[Assessment of schistosomiasis elimination in Changzhou City, Jiangsu Province].

OBJECTIVE: To assess the state of schistosomiasis elimination in 6 districts of Changzhou City, Jiangsu Province, so as to provide the evidence for the formulation of consolidation measures. METHODS: Three towns (streets) were selected according to the schistosomiasis epidemic degree in each district, and one village was sampled from each town. The on-site assessment was carried out between 2016 and 2017, including Oncomelania hupensis snail survey, population investigation and domestic animal investigation. In addition, the related data and materials were evaluated and the monitoring ability was assessed. RESULTS: In the history, there were 54 endemic towns, 368 endemic villages in Changzhou City, with a total area of 3 934.79 hm2 of historic snail spots, and 114 990 schistosomiasis cases so far. In the field assessment in 6 districts, a total of 26 environments were surveyed, with the surveyed area of 36.23 hm2, and there were no living snails captured in each village. A total of 18 199 people were examined for schistosome infection, 255 were blood test positive, and the sero-positive rate was 1.40%. The stool examination was done in 255 sero-positive cases, and no cases were stool-positive. A total of 779 domestic animals were investigated, including 200 cattle, 179 sheep and 400 pigs, and no infections were detected. The files regarding the snail status and schistosomiasis epidemic situation, and the monitoring data were complete and accurate in 6 districts. The annual investment funds for schistosomiasis prevention were 3 120 000 Yuan in Changzhou City, and the number of staff working for schistosomiasis prevention was 86 totally, which could meet the requirements of high quality monitoring. CONCLUSIONS: All 6 districts of Changzhou City have met the requirements of schistosomiasis elimination.

[Investigation of major parasitic diseases and related knowledge, attitude and practice among rural residents in Liyang City].

OBJECTIVE: To investigate the prevalence of major parasitic diseases and related knowledge, attitude and practice among rural residents in Liyang City, so as to provide the evidence for formulating appropriate preventive strategies and measures. METHODS: Three villages were selected from three towns as survey sites, and the residents who were above three years old and had been in the village for over six months were investigated. The Kato-Katz technique was applied to detect intestinal parasite eggs in residents' feces, and the cellophane anal swab was used to detect Enterobius vermicularis eggs among children aged 3-6 years. The iodine liquid smear and saline smear methods were used to examine intestinal protozoa cysts or trophozoites. Hookworm species were identified by the tube filter paper culture method. A structured questionnaire was used to collect the information on residents' knowledge, attitude and practice of the prevention and control of major parasitic diseases. RESULTS: Totally 759 residents were investigated and tested at the three rural survey sites, and only 2 cases were detected of parasitic infection and the total infection rate was 0.26%. Both cases were mild infections without mixed infection. The total awareness rate of knowledge on ascariasis, trichuriasis and ancylostomiasis was 37.9%, while the awareness rate of knowledge on clonorchiasis was 13.8%. The age and educational level were important factors of the knowledge on prevention and control of parasitic diseases among the residents. The formation rates of washing hands before meal and after using the toilet, and never drinking unboiled water were 83.8% and 92.1%, respectively. Totally 11.6% of the residents usually ate raw or half-cooked freshwater fishes and shrimps, and 53.0% had not the behavior to prepare raw and cooked food using the different chopping boards. The proportions of residents using fresh feces as manure and working in the field with bare feet were 13.8% and 22.8% respectively. The proportions of residents who thought they could, could not, or were not sure to change the risk behaviors and habits of parasitic infections were 40.2%, 28.5% and 31.4%, respectively. CONCLUSIONS: The infection rate of major parasitic diseases among the rural residents in Liyang City is low, and the awareness rate of knowledge on preventing parasitic diseases is also low. Therefore, the health education on the prevention and control of parasitic diseases should be strengthened to guide them to develop good hygiene, diet and farming habits. The environmental sanitation should be continuously improved to block the endemic of parasitic infection.

[Assessment and authentication of malaria elimination in Changzhou City].

OBJECTIVE: To analyze the results of assessment and authentication of malaria elimination of 7 county-level cities and districts in Changzhou City, Jiangsu Province, and explore the suitable monitoring methods for malaria after the elimination in this region, so as to provide the evidence for formulating and adjusting the malaria elimination strategies and measures. METHODS: The data from the network reports of malaria epidemic situation, blood examinations of febrile patients, epidemiological questionnaires of malaria cases, investigation of epidemic focuses and disposal tables were collected and analyzed in Changzhou City from 2009 to 2014. The clinicians were assessed with the closed-book written examinations for their ability of the diagnosis and treatment of malaria. The inspection personnel were assessed by the microscopical examinations of Plasmodium. Totally 30 negative blood slides were reviewed. In the natural village where the last local case of malaria was located, 200 blood filter papers were collected for gene detection of Plasmodium. RESULTS: From 2009 to 2014, 145 malaria cases were reported in Changzhou City. Totally 170 638 febrile patients received blood detections for malaria, of which 137 cases were positive and the positive rate was 0.08%. The majority of malaria cases were imported except 8 local malaria infection cases in 2009 and 2 local malaria infection cases in 2010. Four of seven county-level cities (districts) gained an average score of 20 points on the microscopical examinations of Plasmodium. Liyang City got a minimum average score of 18.8 points. In capacity assessment of malaria diagnosis and treatment, Liyang City gained the highest average score of 19.8 points, and Qishuyan District got the lowest average score of 18.0 points. The malaria elimination assessment scores of the 7 county-level cities (districts) were all above 93 points. Four county-level cities (districts) (Xinbei District, Wujin District, Liyang City, and Jintan City) carried out the active case detections. A total of 731 cases were detected and the results were all negative. Liyang City in 2012, Zhonglou District and Jintan City in 2013, Tianning District, Qishuyan District, Xinbei District and Wujin District in 2014, passed the malaria elimination assessment at county (district) level, respectively. CONCLUSIONS: All the 7 county-level cities (districts) of Changzhou City have passed the malaria elimination assessment at a high score. After the malaria elimination, the monitoring should continue to consolidate the achievements.

[Investigation on knowledge, attitude, and practice of schistosomiasis prevention and control and infection status in Armed Police Forces stationed along Yangtze River].

OBJECTIVE: To understand the status of knowledge, attitude, and practice of schistosomiasis prevention and control and infection status in Armed Police Forces stationed along the Yangtze River, so as to provide the reference for formulating the schistosomiasis prevention and control measures in Armed Police Forces. METHODS: A questionnaire survey was conducted in the Armed Police Forces along the Yangtze River in Jiangsu Province, and the investigation content included social demographic data, schistosomiasis prevention knowledge, attitude and behavior. All the subjects were examined for Schistosoma japonicum infection. RESULTS: Totally 376 soldiers were investigated in 2 sites. The total passing rate of schistosomiasis knowledge was 72.87%. The passing rate among different age groups had no significant difference ( χ2 =0.26, P > 0.05). The passing rate of soldiers from endemic areas was significantly higher than that of the soldiers from non-endemic areas ( χ2 =4.71, P < 0.05). The passing rate of officers was significantly higher than that of the soldiers (χ2 = 4.21, P < 0.05). The passing rate of soldiers with the education levels of junior school, high school, college, undergraduate and above increased gradually, with a significant difference (χ2 =8.16, P < 0.05). The soldiers with positive attitude accounted for 93.88%. Among the water contact behaviors, training accounted for 17.55% and participating in the task (such as flood fighting and water work) accounted for 86.44%. When launching, the rate of taking protective measures was 52.93%. The rate of taking protective measures in the knowledge passing group was much higher than that in the knowledge failed group (χ2 =10.55, P < 0.05). The stool was harmlessly treated in the two camps. Among 376 soldiers, the positive rate of blood examinations was 0.53%, but the stool examinations were all negative. CONCLUSIONS: The overall level of knowledge and correct behavior of schistosomiasis prevention in the Armed Police Forces along the Yangtze River still should be improved. The better health education and behavior intervention are crucial to schistosomiasis prevention in the army.

[Analysis of malaria epidemic situation in Changzhou City from 2010 to 2014].

OBJECTIVE: To grasp the malaria epidemic situation in Changzhou City from 2010 to 2014, so as to provide the evidence for formulating and adjusting malaria control strategies and measures. METHODS: The epidemiological data of malaria cases in the special report system from 2010 to 2014 were collected, and the malaria epidemic situation and the diagnosis and treatment of malaria patients were analyzed. RESULTS: There were 132 malaria cases reported in Changzhou City from 2010 to 2014, with a decrease of 27.47% compared to 182 cases from 2005 to 2009. Among the 132 cases, 2 cases were local infected cases and the remaining 130 cases were imported cases. Four cases were clinically diagnosed and 128 cases were laboratory confirmed, with 97 cases of malignant malaria, 14 cases of vivax malaria, 13 cases of ovale malaria, and 4 cases of quartan malaria. The 132 cases were distributed in five districts：56 cases in Jintan City, 51 cases in Liyang City, 19 cases in Tianning District, 3 cases in Wujin District, and 3 cases in Xinbei District. The median duration between the onset and treatment of the disease was 2 days, and the median duration between the diagnosis and treatment was 1 day. The diagnosing units were concentrated on the county-level disease control agencies, and medical institutions at county and municipal levels, accounting for 92.42% (122/132). From 2011 to 2014, there were no local malaria cases. CONCLUSIONS: From 2012 to 2014, there have been no local malaria cases in Changzhou City, and the goal of eliminating malaria has been achieved basically. However, there are still many imported malaria cases, and the infected species are diverse. Therefore, imported malaria is still the key of malaria prevention and control.

[Quality analysis of malaria blood smears of fever patients in Changzhou City in 2014].

OBJECTIVE: To understand the quality of blood smears for Plasmodium detection in Changzhou City, so as to provide the technical support for malaria surveillance in the post-elimination period. METHODS: The blood smears of fever patients from each cities (districts) in Changzhou City in 2014, including more than 3% of the negatives and all the positives, were selected. The quality of the blood smear making, dyeing, cleanliness and results were reviewed by the experts from the municipal malaria microscopy station, and the data were analyzed statistically. RESULTS: Totally 996 negative blood smears were reviewed in 2014, with a review rate of 4.52%. The qualified rates of blood smear making, dyeing and cleanliness were 92.87%, 93.27% and 94.48%, respectively. A total of 34 positive blood smears were reviewed, and there were no false detections and leak detections. The qualified rates of blood smear making and dyeing were more than 90% in all the seven cities (districts). As for qualified rate of cleanliness, except the rate in Qishuyan District (81.36%), those in the other six cities (districts) were all above 90%. The qualified rates of blood smear making, dyeing and cleanliness were all more than 90% in first-class, second-class and third-class hospitals. The major quality defects of the blood smears were sediment, abnormal making and thick membrane shedding, and the proportions were 25.91%, 21.76% and 19.17%, respectively. CONCLUSIONS: The quality of blood smears for Plasmodium detection in Changzhou City is satisfying. In the future, the training and supervision still should be strengthened to guarantee the capacity of microscopic examinations for Plasmodium detection in the surveillance of post-elimination period.

[Effect of comprehensive schistosomiasis control in Changzhou City from 2004 to 2014].

OBJECTIVE: To evaluate the effect of comprehensive schistosomiasis control in Changzhou City in recent 10 years, so as to provide the evidences for formulating the future prevention and control strategy. METHODS: The work reports and the data of the schistosomiasis comprehensive control projects in Changzhou City from 2004 to 2014 were collected, the infection status of residents and livestock as well the Oncomelania hupensis snail situation were analyzed, and the implementation effect of the comprehensive control projects was evaluated. RESULTS: From 2004 to 2014, totally 215 368 person-times were examined, and the positive rate of the blood examinations of the population was 0.24% (478/198 356), and there were no positive cases detected out by using the miracidium hatching method. Totally 11 935 domestic animals were detected and no positives were found. From 2004 to 2014, the total area with snails was 92.27 hm2, and marshland, inland and mountain environments accounted for 34.75%, 34.82% and 30.43%, respectively. The newly discovered area with snails was 34.40 hm2, and marshland, inland and mountain environments accounted for 2.62%, 71.22% and 26.16%, respectively. Totally 8 511 snails were dissected and no schistosome infected snails were found. From 2004 to 2014, a total of 242 600 harmless toilets were built, 2 704 700 domestic animals were reared in pens, 5.82 km-long rivers were dredged, 2 250.11 hm2 of protective forests were constructed, a total area of 625.79 hm2 were controlled with molluscicides, and an area of 149.58 hm2 were environmentally transformed. Totally 5.4 million people received health education. The awareness rate of knowledge on schistosomiasis control of residents was 96.00% in 2014. CONCLUSIONS: There exists the risks of snails import and diffusion and schistosomiasis resurrection in Changzhou City, but under the condition of continuous implementation of comprehensive control measures, the endemic situation of schistosomiasis is stable and the control achievement is consolidated in this city.