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INTRODUCTION: Software to predict the impact of aging on physical appearance is increasingly popular. But it does not consider the complex interplay of factors that contribute to skin aging. OBJECTIVES: To predict the +15-year progression of clinical signs of skin aging by developing Causal Bayesian Belief Networks (CBBNs) using expert knowledge from dermatologists. MATERIAL AND METHODS: Structures and conditional probability distributions were elicited worldwide from dermatologists with experience of at least 15 years in aesthetics. CBBN models were built for all phototypes and for ages ranging from 18 to 65 years, focusing on wrinkles, pigmentary heterogeneity and facial ptosis. Models were also evaluated by a group of independent dermatologists ensuring the quality of prediction of the cumulative effects of extrinsic and intrinsic skin aging factors, especially the distribution of scores for clinical signs 15 years after the initial assessment. RESULTS: For easiness, only models on African skins are presented in this paper. The forehead wrinkle evolution model has been detailed. Specific atlas and extrinsic factors of facial aging were used for this skin type. But the prediction method has been validated for all phototypes, and for all clinical signs of facial aging. CONCLUSION: This method proposes a skin aging model that predicts the aging process for each clinical sign, considering endogenous and exogenous factors. It simulates aging curves according to lifestyle. It can be used as a preventive tool and could be coupled with a generative AI algorithm to visualize aging and, potentially, other skin conditions, using appropriate images.
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Envelhecimento da Pele , Humanos , Teorema de Bayes , Face , Envelhecimento , TestaRESUMO
BACKGROUND: In Western populations, a higher level of fruit consumption has been associated with a lower risk of cardiovascular disease, but little is known about such associations in China, where the consumption level is low and rates of stroke are high. METHODS: Between 2004 and 2008, we recruited 512,891 adults, 30 to 79 years of age, from 10 diverse localities in China. During 3.2 million person-years of follow-up, 5173 deaths from cardiovascular disease, 2551 incident major coronary events (fatal or nonfatal), 14,579 ischemic strokes, and 3523 intracerebral hemorrhages were recorded among the 451,665 participants who did not have a history of cardiovascular disease or antihypertensive treatments at baseline. Cox regression yielded adjusted hazard ratios relating fresh fruit consumption to disease rates. RESULTS: Overall, 18.0% of participants reported consuming fresh fruit daily. As compared with participants who never or rarely consumed fresh fruit (the "nonconsumption" category), those who ate fresh fruit daily had lower systolic blood pressure (by 4.0 mm Hg) and blood glucose levels (by 0.5 mmol per liter [9.0 mg per deciliter]) (P<0.001 for trend for both comparisons). The adjusted hazard ratios for daily consumption versus nonconsumption were 0.60 (95% confidence interval [CI], 0.54 to 0.67) for cardiovascular death, and 0.66 (95% CI, 0.58 to 0.75), 0.75 (95% CI, 0.72 to 0.79), and 0.64 (95% CI, 0.56 to 0.74), respectively, for incident major coronary events, ischemic stroke, and hemorrhagic stroke. There was a strong log-linear dose-response relationship between the incidence of each outcome and the amount of fresh fruit consumed. These associations were similar across the 10 study regions and in subgroups of participants defined by baseline characteristics. CONCLUSIONS: Among Chinese adults, a higher level of fruit consumption was associated with lower blood pressure and blood glucose levels and, largely independent of these and other dietary and nondietary factors, with significantly lower risks of major cardiovascular diseases. (Funded by the Wellcome Trust and others.).
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Glicemia/análise , Pressão Sanguínea , Doenças Cardiovasculares/epidemiologia , Dieta , Frutas , Adulto , Idoso , Índice de Massa Corporal , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/prevenção & controle , China/epidemiologia , Inquéritos sobre Dietas , Feminino , Seguimentos , Humanos , Hiperglicemia/epidemiologia , Hiperglicemia/prevenção & controle , Hipertensão/epidemiologia , Hipertensão/prevenção & controle , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Fatores de RiscoRESUMO
OBJECTIVE: Gallstone disease (GSD) is related to multiple cardiovascular risk factors; the present study was to prospectively examine the association between GSD and ischemic heart disease (IHD). APPROACH AND RESULTS: We examined the association of GSD with IHD among 199 292 men and 288 081 women aged 30-79 years in the China Kadoorie Biobank study. Participants with cancer, heart disease, and stroke at baseline were excluded. Cox proportional hazards regression model was used to estimate the association of GSD with IHD. The prevalence of self-reported GSD was 3.7% in men and 7.3% in women at baseline. During 3 431 124 person-years of follow-up between 2004 and 2013 (median, 7.2 years), we documented 10 245 incident IHD cases in men and 14 714 in women. As compared with men without GSD at baseline, the multivariate-adjusted hazard ratio for IHD was 1.11 (95% confidence interval, 1.02-1.22) for men with GSD; the respective hazard ratio was 1.27 (95% confidence interval, 1.20-1.34) in women and 1.23 (95% confidence interval, 1.17-1.28) in the whole cohort. The sex difference in IHD risk associated with GSD was statistically significant (P=0.009 for interaction with sex). In addition, we found that the association between GSD and IHD was stronger in nonhypertensive than in hypertensive women (P<0.001 for interaction). CONCLUSIONS: In this large prospective study, the presence of GSD was associated with an increased risk of incident IHD, independent of other risk factors of cardiovascular disease. Our findings suggest novel prevention strategy to mitigate heart disease through improvement of gastrointestinal health.
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Cálculos Biliares/diagnóstico , Cálculos Biliares/epidemiologia , Isquemia Miocárdica/diagnóstico , Isquemia Miocárdica/epidemiologia , Adulto , Distribuição por Idade , Idoso , China , Comorbidade , Intervalos de Confiança , Bases de Dados Factuais , Feminino , Cálculos Biliares/terapia , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Isquemia Miocárdica/terapia , Prevalência , Prognóstico , Modelos de Riscos Proporcionais , Estudos Prospectivos , Distribuição por Sexo , Análise de SobrevidaRESUMO
BACKGROUND: Hainan Province is one of the most severe endemic regions with high transmission of Plasmodium falciparum and Plasmodium vivax in China. However, the incidence of P. falciparum and P. vivax has dropped dramatically since 2007 and a national elimination malaria programme (NEMP) was launched after 2010. To better understand the genetic information on P. vivax population before elimination of malaria in Hainan Province, the extent of genetic diversity of P. vivax isolates in Hainan Province was investigated using four polymorphic genetic markers, including P. vivax merozoite surface proteins 1, 3α, and 3ß (pvmsp-1, pvmsp-3α, and pvmsp-3ß) and circumsporozoite protein (pvcsp). METHODS: Isolates of P. vivax (n = 27) from Hainan Province were collected from 2009 to 2010 and pvmsp-1 and pvcsp were analysed by DNA sequencing, respectively. Using polymerase chain reaction-restriction fragment length polymorphism were analysed in pvmsp-3α, and pvmsp-3ß. RESULTS: The DNA sequencing analysis on pvmsp1 revealed that there were three allele types: Salvador-1 (Sal-1), Belem and recombinant (R) types. Among them, Sal-1 type was a dominant strain with eight variant subtypes (88.9%), whereas R- (3.7%) and Belem-type strains (7.4%) had one variant subtypes, respectively. All the isolates carried pvcsp with VK210 type accounting for 85.2% (23/27 isolates) and VK247 type accounting for 14.8% (4/27). Only type A and type B alleles were successfully amplified in pvmsp-3α gene, and a high level of polymorphism was observed in pvmsp-3α. Considering pvmsp-3ß gene, type A was the predominant type in 17 isolates (63%), whereas type B was dominant in only ten isolates (37%). CONCLUSION: The present data indicate that there was high degree of genetic diversity among P. vivax population in Hainan Province of China during the pre-elimination stage of malaria, with 26 unique haplotypes observed among 27 samples.
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Variação Genética , Malária Vivax/parasitologia , Plasmodium vivax/genética , Antígenos de Protozoários/genética , China , Erradicação de Doenças , Humanos , Malária Vivax/prevenção & controle , Proteína 1 de Superfície de Merozoito/genética , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de Restrição , Proteínas de Protozoários/genéticaRESUMO
Pyronaridine and artesunate have been shown to be effective in falciparum malaria treatment. However, pyronaridine is rarely used in Hainan Island clinically, and artesunate is not widely used as a therapeutic agent. Instead, conventional antimalarial drugs, chloroquine and piperaquine, are used, explaining the emergence of chloroquine-resistant Plasmodium falciparum. In this article, we investigated the sensitivity of P. falciparum to antimalarial drugs used in Hainan Island for rational drug therapy. We performed in vivo (28 days) and in vitro tests to determine the sensitivity of P. falciparum to antimalarial drugs. Total 46 patients with falciparum malaria were treated with dihydroartemisinin/piperaquine phosphate (DUO-COTECXIN) and followed up for 28 day. The cure rate was 97.8%. The mean fever clearance time (22.5 ± 10.6 hr) and the mean parasite clearance time (27.3 ± 12.2 hr) showed no statistical significance with different genders, ages, temperatures, or parasite density (P > 0.05). The resistance rates of chloroquine, piperaquine, pyronarididine, and artesunate detected in vitro were 71.9%, 40.6%, 12.5%, and 0%, respectively (P < 0.0001). The resistance intensities decreased as follows: chloroquine > piperaquine > pyronarididine > artesunate. The inhibitory dose 50 (IC50) was 3.77 × 10(-6) mol/L, 2.09 × 10(-6) mol/L, 0.09 × 10(-6) mol/L, and 0.05 × 10(-6) mol/L, and the mean concentrations for complete inhibition (CIMC) of schizont formation were 5.60 × 10(-6) mol/L, 9.26 × 10(-6) mol/L, 0.55 × 10(-6) mol/L, and 0.07 × 10(-6) mol/L, respectively. Dihydroartemisinin showed a strong therapeutic effect against falciparum malaria with a low toxicity.
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Antimaláricos/farmacologia , Antimaláricos/uso terapêutico , Malária Falciparum/tratamento farmacológico , Plasmodium falciparum/efeitos dos fármacos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , China , Feminino , Humanos , Concentração Inibidora 50 , Malária Falciparum/parasitologia , Masculino , Pessoa de Meia-Idade , Testes de Sensibilidade Parasitária , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND: Historically, the incidence of malaria in the Hainan Province, China has been high. However, since 2001 the malaria incidence in Hainan has decreased due to large-scale, public educational, promotional campaigns and the adoption of preventative measures against malaria following the fast growth of socio-economic development. The present study analysed the correlation between prevention measures and social economic development on the incidence of malaria in Hainan from 2001 to 2013. METHODS: The data of malaria preventative measures and socio-economic development were collected from various cities and counties in Hainan Province from 2001 to 2013 and analysed by the grey correlation analysis system. RESULTS: Seasonal preventive medication and local fiscal revenue increases are significantly related to the reduction of malaria incidence from 2001 to 2013 (R1 = 0.751677; R5 = 0.764795). CONCLUSION: Malaria prevention and control measures and local economic development in Hainan decreased malaria incidence from 2001 to 2013.
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Malária/economia , Malária/prevenção & controle , China/epidemiologia , Desenvolvimento Econômico , Humanos , Incidência , Malária/epidemiologia , Controle de Mosquitos/economia , Fatores SocioeconômicosRESUMO
BACKGROUND: Although the numbers of malaria cases in China have been declining in recent years, outbreaks of Plasmodium vivax malaria were still being reported in rural areas south of the Yellow River. To better understand the transmission dynamics of P. vivax parasites in China, the extent of genetic diversity of P. vivax populations circulating in Bozhou of Anhui province of China were investigated using three polymorphic genetic markers: merozoite surface proteins 1 and 3α (pvmsp-1 and pvmsp-3α) and circumsporozoite protein (pvcsp). METHODS: Forty-five P. vivax clinical isolates from Bouzhou of Anhui province were collected from 2009 to 2010 and were analysed using PCR/RFLP or DNA sequencing. RESULTS: Seven and six distinct allelic variants were identified using PCR/RFLP analysis of pvmsp-3α with HhaI and AluI, respectively. DNA sequence analysis of pvmsp-1 (variable block 5) revealed that there were Sal-I and recombinant types but not Belem type, and seven distinct allelic variants in pvmsp-1 were detected, with recombinant subtype 2 (R2) being predominant (66.7%). All the isolates carried pvcsp with VK210 type but not VK247 or P. vivax-like types in the samples. Sequence analysis of pvcsp gene revealed 12 distinct allelic variants, with VK210-1 being predominant (41.5%). CONCLUSIONS: The present data indicate that there is some degree of genetic diversity among P. vivax populations in Anhui province of China. The genetic data obtained may assist in the surveillance of P. vivax infection in endemic areas or in tracking potential future disease outbreak.
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Malária Vivax/epidemiologia , Plasmodium vivax/genética , Polimorfismo Genético , Alelos , Sequência de Aminoácidos , Antígenos de Protozoários/genética , Antígenos de Protozoários/metabolismo , China/epidemiologia , Marcadores Genéticos , Humanos , Malária Vivax/parasitologia , Proteína 1 de Superfície de Merozoito/genética , Proteína 1 de Superfície de Merozoito/metabolismo , Dados de Sequência Molecular , Filogenia , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de Restrição , Proteínas de Protozoários/genética , Proteínas de Protozoários/metabolismo , Alinhamento de SequênciaRESUMO
BACKGROUND: In the island of Hainan, the great majority of malaria cases occur in mountain worker populations. Using the behavioral change communication (BCC) strategy, an interventional study was conducted to promote mountain worker malaria prevention at a test site. This study found the methods and measures that are suitable for malaria prevention among mountain worker populations. METHODS: During the Plasmodium falciparum elimination stage in Hainan, a representative sampling method was used to establish testing and control sites in areas of Hainan that were both affected by malaria and had a relatively high density of mountain workers. Two different methods were used: a BCC strategy and a conventional strategy as a control. Before and after the intervention, house visits, core group discussions, and structural surveys were utilized to collect qualitative and quantitative data regarding mountain worker populations (including knowledge, attitudes, and practices [KAPs]; infection status; and serological data), and these data from the testing and control areas were compared to evaluate the effectiveness of BCC strategies in the prevention of malaria. RESULTS: In the BCC malaria prevention strategy testing areas, the accuracy rates of malaria-related KAP were significantly improved among mountain worker populations. The accuracy rates in the 3 aspects of malaria-related KAP increased from 37.73%, 37.00%, and 43.04% to 89.01%, 91.53%, and 92.25%, respectively. The changes in all 3 aspects of KAP were statistically significant (p < 0.01). In the control sites, the changes in the indices were not as marked as in the testing areas, and the change was not statistically significant (p > 0.05). Furthermore, in the testing areas, both the percentage testing positive in the serum malaria indirect fluorescent antibody test (IFAT) and the number of people inflicted decreased more significantly than in the control sites (p < 0.01). CONCLUSION: The use of the BCC strategy significantly improved the ability of mountain workers in Hainan to avoid malarial infection. Educational and promotional materials and measures were developed and selected in the process, and hands-on experience was gained that will help achieve the goal of total malaria elimination in Hainan.
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Doenças dos Trabalhadores Agrícolas/prevenção & controle , Doenças Endêmicas/prevenção & controle , Comportamentos Relacionados com a Saúde , Promoção da Saúde/métodos , Malária Falciparum/prevenção & controle , Controle de Mosquitos/métodos , Doenças dos Trabalhadores Agrícolas/diagnóstico , Doenças dos Trabalhadores Agrícolas/epidemiologia , Doenças dos Trabalhadores Agrícolas/parasitologia , Animais , Anopheles/parasitologia , Antígenos de Protozoários/sangue , Antimaláricos/administração & dosagem , Antimaláricos/uso terapêutico , China/epidemiologia , Vestuário , Discos Compactos , Técnica Indireta de Fluorescência para Anticorpo , Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Insetos Vetores/parasitologia , Mosquiteiros Tratados com Inseticida , Inseticidas , Internet , Ilhas , Malária Falciparum/diagnóstico , Malária Falciparum/epidemiologia , Malária Falciparum/transmissão , Exposição Ocupacional , Plasmodium falciparum/imunologia , Prevalência , População Rural , Materiais de EnsinoRESUMO
Anopheles sinensis adults were collected by cow-baited trap in Haikou City, Sanya City, Lingshui County, Changjiang County and Qiongzhong County of Hainan Province during 2011-2013. The mosquitoes were exposed to insecticide impregnated papers with discriminating concentrations of DDT (4%), deltamethrin (0.05%), and malathion (5%) using WHO standard assays. Knockdown rate was recorded at 10, 15, 20, 30, 40, 50, and 60 min, and KT50 values were calculated. Mortality was recorded after 24 hours of exposure. The resistance level was graded as sensitive group (S) with a mortality rate of 98%-100%, preliminary resistance group (M) with mortality rate of 80%-97%, and resistance group (R) with mortality rate of lower than 80%. The results showed that the mortality rate of An. sinensis in Qiongzhong County in 24 h-post-exposure to 0.05% deltamethrin was 95.0% with a resistance degree of M. That to 0.05% deltamethrin in the other 4 sites was 17.0%-63.0%, all with a resistance degree of R. That to 4% DDT in Haikou, Sanya, Lingshui, Qiongzhong and Changjiang was 36.0%, 27.0%, 24.0%, 59.1%, and 82.0%, with a resistance level of R, R, R, R, and M, respectively. That to 5% malathion in Haikou, Sanya, and Lingshui was 16.0%-41.0%, all with a resistance degree of R, while that to malathion in Qiongzhong and Changjiang was 100% and 98.0%, respectively, with a resistance level of S.
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Anopheles/efeitos dos fármacos , Resistência a Inseticidas , Inseticidas/farmacologia , Animais , Bovinos , China , Controle de Mosquitos , Nitrilas , PiretrinasRESUMO
In contrast to the gradual reduction in the number of locally transmitted malaria cases in China, the number of imported malaria cases has been increasing since 2008. Here, we report a case of a 39-year-old Chinese man who acquired Plasmodium ovale wallikeri infection while staying in Ghana, West Africa for 6 months in 2012. Microscopic examinations of Giemsa-stained thin and thick blood smears indicated Plasmodium vivax infection. However, the results of rapid diagnostic tests, which were conducted 3 times, were not in agreement with P. vivax. To further check the diagnosis, standard PCR analysis of the small-subunit rRNA gene was conducted, based on which a phylogeny tree was constructed. The results of gene sequencing indicated that this malaria is a variant of P. ovale (P. ovale wallikeri). The infection in this patient was not a new infection, but a relapse of the infection from the one that he had contracted in West Africa.
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Malária/diagnóstico , Plasmodium ovale/classificação , Adulto , Corantes Azur , Sequência de Bases , China , DNA de Protozoário/química , DNA de Protozoário/genética , DNA Ribossômico/química , DNA Ribossômico/genética , Gana , Humanos , Malária/parasitologia , Masculino , Dados de Sequência Molecular , Filogenia , Plasmodium ovale/genética , Plasmodium ovale/isolamento & purificação , Reação em Cadeia da Polimerase , Recidiva , Análise de Sequência de DNA , ViagemRESUMO
Malaria was endemic in Hainan Island, China, for a lengthy period before its elimination. Here, we aim to gain a better understanding of malaria elimination by assessing and quantifying the relative effects of longitudinal changes in specific antimalarial interventions, socioeconomic development approaches, and malaria vectors on malaria prevalence in Hainan during the 1986-2009 pre-elimination period. Annual data were collected on the incidence of malaria, the number of residents protected by drugs (RPD), the number of residents protected by vector control, the presence of Anopheles minimus and Anopheles dirus, the annual per capita income of rural residents, major cash crop (rubber plantation) areas, the literacy rate of adult rural residents, and the rate of reinforced concrete house construction in rural areas. Backward stepwise multiple linear regression models were developed to identify the factors associated with the annual malaria incidence (AMI). The AMI declined from 20.3 to 0.8 per 10,000 population from 1986 to 2009; this decrease was significantly associated with an increase in the number of RPD and improved literacy rate among rural adults. The results of this study implied that the sustained distribution of antimalarial drugs and increase in education levels in risk areas significantly impacted the reduction and elimination of malaria infection in Hainan. We suggest that these findings could be applicable to malaria-endemic areas in Southeast Asia with similar natural and socioeconomic environments to Hainan and where malaria incidence has decreased to a low level.
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Antimaláricos , Malária , Animais , Adulto , Humanos , Mosquitos Vetores , Malária/epidemiologia , Malária/prevenção & controle , Antimaláricos/uso terapêutico , China/epidemiologiaRESUMO
Circular extrachromosomal DNA (ecDNA) in patient tumors is an important driver of oncogenic gene expression, evolution of drug resistance and poor patient outcomes. Applying computational methods for the detection and reconstruction of ecDNA across a retrospective cohort of 481 medulloblastoma tumors from 465 patients, we identify circular ecDNA in 82 patients (18%). Patients with ecDNA-positive medulloblastoma were more than twice as likely to relapse and three times as likely to die within 5 years of diagnosis. A subset of tumors harbored multiple ecDNA lineages, each containing distinct amplified oncogenes. Multimodal sequencing, imaging and CRISPR inhibition experiments in medulloblastoma models reveal intratumoral heterogeneity of ecDNA copy number per cell and frequent putative 'enhancer rewiring' events on ecDNA. This study reveals the frequency and diversity of ecDNA in medulloblastoma, stratified into molecular subgroups, and suggests copy number heterogeneity and enhancer rewiring as oncogenic features of ecDNA.
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Neoplasias Cerebelares , Meduloblastoma , Neoplasias , Humanos , DNA Circular , Meduloblastoma/genética , Estudos Retrospectivos , Neoplasias/genética , Oncogenes , Neoplasias Cerebelares/genéticaRESUMO
Hainan Province is in a tropical area of China and previously experienced serious P. falciparum and P. vivax malaria epidemics. After nearly 70 consecutive years of malaria prevention and control, malaria in Hainan has gradually been eliminated. To achieve the elimination of malaria, Hainan enacted six stages: investigative research and pilot prevention and control, large-scale antimalaria measures, adjustment of strategies for prevention and control, joint prevention and control measures, global funding of routine malaria control, and malaria elimination. Different strategies for malaria control were adopted at different stages. Malaria was most prevalent in the mountainous areas of central and southern Hainan, which contain a high-risk population (the forest goers) and two highly effective malaria vectors (An. dirus and An. minimus). Forest goers have been a high-risk population for malaria in Hainan since their identification in the 1990s. This paper summarizes malaria monitoring in forest goers and the response of forest goers to malaria control and elimination, distilling specific malaria control and elimination measures via case studies in Hainan Province. Two case studies in the malaria control stage demonstrated different measures for outbreaks and sporadic cases in forest goers. In view of the malaria outbreak in Sanya during the elimination stage, three-layered strategies (TLSs) were implemented to control outbreaks and improve control measures. Moreover, this paper also illustrates specific management measures to prevent malaria retransmission from sporadic imported malaria cases during the elimination phase. Hainan finally eliminated malaria in 2020. However, the risk of malaria retransmission is still high due to the prevalence of effective malaria vectors in Hainan, and forest goers are still a high-risk population for malaria retransmission.
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Malária , China/epidemiologia , Florestas , Humanos , Malária/epidemiologia , Malária/prevenção & controle , Prevalência , Fatores de RiscoRESUMO
Five survey sites were selected from Hainan Province and one village were randomly extracted in each site. A survey that covered knowledge and risk factor on angiostrongyliasis cantonensis was conducted and infection rate of Angiostrongylus cantonensis tested by ELISA. Among 393 sampled people, the sero-positive IgG rate was 20.6% and about 39.7% residents were found with a history of eating snails in recent half year, 12.5% from respondents had the habit of eating raw snails. Questionnairing showed that the ratio of awareness on A. cantonensis was 8.4%. All factors were analyzed by multi-logistic module and showed that the history of snail-eating and resident area may be the risk factors.
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Infecções por Strongylida/sangue , Infecções por Strongylida/epidemiologia , Infecções por Strongylida/prevenção & controle , Adolescente , Adulto , Distribuição por Idade , Angiostrongylus cantonensis , Animais , Criança , Pré-Escolar , China/epidemiologia , Feminino , Parasitologia de Alimentos , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Testes Sorológicos , Distribuição por Sexo , Caramujos/parasitologia , Adulto JovemRESUMO
OBJECTIVE: To determine the resistance of malaria vectors to four kinds of common insecticides in some endemic areas of Hainan Province. METHODS: Anopheline mosquitoes were collected between 2008 and 2010 from malaria endemic areas where insecticides were used for years. Anopheles dirus were collected from human-baited trap in Wangxia Town of Changjiang County. An. minimus and An. sinensis were collected by cow-baited trap in Jiangbian Town of Dongfang City. F0 generation female An. sinensis, F1 generation of female An. dirus and An. minimus were selected and exposed to insecticide impregnated papers with discriminating concentrations of DDT (4%), deltamethrin (0.05%), cyfluthrin (0.15%), and malathion (5%) using WHO standard assays. Knockdown rate was recorded at 10, 15, 20, 30, 40, 50, and 60 min, and KTm values were calculated. Mortality was recorded after 24 hours of exposure. RESULTS: Mortality in An. dirus was 100% to DDT, deltamethrin and malathion. Knockdown rate of An. dirus exposed to DDT and deltamethrin was 82.0% and 100%, with a KT50 value of 46.9 and 18.4 min, respectively. Mortality of An. minimus to DDT, deltamethrin, cyfluthrin and malathion was 98.1%, 99.0%, 100%, and 100%, respectively. The knockdown rate of An. minimus to DDT, deltamethrin, and cyfluthrin was 96.3%, 99.0%, and 100%, respectively, and the KTs value was 31.3, 16.8, and 7.4 min, respectively. Mortality of An. sinensis to DDT, deltamethrin, and malathion was 19.8%, 22.9%, and 43.8%, respectively. Knockdown rate of An. sinensis to DDT and deltamethrin was 2.0%, the KT50 can not be calculated. CONCLUSION: An. dirus and An. minimus, the main malaria vectors in the survey sites of Hainan Province, are susceptible to the four insecticides, while secondary malaria vector An. sinensis showed resistance to DDT, deltamethrin, and malathion.
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Anopheles/efeitos dos fármacos , Resistência a Inseticidas/efeitos dos fármacos , Inseticidas/farmacologia , Animais , Anopheles/classificação , China/epidemiologia , Feminino , Inseticidas/classificação , Malária/epidemiologia , Controle de MosquitosRESUMO
BACKGROUND: Hainan is one of the provinces most severely affected by malaria epidemics in China. The distribution pattern and major determinant climate factors of malaria in this region have remained obscure, making it difficult to target countermeasures for malaria surveillance and control. This study detected the spatiotemporal distribution of malaria and explored the association between malaria epidemics and climate factors in Hainan. METHODS: The cumulative and annual malaria incidences of each county were calculated and mapped from 1995 to 2008 to show the spatial distribution of malaria in Hainan. The annual and monthly cumulative malaria incidences of the province between 1995 and 2008 were calculated and plotted to observe the annual and seasonal fluctuation. The Cochran-Armitage trend test was employed to explore the temporal trends in the annual malaria incidences. Cross correlation and autocorrelation analyses were performed to detect the lagged effect of climate factors on malaria transmission and the auto correlation of malaria incidence. A multivariate time series analysis was conducted to construct a model of climate factors to explore the association between malaria epidemics and climate factors. RESULTS: The highest malaria incidences were mainly distributed in the central-south counties of the province. A fluctuating but distinctly declining temporal trend of annual malaria incidences was identified (Cochran-Armitage trend test Z = -25.14, P < 0.05). The peak incidence period was May to October when nearly 70% of annual malaria cases were reported. The mean temperature of the previous month, of the previous two months and the number of cases during the previous month were included in the model. The model effectively explained the association between malaria epidemics and climate factors (F = 85.06, P < 0.05, adjusted R(2) = 0.81). The autocorrelations of the fitting residuals were not significant (P > 0.05), indicating that the model extracted information sufficiently. There was no significant difference between the monthly predicted value and the actual value (t = -1.91, P = 0.08). The R(2) for predicting was 0.70, and the autocorrelations of the predictive residuals were not significant (P > 0.05), indicating that the model had a good predictive ability. DISCUSSION: Public health resource allocations should focus on the areas and months with the highest malaria risk in Hainan. Malaria epidemics can be accurately predicted by monitoring the fluctuations of the mean temperature of the previous month and of the previous two months in the area. Therefore, targeted countermeasures can be taken ahead of time, which will make malaria surveillance and control in Hainan more effective and simpler. This model was constructed using relatively long-term data and had a good fit and predictive validity, making the results more reliable than the previous report. CONCLUSIONS: The spatiotemporal distribution of malaria in Hainan varied in different areas and during different years. The monthly trends in the malaria epidemics in Hainan could be predicted effectively by using the multivariate time series model. This model will make malaria surveillance simpler and the control of malaria more targeted in Hainan.
Assuntos
Clima , Surtos de Doenças , Malária/epidemiologia , China/epidemiologia , Demografia , Geografia , Humanos , Incidência , Malária/prevenção & controle , Malária/transmissão , Modelos Estatísticos , Temperatura , Fatores de TempoRESUMO
The epidemiology of soil-transmitted intestinal nematodes were observed in the central mountain area without anti-helminthic therapy from 1986 to 2008. The results showed that the overall prevalence decreased from 96.4% in 1986 to 35.7% in 2008. The prevalence of Ancylostoma duodenale, Ascaris lumbricoides and Trichuris trichiura decreased from 84.7%. 80.9%, 31.8% in 1986 to 32.5%, 0.3%, 4.2% in 2008, respectively. The proportion of light infection with Ancylostoma duodenale, Ascaris lumbricoides and Trichuris trichiura increased from 56.6%, 41.2%, and 66.9% in 1986 to 97.9%, 100%, and 83.7% in 2008, respectively. While that of heavy infection decreased from 6.8%, 11.9%, and 3.8% in 1986 all to zero in 2008. Water and toilet renovation, rural income increase and the improvement of sanitation and living conditions made the prevalence of soil-transmitted intestinal nematode decreased.
Assuntos
Infecções por Nematoides/epidemiologia , Infecções por Nematoides/parasitologia , Solo/parasitologia , Animais , China/epidemiologia , Humanos , Infecções por Nematoides/transmissão , PrevalênciaRESUMO
OBJECTIVES: In this study, we investigated the effects of intense pulsed light (IPL) combined with 30% supramolecular salicylic acid on facial seborrheic dermatitis. METHODS: A total of 45 patients with mild or moderate facial seborrheic dermatitis were selected from our hospital between September 2018 and September 2019. The patients were divided into three groups consisting of 15 patients each. The first group was exposed to a combination of IPL and 30% supramolecular salicylic acid treatment, the second group was exposed to the IPL treatment alone, and the third group was exposed to the 30% supramolecular salicylic acid treatment alone. They were treated once every 4 weeks in three consecutive rounds. RESULTS: Facial lesions and symptoms were observed 4 and 12 weeks after the first treatment, and adverse reactions were recorded. The combination group showed significant improvement in symptoms 4 weeks after the first treatment, while the individual treatment groups showed no significant improvement. After three rounds of treatments, seborrheic dermatitis had significantly decreased in the three groups; the efficacy of the combined treatment group was significantly higher than that of the IPL group and the 30% supramolecular salicylic acid group. CONCLUSION: IPL combined with 30% supramolecular salicylic acid was effective in the treatment of facial seborrheic dermatitis and provided a quicker result with no adverse reactions.
Assuntos
Dermatite Seborreica , Terapia Combinada , Dermatite Seborreica/tratamento farmacológico , Humanos , Ácido Salicílico/uso terapêutico , Resultado do TratamentoRESUMO
Hainan is a single bancroftian filariasis endemic province where filariasis is prevalent in all 18 cities and counties. A program to control filariasis was started in 1953. The strategy of eliminating infection sources has been adopted as the principal intervention measure in filariasis control. Over 30 years, the sustained effort throughout the province reached the point of basic elimination of filariasis in 1987. After the basic elimination of filariasis, the patterns of filariasis transmission in residual microfilaremia cases in Hainan Province were studied so as to provide a scientific basis for formulating strategies to eliminate filariasis. According to the "Technical scheme for surveillance in areas where fialariasis has been basically eliminated" issued by the Ministry of Health, a longitudinal and cross-sectional and entomological surveillance of fialariasis was carried out using parasitological and entomological and serological methods in the whole province during 1983-2004. In the cross-sectional and entomological surveillances, the last microfilaremia case was found in 1999, no mosquitoes were found to be infected with filarial larvae. A total of 132 microfilaremia cases found in the longitudinal surveillance become negative by 10 years. Since 1997 no mosquitoes were found to be infected with filarial larvae in the longitudinal surveillance. Serological surveillance of the population showed the mean positive rate of IFAT dropped from 10.63% in 1990 to 0.28% in 2000, which being similar to that of nonendemic areas. The results show that residual sources of infection after basic elimination of filariasis were tending to be naturally eliminated and transmission of filariasis has been interrupted in Hainan Province.
Assuntos
Filariose/prevenção & controle , Vigilância da População/métodos , China/epidemiologia , Estudos Transversais , Filariose/diagnóstico , Filariose/tratamento farmacológico , Filariose/epidemiologia , Filariose/transmissão , Humanos , Estudos LongitudinaisRESUMO
OBJECTIVE: To further evaluate the efficacy and safety of tribendimidine in treatment of adult patients with intestinal nematode infections. METHODS: An open and multi-center clinical trial was conducted in the provinces of Hainan, Sichuan and Guizhou. A total of 1,292 infected cases aged 15-70 years were enrolled in the study. Modified Kato-Katz method was used to diagnose the cases with intestinal nematode infections and assess the efficacy 3-4 weeks post treatment. Patients with Ascaris lumbricoides infection were treated orally with tribendimidine enteric coated tablets at a single dose of 300 mg, while in the patients with Ancylostoma duodenale, mixed A. duodenale and A. lumbricoides, or with other helminth infections, a single dose of 400 mg was administered. RESULTS: The cure rate and effective rate of the patients with Ancylostoma infection were 88.4% (1,009/1,141) and 99.1% (1,131/1,141), respectively, while in patients with A. lumbricoides infection, they were 95.0% (419/441) and 99.8% (440/441), respectively. The cure rate of tribendimidine enteric coated tablet given to patients with Trichuris trichiura infection at a single dose of 400 mg was 76.8% (109/142). The adverse effect induced by tribendimidine was light and transient with a rate of 3.3% (42/1,292). No apparent impact was seen on blood and urine routine examinations, hepatic and renal functions as well as ECG examination. CONCLUSION: It is further confirmed that under the used dosage for expanding treatment in larger sample of patients with various ages and infected with Ancylostoma duodenale, A. lumbricoides and other helminths, tribendimidine enteric coated tablet is safe with satisfactory efficacy.