were observed, with mutation frequencies of 97.60, 87.43, and 97.01% in pfdhfr, respectively. A triple mutation (IRN) in pfdhfr was the most prevalent haplotype (86.83%). Six point mutations were detected in pfdhps DNA fragment, Ile431Val (I431V), Ser436Ala (S436A), Ala437Gly (A437G), Lys540Glu(K540E), Ala581Gly(A581G), Ala613Ser(A613S). The pfdhps K540E (27.67%) was the most predominant allele, followed by S436A (27.04%), and a single mutant haplotype (SGKAA; 62.66%) was predominant in pfdhps. In total, 5 haplotypes of the pfdhfr gene and 13 haplotypes of the pfdhps gene were identified. A total of 130 isolates with 12 unique haplotypes were found in the pfdhfr-pfdhps combined haplotypes, most of them (n = 85, 65.38%) carried quadruple allele combinations (CIRNI-SGKAA). Conclusion: A high prevalence of point mutations in the pfdhfr and pfdhps genes of P. falciparum isolates was detected among Chinese migrant workers returning from Africa. Therefore, continuous in vitro molecular monitoring of Sulfadoxine-Pyrimethemine combined in vivo therapeutic monitoring of artemisinin combination therapy (ACT) efficacy and additional control efforts among migrant workers are urgently needed.
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Antimaláricos , Malária Falciparum , África , Antimaláricos/farmacologia , China , Estudos Transversais , Combinação de Medicamentos , Resistência a Medicamentos/genética , Humanos , Mutação , Plasmodium falciparum/genética , Proteínas de Protozoários/genética , Pirimetamina , Sulfadoxina , Tetra-Hidrofolato Desidrogenase/genéticaRESUMO
MicroRNA (miRNA or miR)-based approaches to interrupt the transmission of mosquito-borne diseases have been explored since 2005. A review of these studies and areas in which to proceed is needed. In this review, significant progress is reviewed at the level of individual miRNAs, and miRNA diversification and relevant confounders are described in detail. Current miRNA studies in mosquitoes include four steps, namely, identifying miRNAs, validating miRNA-pathogen interactions, exploring action mechanisms, and performing preapplication investigations. Notably, regarding the Plasmodium parasite, mosquito miRNAs generally bind to mosquito immunity- or development-related mRNAs, indirectly regulating Plasmodium infection; However, regarding arboviruses, mosquito miRNAs can bind to the viral genome, directly modifying viral replication. Thus, during explorations of miRNA-based approaches, researchers need select an ideal miRNA for investigation based on the mosquito species, tissue, and mosquito-borne pathogen of interest. Additionally, strategies for miRNA-based approaches differ for arboviruses and protozoan parasites.
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Arbovírus , Culicidae , MicroRNAs , Plasmodium , Doenças Transmitidas por Vetores , Animais , MicroRNAs/genéticaRESUMO
PURPOSE: The efficacy of traditional therapies for oral carcinoma (OC) is limited. Oncolytic adenovirus, a novel strategy of cancer therapy, shows potential use in OC treatment. However, its clinical application is limited by pre-existing neutralizing antibodies. Thus, this study aimed to examine the efficacy of a new modified adenovirus against OC in vitro and in vivo. MATERIALS AND METHODS: A multiple modified adenovirus (MMAD) armed with IL-13 (MMAD-IL-13) was constructed, and its effect on Cal-27 cells was examined. The potency of MMAD-IL-13 was examined in vitro and in vivo. For in vitro experiment, CCK-8 kit was used to determine the IC50 of MMAD-IL-3 in OC cell lines. For in vivo experiment, Cal-27 xenograft models were used to determine the antitumor effect of MMAD-IL-13. Apoptosis was measured in Cal-27 cells by Western blotting assay. Immunity response was detected in Cal-27 xenograft models 7 days after intratumoral injection with MMAD-IL-13. The potency of MMAD and MMAD-IL-13 was compared in Cal-27 peripheral blood mononuclear cells (PBMCs) models. RESULTS: MMAD-IL-13 was successfully constructed; the harvested virus could be replicated and they overexpressed human IL-13 in Cal-27 cells. Compared with MMAD, MMAD-IL-13 showed enhanced antitumor effect in vitro by inducing apoptosis and reducing percentage of M2 macrophages in tumor environment in vivo. MMAD-IL-13 also showed potent antitumor effect in Cal-27, SCC-4, and Tca8113 cells in vitro and in Cal-27 xenograft models in vivo. However, MMAD-IL13 did not harm normal human oral epithelial cells in vitro and exhibited no effect on body weight in Cal-27 xenograft models. In Cal-27 PBMC models, MMAD-IL-13 showed stronger antitumor effect than MMAD. CONCLUSION: A new oncolytic adenovirus carrying the human IL-13 gene was constructed. This virus effectively led to remission of tumor development and death of OC cells in vivo and in vitro, showing its potential as a clinical cancer therapy.
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BACKGROUND: Accurate detection of blood protozoa from clinical samples is important for diagnosis, treatment and control of related diseases. In this preliminary study, a novel DNA microarray system was assessed for the detection of Plasmodium, Leishmania, Trypanosoma, Toxoplasma gondii and Babesia in humans, animals, and vectors, in comparison with microscopy and PCR data. Developing a rapid, simple, and convenient detection method for protozoan detection is an urgent need. METHODOLOGY/PRINCIPAL FINDINGS: The microarray assay simultaneously identified 18 species of common blood protozoa based on the differences in respective target genes. A total of 20 specific primer pairs and 107 microarray probes were selected according to conserved regions which were designed to identify 18 species in 5 blood protozoan genera. The positive detection rate of the microarray assay was 91.78% (402/438). Sensitivity and specificity for blood protozoan detection ranged from 82.4% (95%CI: 65.9% ~ 98.8%) to 100.0% and 95.1% (95%CI: 93.2% ~ 97.0%) to 100.0%, respectively. Positive predictive value (PPV) and negative predictive value (NPV) ranged from 20.0% (95%CI: 2.5% ~ 37.5%) to 100.0% and 96.8% (95%CI: 95.0% ~ 98.6%) to 100.0%, respectively. Youden index varied from 0.82 to 0.98. The detection limit of the DNA microarrays ranged from 200 to 500 copies/reaction, similar to PCR findings. The concordance rate between microarray data and DNA sequencing results was 100%. CONCLUSIONS/SIGNIFICANCE: Overall, the newly developed microarray platform provides a convenient, highly accurate, and reliable clinical assay for the determination of blood protozoan species.
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Babesia/isolamento & purificação , Sangue/parasitologia , Leishmania/isolamento & purificação , Análise de Sequência com Séries de Oligonucleotídeos/métodos , Plasmodium/isolamento & purificação , Toxoplasma/isolamento & purificação , Trypanosoma/isolamento & purificação , Babesia/genética , Primers do DNA/genética , DNA de Protozoário/genética , Humanos , Leishmania/genética , Plasmodium/genética , Sensibilidade e Especificidade , Toxoplasma/genética , Trypanosoma/genéticaRESUMO
Objective: To analyze sequence variation and construct phylogenetic tree based on 18S ribosomal DNA among five species of Plasmodium in Yunnan border between China and Myanmar and other areas. Methods: Blood samples (or DNA samples)from malaria patients were collected from 2000 to 2015 in Yunnan border and Myanmar and other areas. DNA was extracted from blood samples, and the 18S rDNA fragment was amplified, sequenced and aligned with relevant sequences available in the GenBank. The phylogenetic tree was constructed by methods of neighbor joining (NJ), maximum likelihood (ML), and maximum parsimony (MP), respectively. Results: A total of 94 blood samples or DNA from malaria patients were collected. The 18S rDNA was successfully amplified from all the samples. Sequence alignment revealed variations of 0-0.2%, 0-0.1%, 0-0.1%, 0-0.1% and 0 for 18S rDNA sequence among Plasmodium falciparum, P. vivax, P. malariae, P. ovale and P. knowlesi, respectively. The phylogenetic tree constructed with the three method showed consistency. Phylogenic analysis revealed that there were five big branches of Plasmodium spp. studied. The P. falciparum branch clustered with the isolates from Cameroonï¼KC428741, KC428742ï¼, Brazilï¼KC906718ï¼, and Malaysiaï¼HQ283221ï¼ in GenBank. The P. vivax branch clustered with isolates from Cameroonï¼HF945443ï¼, India ï¼HM014361, JQ627158ï¼, and Colombia ï¼U83877ï¼. However, the samples Pv11, Pv18 and Pv21 formed a small branch that showed closer phylogenetic relationship with P. cynomolgiï¼L07559ï¼, an isolate from Macaca fascicularis. Moreover, P. malariae samples from Yunnan Province including Pm1, Pm3 and Pm4 clustered to form a small branch, and then clustered with samples from Hainan Province, showing geographical diversity. All the isolates of P. ovale clustered with isolates from Vietnamï¼EU935736 and AF387038ï¼. All the isolates of P. knowlesi clustered into a branch, and showed close relationship with those from Myanmar (GU816250 and GU816246). Conclusion: There is no significant difference in 18S rDNA gene of the five species of Plasmodium from Yunnan border between China and Myanmar and other areas. The phylogenetic tree constructed with the NJ, MP and ML methods shows consistency.
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Filogenia , China , DNA Ribossômico , Variação Genética , Humanos , Malária , Mianmar , Plasmodium , Alinhamento de SequênciaRESUMO
OBJECTIVE: To identify and locate the serine protease inhibitor 14 (SRPN14) gene of Anopheles sinensis, and analyze its genetic polymorphism among populations as well as the selective pressure during evolution. METHODS: Primers were designed based on the genomic sequencing data of An. sinensis, and PCR amplification system for the SRPN14 gene was established. The chromosomal location of SRPN14 gene was determined by fluorescence in situ hybridization. The SRPN14 gene of An. sinensis populations collected from 18 sampling sites in 12 provinces (municipality) was sequenced, its genetic variations within and among populations calculated, and the selective pressure during adaptive evolution evaluated. RESULTS: The amplified part of the SRPN14 gene of An. sinensis was 429 bp in length, and had 77%(nt) and 88% (aa)similarities with An. gambiae. The SRPN14 gene located on 2L: 23C of salivary gland chromosomes of An. sinensis. The sequences of 411 individuals from 13 An. sinensis populations were analyzed. In the 411 individuals, the total number of alleles of the SRPN14 gene was 204, among which 51 (25.00% ) showed inter-population consistency. The ranges of SRPN14 allel number and genetic polymorphism were from 11 (Liaoning) to 33 (Chongqing), and from 0.008 (Liaoning) to 0.024 (Hainan), respectively. AMOVA result showed that genetic divergence within populations was significantly higher than that among populations; variation within populations was 95.79% of the total variation. The genetic divergence among populations was small, with FST value of 0.042. The number of synonymous substitutions in SRPN14 was significantly higher than that of non-synonymous substitutions sites, and ω was less than 1 in all populations. CONCLUSION: Genetic polymorphism occurs in SRPN14 gene of An. sinensis populations, and its evolution is under the negative selective pressure.
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Anopheles , Evolução Molecular , Polimorfismo Genético , Animais , Sequência de Bases , Humanos , Hibridização in Situ Fluorescente , Proteínas de InsetosRESUMO
OBJECTIVE: To analyze the surveillance data of malaria in Tengchong County of Yunnan Province in 2013, so as to provide the evidence for carrying out the malaria elimination in the future. METHODS: The data of epidemic situation and surveillance of malaria in Tengchong County in 2013 were collected and analyzed for the prevalence state as well as and the monitoring indicators including the blood examination of fever patients of unknown origin, initiative detection of cases, under-reporting survey, sentinel surveillance and species and density investigation of Anopheles mosquitoes. RESULTS: Totally 138 malaria cases were reported in Tengchong County in 2013, among which 118 cases were infected with Plasmodium vivax and 20 cases with P. falciparum, and all the reported cases were imported. The completion rates of blood examinations, case reports and case investigations all reached 100%. A total of 57 cases were involved in initiative detection, but no positive cases were found. The twice under-reporting of malaria case surveys were conducted and 1 case had been under-reported. The sentinel surveillance was carried out both in the domestic and overseas sites at the same time to detect the suspected malaria cases, 172 cases were screened totally, and 15 ones were detected as positives. Totally 528 returnees were screened, and there were no positive case found. A. sinensis and A. liangshanensis were the dominant species, followed by A. minimus, A. maculatus and others. CONCLUSIONS: The malaria epidemic situation is stable in Tengchong County in 2013, and all the work in surveillance has been conducted successfully, but there still exist some difficulties in the process of malaria elimination. The local health departments should further strengthen the surveillance on imported cases and the management on migrant population as well as the capability building for health workers in malaria control in the future.
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Erradicação de Doenças/métodos , Epidemias/prevenção & controle , Malária/epidemiologia , Vigilância de Evento Sentinela , Adolescente , Adulto , Animais , Anopheles/crescimento & desenvolvimento , Anopheles/parasitologia , Criança , Pré-Escolar , China/epidemiologia , Erradicação de Doenças/tendências , Emigração e Imigração/estatística & dados numéricos , Emigração e Imigração/tendências , Feminino , Humanos , Insetos Vetores/crescimento & desenvolvimento , Insetos Vetores/parasitologia , Malária/diagnóstico , Malária/parasitologia , Masculino , Pessoa de Meia-Idade , Plasmodium/fisiologia , Prevalência , Adulto JovemRESUMO
Reduction patterns of Plasmodium falciparum and P. vivax malaria transmission and the role of an integrated strategy of case management and vector control are compared between different ecological zones. The epidemiology of malaria in Hainan and Yunnan provinces was disparate, even though distinct malaria control strategies have been adapted to different situations based on risk group, vector behaviours, local health infrastructure, and environmental conditions. The island Hainan appears to be victorious in eliminating malaria. However, there is still a long way to go to prevent the reintroduction of malaria in Hainan province and eliminating malaria in the border areas of Yunnan province. This review of the experiences and challenges from malaria control to elimination in Hainan and Yunnan provinces of southern China will provide a basis for the future elimination of malaria in the whole country.
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Erradicação de Doenças , Malária/prevenção & controle , China/epidemiologia , Humanos , Malária/epidemiologia , Plasmodium falciparum , Plasmodium vivaxRESUMO
The national action plan for malaria elimination in China (2010-2020) was issued by the Chinese Ministry of Health along with other 13 ministries and commissions in 2010. The ultimate goal of the national action plan was to eliminate local transmission of malaria by the end of 2020. Surveillance and response are the most important components driving the whole process of the national malaria elimination programme (NMEP), under the technical guidance used in NMEP. This chapter introduces the evolution of the surveillance from the control to the elimination stages and the current structure of national surveillance system in China. When the NMEP launched, both routine surveillance and sentinel surveillance played critical role in monitoring the process of NMEP. In addition, the current response strategy of NMEP was also reviewed, including the generally developed "1-3-7 Strategy". More effective and sensitive risk assessment tools were introduced, which cannot only predict the trends of malaria, but also are important for the design and adjustment of the surveillance and response systems in the malaria elimination stage. Therefore, this review presents the landscape of malaria surveillance and response in China as well as their contribution to the NMEP, with a focus on activities for early detection of malaria cases, timely control of malaria foci and epidemics, and risk prediction. Furthermore, challenges and recommendations for accelerating NMEP through surveillance are put forward.
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Malária/prevenção & controle , Programas Nacionais de Saúde , China/epidemiologia , Humanos , Malária/epidemiologia , Malária/transmissão , Vigilância em Saúde PúblicaAssuntos
Malária/epidemiologia , Malária/parasitologia , Adolescente , Adulto , África , Animais , Pré-Escolar , China/epidemiologia , Feminino , Humanos , Masculino , Viagem , Adulto JovemRESUMO
BACKGROUND: In the battle against malaria in China, the rate of elementary and high school students' awareness on malaria knowledge is an important index for malaria elimination, but only rare data is available. This study aimed to investigate the level of malaria awareness in students at elementary and high schools in malaria endemic areas of China, and to provide the baseline information for the malaria elimination. METHODS: This cross-sectional survey was conducted in 20 different malaria-endemic provinces in the first year of China's National Malaria Elimination Programme (NMEP). A structured questionnaire was administrated to students at elementary and high schools enrolled. A total of 44,519 questionnaires were effective while 1,220 were excluded because of incomplete survey responses. RESULTS: More than 60% of students were aware of malaria, but only 9,013 of them answered correctly to all five questions, and there were still 1,862 students unaware of malaria. There were significant differences of the awareness of malaria among different age groups, between male and female, between two different education levels. DISCUSSION: The study reveals that students at elementary and high school levels did not have adequate knowledge of malaria about biology, pathogenicity, transmitting vectors and preventive methods and so on at the beginning of NMEP in China. Further emphasis should be paid on health education campaigns in China to increase students' public awareness of malaria about vector control, treatment, prevention.