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1.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(4): 353-355, 2019 Sep 24.
Artigo em Chinês | MEDLINE | ID: mdl-31612666

RESUMO

Following the concerted efforts for nearly 70 years, great achievements have been obtained in parasitic diseases control in China, and some important parasitic diseases have been eliminated or moving towards elimination in the country. With the socioeconomic development, the implementation of the "Road and Belt Initiative" and the increase in the international communication and overseas investment, there is a rise in the number of overseas labors, businessmen, students, travelers, visitors and participants in national and international communication activities, resulting in a gradual increase in the number of cases with parasitic diseases imported from endemic to non-endemic areas of China and from foreign countries to China. The increase in the number of imported cases causes new challenges for the elimination of parasitic diseases in China. The paper describes the current status of malaria, schistosomiasis and leishmaniasis, analyzes the challenges for the current control activities, and proposes the control strategies and interventions.


Assuntos
Leishmaniose , Malária , Esquistossomose , China/epidemiologia , Doenças Transmissíveis Importadas/epidemiologia , Humanos , Leishmaniose/epidemiologia , Leishmaniose/prevenção & controle , Malária/epidemiologia , Malária/prevenção & controle , Fatores de Risco , Esquistossomose/epidemiologia , Esquistossomose/prevenção & controle
2.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(4): 418-422, 2019 Jul 24.
Artigo em Chinês | MEDLINE | ID: mdl-31612679

RESUMO

OBJECTIVE: To understand Leishmania infections among employees of China Petroleum First Construction Corporation returning from Uzbekistan, and take timely actions to prevent the spread of the epidemic. METHODS: Questionnaire survey was conducted to collect screening subjects'information. Palpation of the liver, spleen and superficial lymph nodes was performed by a physician, and the lesions on the frequently exposed skin were detected by a dermatologist. In addition, the liver and spleen sizes were measured using B-mode ultrasonography, and serum samples were collected to be subjected to an rK39-based rapid diagnostic test for detection of visceral leishmaniasis. Leishmania was detected using microscopy in the specimens sampled from the lesioned skin, and the parasites species was identified using molecular assays in parasitologically positive specimens. RESULTS: Among the 181 employees screened, enlarged cervical lymph nodes were palpable in 6 subjects, and skin lesions were found in 12 cases. B-mode ultrasonography displayed hepatosplenomegaly in 5 cases, and rK39 test were positive in 3 serum samples. Two classical lesioned skin specimens were sampled, and Leishmania was detected in one specimen. The promastigote DNA was extracted and two fragments of 120 bp and 350 bp in sizes were amplified using PCR assay with K13A/K13B and L5.8S/LITSR primers specific to Leishmania. The two amplification products were 90% and 98% homologous to the corresponding sequences of L. major (GenBank accession numbers: EU370906.1 and FN677342.1). CONCLUSIONS: Six patients with cutaneous leishmaniasis were screened, including 2 uncured cases. One uncured case was diagnosed as imported cutaneous leishmaniasis caused by L. major infection.


Assuntos
Doenças Transmissíveis Importadas , Leishmania , Leishmaniose Cutânea , China/epidemiologia , Doenças Transmissíveis Importadas/diagnóstico , Doenças Transmissíveis Importadas/epidemiologia , Doenças Transmissíveis Importadas/parasitologia , DNA de Protozoário , Epidemias , Humanos , Leishmania/genética , Leishmaniose Cutânea/diagnóstico , Leishmaniose Cutânea/epidemiologia , Fígado/diagnóstico por imagem , Linfonodos/patologia , Reação em Cadeia da Polimerase , Baço/diagnóstico por imagem , Inquéritos e Questionários , Ultrassonografia , Uzbequistão
3.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(4): 436-438, 2019 Jul 22.
Artigo em Chinês | MEDLINE | ID: mdl-31612684

RESUMO

OBJECTIVE: To analyze the epidemiological characteristics of reported malaria cases in Leshan City, so as to provide insights into malaria control. METHODS: The data pertaining to malaria cases and epidemiological individual information in Leshan City from 2012 to 2018 were captured from the National Notifiable Communicable Disease Reporting System and the Information System for Parasitic Diseases Control and Prevention, and a descriptive epidemiological analysis was performed. RESULTS: A total of 34 malaria cases were reported in Leshan City from 2012 to 2018, and all cases were confirmed as imported malaria cases by Sichuan provincial malaria diagnosis reference laboratory. Of all 34 cases, there were 14 vivax malaria cases, 18 falciparum malaria cases, a malariae malaria case and an ovale malaria case. The sites where malaria parasite infections occurred mainly included African areas (accounting for 58.82%) and Southeastern Asian areas (accounting for 29.41%), and the malaria cases were mainly reported in January, February, June and July, which accounted for 65.63% of all cases. The cases included 33 men and a woman, and had ages of 21 to 59 years. The cases'occupations mainly involved overseas peasants, technical workers and businessmen. The duration from onset of malaria to diagnosis ranged from 0 to 31 days, and the percentage of definitive diagnosis was 85.29% at initial diagnosis. CONCLUSIONS: There are no local malaria cases in Leshan City; however, imported malaria cases are reported. The monitoring, management and health education of overseas returners should be further strengthened and malaria training should be improved to enhance the diagnostic and treatment capability in professionals, so as to consolidate malaria control achievements.


Assuntos
Malária , Adulto , África , Ásia Sudeste , China/epidemiologia , Doenças Transmissíveis Importadas/epidemiologia , Doenças Transmissíveis Importadas/parasitologia , Feminino , Humanos , Malária/epidemiologia , Malária/parasitologia , Masculino , Pessoa de Meia-Idade , Ocupações , Fatores de Risco , Adulto Jovem
4.
Braz J Infect Dis ; 23(5): 307-312, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31472124

RESUMO

BACKGROUND: Following socio-economic turmoil in Venezuela, millions of the Venezuelan people are migrating to the neighboring Latin American countries including Brazil. Besides the social and economic burden of these migrants, Brazil must manage the health-related issues arising as consequence of these Venezuelan migrants. Poor health services in Venezuela along with unhygienic travelling conditions, lack of food (malnutrition) and potable water, unhealthy and overcrowded refugee camps or shelters, poor availability of medical services have made the migrant Venezuelan population susceptible to various diseases, especially infectious diseases. SINAN system is a health-related system in Brazil that keeps track of different health occurrences in the society and allows health care workers and policymakers free access to these data. OBJECTIVES: To evaluate the emergence of infectious diseases as a consequence of the arrival of Venezuelans immigrants in Brazil and to assess the importance of SINAN for epidemiological surveillance. METHODS: Observational retrospective study. Data were collected from the SINAN system between 2015 and 2017 and was analyzed using descriptive statistics, and Mann-Whitney test (using SPSS tool version 12). Evaluated infectious diseases in this study were tuberculosis, sexually transmitted infections (STIs), HIV/AIDS, syphilis, viral hepatitis, leishmaniasis, and malaria. RESULTS: STIs were the most commonly reported diseases. Compared to Brazilians, Venezuelan migrants reported significantly higher number of HIV/Aids (p < 0.046) and leishmaniasis cases (p < 0.049), while Brazilians reported significantly higher number of hepatitis cases (p < 0.046). Malaria was also more prevalent among Venezuelan migrants than native Brazilians. CONCLUSION: Increased incidence of infectious diseases among the migrant population should be considered seriously as lack of adequate control of these diseases might lead to outbreaks.


Assuntos
Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Importadas/epidemiologia , Notificação de Doenças/estatística & dados numéricos , Emigrantes e Imigrantes/estatística & dados numéricos , Brasil/epidemiologia , Monitoramento Epidemiológico , Humanos , Prevalência , Estudos Retrospectivos , Estações do Ano , Fatores Socioeconômicos
5.
Med. clín (Ed. impr.) ; 153(5): 205-212, sept. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-183997

RESUMO

El incremento de los viajes internacionales, la creciente presencia de vectores transmisores de arbovirus en nuestro país, las alertas de fiebres hemorrágicas, como el actual brote de ébola en la R. D. del Congo y los casos autóctonos de fiebre hemorrágica de Crimea-Congo en nuestro país, ponen de nuevo en primer plano las enfermedades tropicales. El aislamiento de los casos sospechosos de enfermedades de alta transmisibilidad y letalidad ha de ser una prioridad (fiebres hemorrágicas, MERS-CoV). Al valorar al paciente, una cuidadosa historia clínica basada en los aspectos epidemiológicos de la zona de procedencia, las actividades realizadas, el tiempo de estancia en el mismo y el inicio de los síntomas nos ayudarán finalmente, si no al diagnóstico definitivo, sí al menos a descartar las enfermedades que signifiquen una amenaza para él. Por su frecuencia y gravedad la malaria debe ser descartada, sin olvidar las otras causas habituales de fiebre con las que el médico de urgencias debe estar familiarizado también


The increase in international travel, the growing presence of arbovirus vectors in our country, and notifications of haemorrhagic fever such as the current outbreak of Ebola in D.R. Congo and the cases of Crimea-Congo haemorrhagic fever in our country have again cast the spotlight on tropical diseases Isolating suspected cases of highly contagious and lethal diseases must be a priority (Haemorrhagic fever, MERS-CoV). Assessing the patient, taking a careful medical history based on epidemiological aspects of the area of origin, activities they have carried out, their length of stay in the area and the onset of symptoms, will eventually help us, if not to make a definitive diagnosis, at least to exclude diseases that pose a threat to these patients. Malaria should be ruled out because of its frequency, without forgetting other common causes of fever familiar to emergency doctors


Assuntos
Humanos , Controle Sanitário de Viajantes , Doença Relacionada a Viagens , Isolamento de Pacientes/tendências , Saúde do Viajante , Doenças Transmissíveis Importadas/epidemiologia , Febres Hemorrágicas Virais/epidemiologia , Infecções por Arbovirus/epidemiologia , Arbovirus/isolamento & purificação , Meningite/epidemiologia , Febre Tifoide/epidemiologia , Rickettsia/isolamento & purificação , Coronavirus/isolamento & purificação , Esquistossomose/epidemiologia
7.
Emerg Infect Dis ; 25(8): 1589-1591, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31310205

RESUMO

We report a disease outbreak caused by chikungunya virus in Zhejiang Province, China, in August 2017. Phylogenic analysis indicated that this virus belonged to the Indian Ocean clade of the East/Central/South African genotype and was imported by a traveler returning from Bangladesh.


Assuntos
Febre de Chikungunya/epidemiologia , Febre de Chikungunya/virologia , Vírus Chikungunya , Surtos de Doenças , Bangladesh , Febre de Chikungunya/história , Vírus Chikungunya/classificação , Vírus Chikungunya/genética , China/epidemiologia , Doenças Transmissíveis Importadas/epidemiologia , Doenças Transmissíveis Importadas/virologia , Genoma Viral , História do Século XXI , Humanos , Filogenia , Doença Relacionada a Viagens
9.
Malar J ; 18(1): 230, 2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31291951

RESUMO

BACKGROUND: Malaria was eliminated in Spain in 1964. Since then, more than 10,000 cases of malaria have been reported, mostly in travellers and migrants, making it the most frequently imported disease into this country. In order to improve knowledge on imported malaria cases characteristics, the two main malaria data sources were assessed: the national surveillance system and the hospital discharge database (CMBD). METHODS: Observational study using prospectively gathered surveillance data and CMBD records between 2002 and 2015. The average number of hospitalizations per year was calculated to assess temporal patterns. Socio-demographic, clinical and travel background information were analysed. Bivariate and multivariable statistical methods were employed to evaluate hospitalization risk, fatal outcome, continent of infection and chemoprophylaxis failure and their association with different factors. RESULTS: A total of 9513 malaria hospital discharges and 7421 reported malaria cases were identified. The number of reported cases was below the number of hospitalizations during the whole study period, with a steady increase trend in both databases since 2008. Males aged 25-44 were the most represented in both data sources. Most frequent related co-diagnoses were anaemia (20.2%) and thrombocytopaenia (15.4%). The risks of fatal outcome increased with age and were associated with the parasite species (Plasmodium falciparum). The main place of infection was Africa (88.9%), particularly Equatorial Guinea (33.2%). Most reported cases were visiting friends and relatives (VFRs) and immigrants (70.2%). A significant increased likelihood of hospitalization was observed for children under 10 years (aOR:2.7; 95% CI 1.9-3.9), those infected by Plasmodium vivax (4.3; 95% CI 2.1-8.7) and travellers VFRs (1.4; 95% CI 1.1-1.7). Only 4% of cases reported a correct regime of chemoprophylaxis. Being male, over 15 years, VFRs, migrant and born in an endemic country were associated to increased risk of failure in preventive chemotherapy. CONCLUSIONS: The joint analysis of two data sources allowed for better characterization of imported malaria profile in Spain. Despite the availability of highly effective preventive measures, the preventable burden from malaria is high in Spain. Pre-travel advice and appropriately delivered preventive messages needs to be improved, particularly in migrants and VFRs.


Assuntos
Antimaláricos/administração & dosagem , Doenças Transmissíveis Importadas/epidemiologia , Hospitalização/estatística & dados numéricos , Malária Falciparum/epidemiologia , Malária Vivax/epidemiologia , Adolescente , Adulto , Fatores Etários , Quimioprevenção/estatística & dados numéricos , Doenças Transmissíveis Importadas/parasitologia , Doenças Transmissíveis Importadas/prevenção & controle , Feminino , Humanos , Incidência , Malária Falciparum/parasitologia , Malária Falciparum/prevenção & controle , Malária Vivax/parasitologia , Malária Vivax/prevenção & controle , Masculino , Pessoa de Meia-Idade , Plasmodium falciparum/fisiologia , Plasmodium vivax/fisiologia , Prevalência , Fatores de Risco , Fatores Sexuais , Espanha/epidemiologia , Viagem/estatística & dados numéricos , Adulto Jovem
10.
Int J Antimicrob Agents ; 54(2): 233-239, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31173865

RESUMO

Here we describe an outbreak due to NDM-1+CTX-M-15+DHA-1-producing Klebsiella pneumoniae (NDM-1-Kp) in Spain related to a patient previously admitted to a healthcare centre in an endemic area (Pakistan). Nine colonised patients were detected in the Neurosurgery ward between September 2015 and February 2016 during the R-GNOSIS European Project. NDM-1-Kp isolates from clinical samples were also recovered in three of these patients. Surveillance culture at admission was negative in the index case, but NDM-1-Kp colonisation was detected 27 days later after receiving antibiotic treatment. Co-colonisation with a second NDM-1-Kp isolate was identified in this patient 61 days post-admission. Overall length of stay (LOS = 75 days) (P < 0.01) and LOS until carbapenemase detection (LOS-1 = 36 days) was longer in NDM-1-Kp carriers than in patients with other carbapenemase-producing Enterobacterales. Intervention strategies were implemented after the outbreak declaration and NDM-1-Kp transmission was contained. Among the NDM-1-Kp isolates, two clones [ST437 (index case and Patient 2) and ST101 (index case and Patients 3-9)] with different IncFIB NDM-1-containing plasmids were identified. Whole-genome sequencing revealed a high content of antimicrobial resistance genes in both isolates in addition to a large number of virulence factors. Colonisation with other epidemic (OXA-48-ST11-K. pneumoniae and VIM-1-ST54-K. pneumoniae) and non-epidemic (VIM-1-ST908-K. pneumoniae and VIM-ST431-Escherichia coli) clones was also detected in two NDM-1 carriers. Implementation of adequate infection control measures and uninterrupted active surveillance programmes for detecting patients with a low colonisation status are crucial to prevent the introduction and dissemination of NDM-type enzymes in our region.


Assuntos
Proteínas de Bactérias/análise , Doenças Transmissíveis Importadas/epidemiologia , Surtos de Doenças , Infecções por Klebsiella/epidemiologia , Klebsiella pneumoniae/enzimologia , beta-Lactamases/análise , Adulto , Idoso , Idoso de 80 Anos ou mais , Proteínas de Bactérias/genética , Doenças Transmissíveis Importadas/microbiologia , Doenças Transmissíveis Importadas/transmissão , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Infecção Hospitalar/transmissão , Transmissão de Doença Infecciosa , Feminino , Humanos , Controle de Infecções , Infecções por Klebsiella/microbiologia , Infecções por Klebsiella/transmissão , Klebsiella pneumoniae/classificação , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/isolamento & purificação , Masculino , Pessoa de Meia-Idade , Paquistão , Espanha/epidemiologia , Viagem , beta-Lactamases/genética
11.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(6): 719-725, 2019 Jun 10.
Artigo em Chinês | MEDLINE | ID: mdl-31238626

RESUMO

Objectives: To establish a geographic information application system for analyzing the spatial and temporal distribution of major infectious diseases in various regions of the world and to assess the risk of importation of those diseases, to China. Methods: We collected and integrated the following information on: 1) outbreaks and areas of epidemics of major infectious diseases in the world from 2000 to 2017, 2) cases of infectious diseases in arriving travelers through active surveillance at international entry-exit ports in mainland China from 2014 to 2016, 3) numbers of annual global international flights and travelers in the country. With the above information, a global space-time distribution database on major infectious diseases was then established, using the technology related to the system. Models regarding technologies on time-space analysis, probabilistic risk assessment and geographic information visualization, were applied to establish a geographic information system on risk assessment of infectious diseases that imported to China. Results: Through integration of information on outbreaks and epidemic areas of 60 major infectious diseases in 220 countries and regions around the world, as well as 42 kinds of infectious diseases identified among the international arrivals in mainland China, a system was then developed. Information on the distribution of major infectious diseases and their potential risks in the worldwide various regions, characteristics of spectrum and disease burden of infectious diseases imported to each province of mainland China were displayed. Thus, risks on importing infectious diseases in each province via air way were able to be evaluated and simulated by the probabilistic risk assessment model, under the information on specific kind of infectious disease, outside China. Conclusion: Geographic Information System on Risk Assessment Regarding Infectious Diseases Imported to China provides basic data for epidemiological reconnaissance and assessment on risks of importing infectious diseases outside China, thus would be helpful for the improvement of strategies on surveillance, prevention and control regarding the importing infectious diseases, in China.


Assuntos
Doenças Transmissíveis Importadas/epidemiologia , Surtos de Doenças/prevenção & controle , Monitoramento Epidemiológico , Sistemas de Informação Geográfica , China , Humanos , Medição de Risco
12.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(2): 178-181, 2019 Apr 22.
Artigo em Chinês | MEDLINE | ID: mdl-31184052

RESUMO

OBJECTIVE: To understand the malaria epidemic situation and characteristics in Jiangsu Province in 2017, so as to provide the evidence for formulating the targeted strategy of malaria elimination. METHODS: The data of malaria cases in Jiangsu Province in 2016 were collected from China's Routine Diseases Surveillance Information System (CRDSIS). RESULTS: Totally, 239 imported malaria cases were reported in Jiangsu Province in 2017, and the cases decreased by 22.40% compared to 308 cases in 2015. Except 2 malaria case caused by blood transfusion, the rest patients were all imported. Among them, there were 163 falciparum malaria cases, 21 vivax malaria cases, 11 quartan malaria cases, 43 ovale malaria cases, and 1 mixed infection case (Plasmodium falciparum and P. ovale). The numbers of imported cases of Nantong (39 cases, 16.32%), Suzhou (26 cases, 10.88%), Taizhou (25 cases, 10.46%), Huai'an (24 cases, 10.04%), and Lianyungang (22 cases, 9.21%) ranked in the top 5 cities across Jiangsu Province, the malaria cases in the five cities accounted for 56.90% (136/239). The infection source areas of the imported malaria cases included Africa (225 cases), Asia (8 cases), Oceania (2 cases), and South America (2 cases). CONCLUSIONS: Jiangsu Province has no local malaria cases for 6 consecutive years. Despite the imported cases in 2017 decreased some-what compared to that in 2016, it is still necessary to strengthen the surveillance of imported malaria cases and improve malaria diagnosis and treatment in the whole province.


Assuntos
Doenças Transmissíveis Importadas , Malária , China/epidemiologia , Doenças Transmissíveis Importadas/epidemiologia , Doenças Transmissíveis Importadas/parasitologia , Erradicação de Doenças , Humanos , Malária/epidemiologia , Malária/parasitologia , Plasmodium , Vigilância da População , Prevalência
13.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(2): 182-184, 2019 May 08.
Artigo em Chinês | MEDLINE | ID: mdl-31184053

RESUMO

OBJECTIVE: To study the epidemiological characteristics of imported malaria in Chenzhou City, Hunan Province, so as to provide the reference for consolidating the malaria elimination and formulating the prevention and control strategies of imported malaria. METHODS: The epidemiological characteristics of imported malaria were statistically analyzed in Chenzhou City from 2010 to 2017. RESULTS: Totally 46 malaria cases, which were all imported, were reported in Chenzhou City from 2010 to 2017, with an average annual incidence of 0.12/105. The reported malaria cases were mainly falciparum malaria, accounting for 60.87% of the total number of cases. There was no obvious seasonal distribution of malaria cases, but the top of reported cases were in June. Totally 73.91% of malaria cases were concentrated in Beihu District, Suxian District, Guiyang County and Zixing City. These cases were mainly the young and middle-aged and 69.57% of the cases were from 36 to 60 years old. There was a statistically significant difference in the distribution of malaria patients among the age groups (χ2 = 47.80, P < 0.01). The median time from onset to diagnosis was 6 days, and the case confirmed institutions were dominated by municipal and above medical institutions, accounting for 52.17% of the total number of cases. There was a statistically significant difference in the proportion of confirmed cases among medical and health institutions at all levels ( χ2 = 41.96, P < 0.01). CONCLUSIONS: The importation of malaria in Chenzhou City is still severe. The awareness of malaria diagnosis and treatment in primary medical institutions, malaria patients' serum tests, and the health education of malaria control and prevention knowledge should be strengthened to consolidate the malaria elimination results.


Assuntos
Doenças Transmissíveis Importadas , Malária , Adulto , China/epidemiologia , Doenças Transmissíveis Importadas/epidemiologia , Doenças Transmissíveis Importadas/parasitologia , Humanos , Incidência , Malária/epidemiologia , Malária/prevenção & controle , Pessoa de Meia-Idade , Fatores de Risco
14.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(2): 188-191, 2019 May 16.
Artigo em Chinês | MEDLINE | ID: mdl-31184055

RESUMO

OBJECTIVE: To describe and analyze the epidemiological characteristics of malaria in Dalian City, so as to provide the evidence for adjusting and formulating malaria control strategy and measures, being in accordance with the practical situation in Dalian City. METHODS: The data of malaria cases in Dalian City from 2005 to 2016 were collected from China Diseases Surveillance Information Reporting Management System (DSIRMS), to describe and analyze the epidemiologic characteristics of malaria in Dalian City. RESULTS: A total of 143 malaria cases were reported in Dalian from 2005 to 2016, including 115 laboratory diagnosed cases, 27 clinically diagnosed cases, and 1 suspected diagnosed case. Among the 115 laboratory diagnosed patients, 65 patients were infected with Plasmodium falciparum, 19 were infected with P. vivax, and 15 had mixed infection, 4 were infected with P. ovale, 3 were infected with P. malariae, and 9 were unclassified. All the cases were imported, 127 were imported from Africa, accounting for 88.81%, mainly were imported from Equatorial Guinea, Liberia, Ghana and Nigeria. Most of the cases were imported from May to October, accounting for 58.74% (84/143), and the imported cases emerged a small peak in August. The ratio of males to females was 10∶1, and the median age was 42 years. Among the total cases, fishermen, migrant workers, and work-man accounted for 55.24% (79/143). Seventy-five patients lived in rural districts, and 68 patients lived in urban districts. The median interval from backing to China to disease onset was 8 days. The proportion of disease onset within one month after backing to China was 76.27% (90/118). The median interval from disease onset to diagnosis was 4 days, and the longest interval was 71 days. Totally 141 patients were cured and 2 died. CONCLUSIONS: In order to avoid malaria death, we should strengthen the malaria prevention and control, especially in rural districts, enhance the training for professionals in the county health facilities, and the surveillance and health education for those who are returned from malaria-endemic areas.


Assuntos
Malária , Adulto , China/epidemiologia , Doenças Transmissíveis Importadas/epidemiologia , Doenças Transmissíveis Importadas/parasitologia , Doenças Transmissíveis Importadas/prevenção & controle , Feminino , Humanos , Malária/epidemiologia , Malária/parasitologia , Masculino , Plasmodium , Razão de Masculinidade
15.
Mem Inst Oswaldo Cruz ; 114: e190064, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31215589

RESUMO

Imported malaria is a malaria infection diagnosed outside the area where it was acquired and is induced by human migration and mobility. This retrospective study was performed based on secondary data from 2007 to 2015. In total, 736 cases of imported malaria (79.7% of 923 cases) were recorded in Rio de Janeiro state. Of the imported cases, 55.3% came from abroad, while 44.7% came from other regions of Brazil. Most cases of imported malaria in Brazil (85.5%) originated in Amazônia Legal, and Burundi (Africa) accounted for 59% of the cases from abroad. Analyses of the determinants of imported malaria in Rio de Janeiro state must be continued to understand the relationship between the origin and destination of cases.


Assuntos
Doenças Transmissíveis Importadas/epidemiologia , Malária/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Criança , Pré-Escolar , Cidades/epidemiologia , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Análise Espaço-Temporal , Fatores de Tempo , Populações Vulneráveis , Adulto Jovem
16.
Malar J ; 18(1): 200, 2019 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-31208453

RESUMO

BACKGROUND: Malaria is considered as a major threat to health systems. It is still considered as one of the most important infectious diseases in Iran, but with an elimination goal in 2025. This study aimed to review the malaria situation in Iran over the 16 years. METHODS: The data was collected from epidemiological registration forms that had been completed by physicians and malaria focal points in the National Centers for Disease Control and Prevention. RESULTS: During the study period, 134,273 malaria cases were reported. The malaria incidence decreased from 0.24/1000 cases in 2002 to 0.01/1000 in 2017. From 2009 onward, the number of imported cases increased in comparison with the autochthonous and indigenous cases. Most cases were seen in males and people over 15 years of age. Moreover, the dominant registered reports were from rural areas. Most malaria cases were reported from the south and southeastern of Iran. Plasmodium vivax was the dominant species. CONCLUSION: The dramatic drop in the incidence of autochthonous cases can hopefully support malaria elimination as a major goal in the near future.


Assuntos
Malária/epidemiologia , Plasmodium/fisiologia , Fatores Etários , Doenças Transmissíveis Importadas/epidemiologia , Doenças Transmissíveis Importadas/parasitologia , Geografia , Humanos , Incidência , Irã (Geográfico)/epidemiologia , Malária/parasitologia , Plasmodium/classificação , Plasmodium/isolamento & purificação , Fatores Sexuais , Fatores de Tempo
17.
Malar J ; 18(1): 158, 2019 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-31053075

RESUMO

BACKGROUND: As malaria cases have declined throughout Nepal, imported cases comprise an increasing share of the remaining malaria caseload, yet how to effectively target mobile and migrant populations (MMPs) at greatest risk is not well understood. This formative research aimed to confirm the link between imported and indigenous cases, characterize high-risk MMPs, and identify opportunities to adapt surveillance and intervention strategies to them. METHODS: The study used a mixed-methods approach in three districts in far and mid-western Nepal, including (i) a retrospective analysis of passive surveillance data, (ii) a quantitative health facility-based survey of imported cases and their MMP social contacts recruited by peer-referral, and (iii) focus group (FG) discussions and key informant interviews (KIIs) with a subset of survey participants. Retrospective case data were summarised and the association between monthly indigenous case counts and importation rates in the previous month was investigated using Bayesian spatio-temporal regression models. Quantitative data from structured interviews were summarised to develop profiles of imported cases and MMP contacts, including travel characteristics and malaria knowledge, attitudes and practice. Descriptive statistics of the size of cases' MMP social networks are presented as a measure of potential programme reach. To explore opportunities and barriers for targeted malaria surveillance, data from FGs and KIIs were formally analysed using a thematic content analysis approach. RESULTS: More than half (54.1%) of malaria cases between 2013 and 2016 were classified as imported and there was a positive association between monthly indigenous cases (incidence rate ratio (IRR) 1.02 95% CI 1.01-1.03) and the previous month's case importation rate. High-risk MMPs were identified as predominantly adult male labourers, who travel to malaria endemic areas of India, often lack a basic understanding of malaria transmission and prevention, rarely use ITNs while travelling and tend not to seek treatment when ill or prefer informal private providers. Important obstacles were identified to accessing Nepali MMPs at border crossings and at workplaces within India. However, strong social connectivity during travel and while in India, as well as return to Nepal for large seasonal festivals, provide opportunities for peer-referral-based and venue-based surveillance and intervention approaches, respectively. CONCLUSIONS: Population mobility and imported malaria cases from India may help to drive local transmission in border areas of far and mid-western Nepal. Enhanced surveillance targeting high-risk MMP subgroups would improve early malaria diagnosis and treatment, as well as provide a platform for education and intervention campaigns. A combination of community-based approaches is likely necessary to achieve malaria elimination in Nepal.


Assuntos
Doenças Transmissíveis Importadas/prevenção & controle , Malária/prevenção & controle , Malária/transmissão , Migrantes/psicologia , Adolescente , Adulto , Teorema de Bayes , Criança , Pré-Escolar , Doenças Transmissíveis Importadas/epidemiologia , Estudos Transversais , Erradicação de Doenças/métodos , Monitoramento Epidemiológico , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Nepal/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Inquéritos e Questionários , Migrantes/estatística & dados numéricos , Viagem , Adulto Jovem
19.
Nat Commun ; 10(1): 2332, 2019 05 27.
Artigo em Inglês | MEDLINE | ID: mdl-31133635

RESUMO

Malaria burden on Bioko Island has decreased significantly over the past 15 years. The impact of interventions on malaria prevalence, however, has recently stalled. Here, we use data from island-wide, annual malaria indicator surveys to investigate human movement patterns and their relationship to Plasmodium falciparum prevalence. Using geostatistical and mathematical modelling, we find that off-island travel is more prevalent in and around the capital, Malabo. The odds of malaria infection among off-island travelers are significantly higher than the rest of the population. We estimate that malaria importation rates are high enough to explain malaria prevalence in much of Malabo and its surroundings, and that local transmission is highest along the West Coast of the island. Despite uncertainty, these estimates of residual transmission and importation serve as a basis for evaluating progress towards elimination and for efficiently allocating resources as Bioko makes the transition from control to elimination.


Assuntos
Doenças Transmissíveis Importadas/epidemiologia , Malária Falciparum/epidemiologia , Doença Relacionada a Viagens , Viagem/estatística & dados numéricos , Doenças Transmissíveis Importadas/parasitologia , Doenças Transmissíveis Importadas/prevenção & controle , Guiné Equatorial/epidemiologia , Humanos , Ilhas/epidemiologia , Malária Falciparum/parasitologia , Malária Falciparum/prevenção & controle , Plasmodium falciparum/isolamento & purificação , Prevalência , Fatores de Risco , Viagem/tendências
20.
Malar J ; 18(1): 176, 2019 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-31113437

RESUMO

BACKGROUND: Plasmodium ovale curtisi and Plasmodium ovale wallikeri are regarded as less virulent forms of malaria with a geographic distribution including Southeast Asia, Central and West Africa, and is increasingly reported as an infection in returning travellers. A species of malaria that may have delayed or relapsing presentations similar to Plasmodium vivax, the clinical presentation of P. ovale spp. has been described to have prepatent periods of 2 weeks or slightly longer with reports of relapse following primary infection out to 8-9 months. This presentation may be obscured further in the setting of anti-malarial exposure, with report of delayed primary infection out to 4 years. Presented is a cluster of 4 imported P. ovale spp. cases in returning Peruvian military personnel assigned to United Nations peace-keeping operations in the Central African Republic. CASE PRESENTATION: From January to December 2016, Peruvian peace-keepers were deployed in support of United Nations (UN) operations in the Central African Republic (CAR). While serving abroad, Navy, Army, and Air Force members experienced 223 episodes of Plasmodium falciparum malaria following interruption of prophylaxis with mefloquine. Diagnosis was made using rapid diagnostics tests (RDTs) and/or smear with no coinfections identified. Cases of malaria were treated with locally-procured artemether-lumefantrine. Returning to Peru in January 2017, 200 peace-keepers were screened via thick and thin smear while on weekly mefloquine prophylaxis with only 1 showing nucleic acid within red blood cells consistent with Plasmodium spp. and 11 reporting syndromes of ill-defined somatic complaints. Between a period of 5 days to 11 months post return, 4 cases of P. ovale spp. were diagnosed using smear and polymerase chain reaction (PCR) following febrile complaints. All cases were subsequently treated with chloroquine and primaquine, with cure of clinical disease and documented clearance of parasitaemia. CONCLUSION: These patients represent the first imported cases in Peru of this species of malaria as well as highlight the challenges in implementing population level prophylaxis in a deployed environment, and the steps for timely diagnosis and management in a non-endemic region where risk of introduction for local transmission exists.


Assuntos
Doenças Transmissíveis Importadas/parasitologia , Malária/diagnóstico , Malária/epidemiologia , Plasmodium ovale/isolamento & purificação , Adulto , Antimaláricos/uso terapêutico , Combinação Arteméter e Lumefantrina/uso terapêutico , República Centro-Africana/epidemiologia , Doenças Transmissíveis Importadas/epidemiologia , Feminino , Humanos , Malária/tratamento farmacológico , Malária/prevenção & controle , Masculino , Pessoa de Meia-Idade , Militares/estatística & dados numéricos , Parasitemia/tratamento farmacológico , Peru , Plasmodium ovale/genética , Nações Unidas
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