Assessment of the Health-Related Quality of Life in Neurocysticercosis Patients in Hot Spot Areas - China, 2017-2018.

What is already known about this topic?: Neurocysticercosis is the most severe form of infection caused by ingesting cysticerci, the larval cysts of the pork tapeworm, Taenia solium. Approximately 50 million people worldwide have neurocysticercosis, which is the leading cause of acquired epilepsy in many endemic countries. What is added by this report?: The health of neurocysticercosis patients can be seriously impaired, including through loss of mobility, inability to do self-care, impairment of usual activities, pain/discomfort, anxiety/depression, and impaired cognition. Cognitive impairment is the major consequence of neurocysticercosis and significant contributor to decreased health-related quality of life. Our study made the first estimate of disability weight from neurocysticercosis as a key parameter for disease burden assessment in China. What are the implications for public health practice?: To prevent severe health outcomes from neurocysticercosis in China, it is necessary to improve public awareness of neurocysticercosis and relevant health behaviors.

Cost yield of different treatment strategies against Clonorchis sinensis infection.

BACKGROUND: Clonorchiasis is attributed to the ingestion of raw freshwater fish harboring Clonorchis sinensis. Morbidity control is targeted through the administration of antihelminthics. This study modelled the cost yield indicated by effectiveness and utility of different treatment strategies against clonorchiasis. METHODS: About 1000 participants were enrolled from each of 14 counties selected from four provincial-level administrative divisions namely Guangxi, Guangdong, Heilongjiang and Jilin in 2017. Fecal examination was adopted to detect C. sinensis infection, while behavior of ingesting raw freshwater fish was enquired. Counties were grouped into four categories based on prevalence, namely low prevalence group (< 1%), moderate prevalence group (1-9.9%), high prevalence group (10-19.9%) and very high prevalence group (≥ 20%), while population were divided into three subgroups, namely children aged below 14 years old, adult female and adult male both aged over 14 years old. The average of cost effectiveness indicated by the cost to treat single infected cases with C. sinensis and of cost utility indicated by the cost to avoid per disability-adjusted life years (DALYs) caused by C. sinensis infection was calculated. Comparisons were performed between three treatment schedules, namely individual treatment, massive and selective chemotherapy, in which different endemic levels and populations were considered. RESULTS: In selective chemotherapy strategy, the cost to treat single infected case in very high prevalence group was USD 10.6 in adult male, USD 11.6 in adult female, and USD 13.2 in children. The cost increased followed the decrease of endemic level. In massive chemotherapy strategy, the cost per infected case in very high prevalence group was USD 14.0 in adult male, USD 17.1 in adult female, USD 45.8 in children, which were also increased when the endemic level decreased. In individual treatment strategy, the cost was USD 12.2 in adult male, USD 15.0 in adult female and USD 41.5 in children in very high prevalence group; USD 19.2 in adult male, USD 34.0 in adult female, and USD 90.1 in children in high prevalence group; USD 30.4 in adult male, USD 50.5 in adult female and over USD 100 in children in moderate prevalence group; and over USD 400 in any population in low prevalence group. As to cost utility, the differences by treatment strategies, populations and endemic levels were similar to those in cost effectiveness. CONCLUSIONS: Both cost effectiveness and cost utility indicators are highly impacted by the prevalence and population, as well as the treatment schedules. Adults especially men in the areas with a prevalence over 10% should be prioritized, in which selective chemotherapy was best and massive chemotherapy was also cost effective. In moderate endemic areas, the yield is not ideal, but selective chemotherapy for adult male may also be adopted. In low endemic areas, all strategies were high costly and new strategies need to be developed.

Mechanisms by which mastitis affects reproduction in dairy cow: A review.

Reproductive performance is a key factor in determining the profitability of dairy farm, which is affected by many factors such as environment and diseases. Mastitis is a common and important disease, which has caused huge economic losses to the dairy industries worldwide. Mammary gland infection causes immune responses, resulting in the abnormal secretion of cytokines and hormones and abnormal function of the reproductive system such as the ovary, corpus luteum, uterus and embryo. Cows with mastitis have delayed oestrus, decreased pregnancy rate and increased risk of abortion. The adverse effects of mastitis on reproductive performance are affected by many factors, such as occurrence time, pathogen and cow factors. This paper primarily reviews the progress in the effects and mechanisms of mastitis on reproductive performance, with emphasis on maternal transcriptome, genomic analysis, epigenetic modification, microbiota, inflammatory regulation and immune evasion mechanism of mastitis, aiming to provide directions for the prevention and control of mastitis in the future.

Assessment of health education products aimed at controlling and preventing helminthiases in China.

BACKGROUND: Helminthiases have placed a huge burden of disease on the population in China. However, widespread control activities have led to significant achievements. As health education has been widely disseminated and plays an important role in the control and elimination of these diseases, we collected health education products aimed at controlling and preventing helminthiases in China. We analyzed their characteristics and assessed their quality. METHODS: Firstly, health education products aimed at controlling and preventing helminthiases were collected from a diverse range of organizations. Secondly, the expert brainstorming and Delphi methods were applied to establish an evaluation system, which was then used to assess the collected products systematically. Those deemed excellent were awarded. Characteristics - including type, source, targeted disease(s), targeted population, and languages - of the collected products and the awarded products were presented here. RESULTS: In total, 96 health education products on helminthiases were collected from 53 organizations. Most products belonged to either the graphic design (47) or daily-use (24) category. Seventy were collected from Centers for Disease Control and Prevention and 20 from institutes or control stations of parasitic diseases, primarily at the provincial and county levels. Regarding disease targets of the products, 67 focused on a single helminthiasis, 25 on multiple helminthiases, and the remaining four on non-specific diseases. Of the 67 single helminthiasis-focused products, most targeted schistosomiasis (37), followed by echinococcosis (16). The majority of products (79) targeted the general population, while 11 targeted students specifically. Regarding languages, 86 products were only in Chinese, while the other ten were in both Chinese and the minority languages of China. Out of these ten products, one targeted schistosomiasis and the other nine targeted echinococcosis. Thirty-four products were awarded. The characteristics of the awarded products were similar to those of the collected products. CONCLUSIONS: A diverse range of health education products have been designed and applied for the prevention and control of helminthiases in China. Many products have good features such as specifying the targeted diseases and populations. However, there are significant gaps in terms of both the quantity and quality of products pertaining to some of the diseases. Experiences from the awarded products could be drawn upon to design more products aimed at a range of different helminthiases.

More Poop, More Precision: Improving Epidemiologic Surveillance of Soil-Transmitted Helminths with Multiple Fecal Sampling using the Kato-Katz Technique.

Soil-transmitted helminths, or parasitic intestinal worms, are among the most prevalent and geographically widespread parasitic infections in the world. Accurate diagnosis and quantification of helminth infection are critical for informing and assessing deworming interventions. The Kato-Katz thick smear technique, the most widely used laboratory method to quantitatively assess infection prevalence and infection intensity of helminths, has often been compared with other methods. Only a few small-scale studies, however, have considered ways to improve its diagnostic sensitivity. This study, conducted among 4,985 school-age children in an area of rural China with moderate prevalence of helminth infection, examines the effect on diagnostic sensitivity of the Kato-Katz technique when two fecal samples collected over consecutive days are examined and compared with a single sample. A secondary aim was to consider cost-effectiveness by calculating an estimate of the marginal costs of obtaining an additional fecal sample. Our findings show that analysis of an additional fecal sample led to increases of 23%, 26%, and 100% for Ascaris lumbricoides, Trichuris trichiura, and hookworm prevalence, respectively. The cost of collecting a second fecal sample for our study population was approximately USD4.60 per fecal sample. Overall, the findings suggest that investing 31% more capital in fecal sample collection prevents an underestimation of prevalence by about 21%, and hence improves the diagnostic sensitivity of the Kato-Katz method. Especially in areas with light-intensity infections of soil-transmitted helminths and limited public health resources, more accurate epidemiological surveillance using multiple fecal samples will critically inform decisions regarding infection control and prevention.

Epidemiological profile of Clonorchis sinensis infection in one community, Guangdong, People's Republic of China.

BACKGROUND: Clonorchiasis caused by ingesting improperly prepared fish ranks among the most important but still neglected food-borne parasitic diseases, especially in the People's Republic of China (P.R. China). To promote the implementation of interventions efficiently, the demonstration of an epidemiological profile of Clonorchis sinensis infection is essential in hyper-epidemic areas. METHODS: In one community with higher levels of economic development in Guangdong province, P.R. China, villagers were motivated to provide stool samples for examining helminth eggs. Then, those infected with C. sinensis completed the structured questionnaire including demographical characteristics, knowledge and behavior. RESULTS: A total of 293 villagers infected with C. sinensis participated in questionnaire investigation. Among them, 94.54% were adult and 93.17% were indigenous. The geometric mean of C. sinensis eggs per gram of feces in the children, adult females and adult males was 58, 291 and 443, respectively. The divergence between knowledge and behavior in the adults, especially the adult males, was shown. Out of 228 persons eating raw fish, 160 did it more frequently at restaurants, the proportion of which varied in different populations, showing 25.00%, 54.88% and 80.28% in the children, adult females and adult males, respectively. CONCLUSIONS: Different interventions need to be adopted in different populations. Chemotherapy should be prioritized in the adults, especially the adult males. In addition, health education targeting the children, is essential and may play a crucial role in controlling clonorchiasis in the long term. In order to successfully control clonorchiasis, intervention in the restaurant should not be overlooked in some endemic areas.

Disability weight of Clonorchis sinensis infection: captured from community study and model simulation.

BACKGROUND: Clonorchiasis is among the most neglected tropical diseases. It is caused by ingesting raw or undercooked fish or shrimp containing the larval of Clonorchis sinensis and mainly endemic in Southeast Asia including China, Korea and Vietnam. The global estimations for population at risk and infected are 601 million and 35 million, respectively. However, it is still not listed among the Global Burden of Disease (GBD) and no disability weight is available for it. Disability weight reflects the average degree of loss of life value due to certain chronic disease condition and ranges between 0 (complete health) and 1 (death). It is crucial parameter for calculating the morbidity part of any disease burden in terms of disability-adjusted life years (DALYs). METHODOLOGY/PRINCIPAL FINDINGS: According to the probability and disability weight of single sequelae caused by C. sinensis infection, the overall disability weight could be captured through Monte Carlo simulation. The probability of single sequelae was gained from one community investigation, while the corresponding disability weight was searched from the literatures in evidence-based approach. The overall disability weights of the male and female were 0.101 and 0.050, respectively. The overall disability weights of the age group of 5-14, 15-29, 30-44, 45-59 and 60+ were 0.022, 0.052, 0.072, 0.094 and 0.118, respectively. There was some evidence showing that the disability weight and geometric mean of eggs per gram of feces (GMEPG) fitted a logarithmic equation. CONCLUSION/SIGNIFICANCE: The overall disability weights of C. sinensis infection are differential in different sex and age groups. The disability weight captured here may be referred for estimating the disease burden of C. sinensis infection.

Fragment-based local statistical potentials derived by combining an alphabet of protein local structures with secondary structures and solvent accessibilities.

General and transferable statistical potentials to quantify the compatibility between local structures and local sequences of peptide fragments in proteins were derived. In the derivation, structure clusters of fragments are obtained by clustering five-residue fragments in native proteins based on their conformations represented by a local structure alphabet (de Brevern et al., Proteins 2000;41:271-287), secondary structure states, and solvent accessibilities. On the basis of the native sequences of the structurally clustered fragments, the probabilities of different amino acid sequences were estimated for each structure cluster. From the sequence probabilities, statistical energies as a function of sequence for a given structure were directly derived. The same sequence probabilities were employed in a database-matching approach to derive statistical energies as a function of local structure for a given sequence. Compared with prior models of local statistical potentials, we provided an integrated approach in which local conformations and local environments are treated jointly, structures are treated in units of fragments instead of individual residues so that coupling between the conformations of adjacent residues is included, and strong interdependences between the conformations of overlapping or neighboring fragment units are also considered. In tests including fragment threading, pseudosequence design, and local structure predictions, the potentials performed at least comparably and, in most cases, better than a number of existing models applicable to the same contexts indicating the advantages of such an integrated approach for deriving local potentials and suggesting applicability of the statistical potentials derived here in sequence designs and structure predictions.

[Study on the mixed testing of serum samples in seroepidemiological survey of parasitic diseases].

OBJECTIVE: In order to accumulate experiences for improving the efficiency in serological tests, the present study on mixed testing of serum samples was performed by taking the serological test of trichinellosis and toxoplasmosis as the examples, and had proved the effects on cost-effectiveness of seroepidemiological survey of parasitic disease with method of mixed-samples test. METHODS: According to the binomial distribution principle, to develop an approach to the feasibility of mixed testing of serum samples, and to work on a cost-effectiveness analysis of one-by-one testing and mixed testing using hygienic economic analysis method was performed. For serological test of trichinellosis and toxoplasmosis, 3 kinds of mixed testing methods, namely 3 serum sample mixture, 5 serum sample mixture and 10 serum sample mixture, were performed. RESULTS: The results showed that all the 3 kinds of mixed tests of trichinellosis and toxoplasmosis showing positive result if only 1 weak positive serum sample were mixed with. When the serum samples being mixed were all negative ones, then among the 24 groups tested with each kind of negative serum sample mixture of trichinellosis (3 serum samples, 5 serum samples and 10 serum samples), they all showed negative. However, among the 12 groups tested with 2 kinds of negative serum mixture of toxoplasmosis (3 serum samples and 5 serum samples), all showed negative while among the 18 groups tested with the 10 serum sample mixture, 16 groups showed negative and 2 were positive. The mixed testing of trichinellosis and toxoplasmosis showed that the efficiency of mixed testing was related to the serological positive rate of the parasitic diseases to be examined. When serological positive rate was 10%, the efficiency of mixed testing was higher in 4 serum sample group. When serological positive rate was 1%, the efficiency of mixed testing was higher in 10 serum sample group and when serological positive rate was 0.1%, the in crease of the size of mixed serum samples could decrease the number of testing, but the prerequisite was that there must be one positive sample, so that the positivity for all the mixed tests could be detected. If mixed testing were performed on all negative samples, no positivity could be detected. CONCLUSION: The result of cost-effectiveness analysis demonstrated that for seroepidemiological survey of parasitic diseases, the cost for mixed testing was low, especially when the serological positive rate was expected low (< or = 1%, thus the mixed testing could save a large amount of the cost.