Résumé
Soil-transmitted nematodiasis was once widely prevalent in Jiangsu Province, which seriously threatened human health and hindered socioeconomic development. The control efforts over decades resulted in a remarkable decline in the prevalence of soil-transmitted nematode human infections in Jiangsu Province, with a reduction from 59.32% in 1989 to 0.12% in 2019, and the human prevalence remains at < 0.5% since 2013. Since 1987, an integrated strategy has been adopted for the control of soil-transmitted nematodiasis in Jiangsu Province; however, the core interventions varies at different stages, which mainly include deworming, water and sanitation service improvement, health education, and monitoring and assessment. The criteria of effective soil-transmitted nematodiasis control had been achieved in all epidemic counties (districts) of Jiangsu Province by 2019. Further actions to strengthen health education and monitoring and implement precision control measures are required to consolidate the achievements of soil-transmitted nematodiasis control and eliminate the harm of soil-transmitted nematodiasis to humans. This review summarizes the epidemiology, control progress and evolution of control strategy of soil-transmitted nematodiasis in Jiangsu Province.
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Objective To investigate the risk of Anisakis infections among high-risk populations along the coastal areas of Jiangsu Province, so as to develop the strategy for the prevention and control of anisakiasis in the province. Methods Three counties along the coastal areas of Jiangsu Province were selected as the study sites in 2018, including Rudong County in Nantong City, Haizhou District in Lianyungang City and Dongtai City in Yancheng City. The knowledge, attitude and practice (KAP) of anisakiasis prevention and control, and the prevalence of serum specific IgG antibody against Anisakis were investigated among high-risk populations among these three study sites, including fishermen, fish seller and people who liked eating fresh and live marine fish. Factors affecting the prevalence of the specific IgG antibody against Anisakis were identified using a multiple logistic regression model. In addition, Anisakis larvae infections were detected in fresh and live marine fish samples collected from local markets, and the prevalence and intensity of Anisakis infections were estimated. Results A total of 625 high-risk populations were investigated, including 349 men (55.8%). Only 13.0% of the subjects heard about anisakiasis, and a low awareness rate of anisakiasis prevention and control knowledge was seen among these three types of high-risk populations. There were 21.6% of the subjects eating raw or half-cooked marine fish, 5.8% eating undercooked marine fish, 3.2% presenting vomiting, nausea and diarrhea after eating marine fish, 5.1% developing systemic allergic symptoms, and 65.6% using the same chopping board for raw and cooked food. The sero-prevalence of the anti-Anisakis IgG antibody was 7.0% among the study subjects. Multiple logistic regression analysis identified education level [OR = 0.687, 95% CI (0.478, 0.987)] and development of systemic allergic symptoms [OR = 4.641, 95% CI(1.411, 15.268)]as factors affecting the positive anti-Anisakis IgG antibody among the study subjects. Among 494 fresh and live marine fish detected, the prevalence and intensity of Anisakis larvae infection was 64.0% and 8.1 larvae per fish, with high prevalence seen in Trichiurus haumela and Pneumatophorus japonicas. Conclusions The awareness of anisakiasis prevention and control knowledge is low among the high-risk populations living along the coastal areas of Jiangsu Province, and there are high-risk behaviors, such as eating raw or half-cooked food, using the same chopping board for raw and cooked food. In addition, the prevalence of Anisakis infections is high in the marine fish in these areas. Therefore, the health education and health promotion for anisakiasis prevention and control should be intensified.
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Objective To investigate the polarization of human acute monocytic leukemia THP-1 cells-derived macrophages induced by Nippostrongylus brasiliensis proteins in vitro, so as to provide insights into the elucidation of the mechanisms underlying host immune responses to hookworm infections. Methods The in-vitro culture of N. brasiliensis was established and maintained in the laboratory, and the third- (L3) and fifth-stage larvae (L5) were collected under a sterile condition for preparation of L3 and L5 proteins. The in-vitro culture of THP-1 cells was established, stimulated with 500 ng/mL PMA to yield M0 macrophages that were adherent to the plate wall. The LPS + IFN-γ group, IL-4 + IL-13 group, L3 protein group and L5 protein group were given stimulation with 500 ng/mL LPS plus 100 ng/mL IFN-γ, IL-4 and IL-13 (both 100 ng/mL), L3 protein (5 mg/mL) and L5 protein (5 mg/mL), respectively, while the negative control group was given no stimulation. The cell morphology was observed using microscopy, the mRNA expression of M1/M2 macrophages-specific genes was quantified using a quantitative real-time PCR (qPCR) assay, and the surface markers of M1/M2 macrophages were detected using flow cytometry, while the levels of cytokines secreted by M1/M2 macrophages were measured using enzyme-linked immunosorbent assay (ELISA) following stimulations, so as to examine the polarization of THP-1-derived macrophages induced by N. brasiliensis proteins in vitro. Results Following stimulation with PMA, THP-1 cells appeared wall-adherent M0 macrophages, and polarized to typical M1 macrophages following stimulation with LPS + IFN-γ, and typical M2 macrophages following stimulation with IL-4 + IL-13, IL-3 protein or L5 protein. There was a significant difference in the proportion of M1 macrophages among the negative control group, the LPS + IFN-γ group, the IL-4 + IL-13 group, the L3 protein group and the L5 protein group (χ2 = 3 721.00, P < 0.001), with the highest proportion detected in the LPS + IFN-γ group, and there was also a significant difference in the proportion of M2 macrophages among groups (χ2 = 105.43, P < 0.001). There were significant differences among groups in terms of the mRNA expression of CCL2 (F = 191.95, P < 0.001), TNF-α (F = 129.95, P < 0.001), IL-12b (F = 82.89, P < 0.001), PPARγ (F = 11.30, P < 0.001), IL-10 (F = 9.51, P < 0.001) and Mrc1 genes (F = 12.35, P < 0.001). In addition, there were significant differences in the proportion of positive CD86 and CD206 expression among groups (χ2 = 24 004.33 and 832.50, P < 0.001). Higher IL-1β and TNF-α levels were measured in the LPS + IFN-γ group than in the IL-4 + IL-13 group, the L3 protein group and the L5 protein group (P < 0.001), and greater TGF-β1 and IL-10 levels were seen in the IL-4 + IL-13 group, the L3 protein group and the L5 protein group than in the negative control group and the LPS + IFN-γ group (P < 0.05). Conclusions Both L3 and L5 proteins of N. brasiliensis may induce the polarization of THP-1-derived macrophages to M2 type in vitro.
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Objective To understand the current status of chronic filariasis patients in Jiangsu Province so as to provide basic data for following-up care for them. Methods The patients were followed up one by one according to history archives between June and July, 2018, and the clue investigation was also conducted. The base data of the patients was collected through a face-to-face questionnaire survey and analyzed. Results There were still 3 160 chronic filariasis patients in Jiangsu Province. Among them, the male accounted for 40.0%, and 91.8% of the patients were older adults aged 60 years or above. From the aspect of regional distribution, Suqian (24.2%), Huai’an (19.5%), Suzhou (17.3%), Xuzhou (11.2%), and Yancheng (9.8%) were the five top high prefectures. The patients with simple lymphatic inflammation or lymphadenitis, simple lymphedema or elephantiasis, simple chyluria, simple hydrocele of tunica vaginalis, and two symptoms or more accounted for 2.7%, 37.1%, 11.2%, 0.9%, and 48.1%, respectively. For the patients with lymphedema or elephantiasis, 97.8% of edema was seen in the lower limbs, and more than 90% of the edema stages were I-III. The number of current caring sites was 220, covering 2 091 patients. The average number of times of caring activities in this year was 3.2. The average cumulative time of caring activities among all the sites was 11.3 years. Conclusions The number of chronic filariasis patients has been dramatically decreased, most of the patients are old and have long disease durations. The caring sites have not covered all the patients. In order to release the symptoms and improve the life quality of the patients, all the patients should be taken care of in Jiangsu Province.
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Objective To understand the current status of chronic filariasis patients in Jiangsu Province so as to provide basic data for following-up care for them. Methods The patients were followed up one by one according to history archives between June and July, 2018, and the clue investigation was also conducted. The base data of the patients was collected through a face-to-face questionnaire survey and analyzed. Results There were still 3 160 chronic filariasis patients in Jiangsu Province. Among them, the male accounted for 40.0%, and 91.8% of the patients were older adults aged 60 years or above. From the aspect of regional distribution, Suqian (24.2%), Huai’an (19.5%), Suzhou (17.3%), Xuzhou (11.2%), and Yancheng (9.8%) were the five top high prefectures. The patients with simple lymphatic inflammation or lymphadenitis, simple lymphedema or elephantiasis, simple chyluria, simple hydrocele of tunica vaginalis, and two symptoms or more accounted for 2.7%, 37.1%, 11.2%, 0.9%, and 48.1%, respectively. For the patients with lymphedema or elephantiasis, 97.8% of edema was seen in the lower limbs, and more than 90% of the edema stages were I-III. The number of current caring sites was 220, covering 2 091 patients. The average number of times of caring activities in this year was 3.2. The average cumulative time of caring activities among all the sites was 11.3 years. Conclusions The number of chronic filariasis patients has been dramatically decreased, most of the patients are old and have long disease durations. The caring sites have not covered all the patients. In order to release the symptoms and improve the life quality of the patients, all the patients should be taken care of in Jiangsu Province.