RESUMO
BACKGROUND: Malaria control in remote, forested areas of the Mekong region relies on personal protection from mosquito bites. Uptake of these methods may be limited by knowledge of the link between mosquitoes and malaria as well as social and economic aspects. Understanding barriers to uptake will inform malaria control programmes on targets for improvement of delivery. METHODS: A total 748 key respondents: health providers and village heads, from 187 villages and 25 different ethnic groups, were interviewed using structured questionnaires. Differences in use of personal protection, and knowledge of malaria between groups were analysed using chi-square; and binary logistic regression used for multivariate analysis. RESULTS: Malaria knowledge was poor with 19.4% of women and 37.5% of men linking mosquitoes with malaria, although 95.6% knew one or more methods of mosquito control. Virtually all respondents used personal protection at some time during the year; and understanding of malaria transmission was strongly associated with bednet use. Those working in forest agriculture were significantly more likely to know that mosquitoes transmit malaria but this did not translate into a significantly greater likelihood of using bednets. Furthermore, use of personal protection while woing outdoors was rare, and less than 3% of respondents knew about the insecticide impregnation of bednets. The use of bednets, synthetic repellents and mosquito coils varied between ethnic groups, but was significantly more frequent among those with higher income, more years of education and permanent housing. The reported use of repellents and coils was also more common among women despite their low knowledge of malaria transmission, and low likelihood of having heard information on malaria within the last year. CONCLUSION: The use of personal protection must be increased, particularly among outdoor workers that have higher malaria risk. However, personal protection is widely used and widely accepted to prevent nuisance biting mosquitoes, with the major barrier to use being affordability. Therefore, social marketing campaigns aimed at women and those that work outdoors that provide highly subsidised products, especially insecticide impregnation kits for bednets and hammock nets are most likely to succeed in lowering malaria morbidity among non Han-Chinese groups in rural China.
Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Malária/prevenção & controle , Adulto , Roupas de Cama, Mesa e Banho/estatística & dados numéricos , China , Feminino , Humanos , Repelentes de Insetos , Entrevistas como Assunto , Modelos Logísticos , Malária/etnologia , Masculino , Pessoa de Meia-Idade , Grupos Minoritários , Roupa de Proteção/estatística & dados numéricos , População Rural , Inquéritos e QuestionáriosRESUMO
BACKGROUND: To achieve yaws eradication, the use of the new WHO strategy of initial mass treatment with azithromycin and surveillance twice a year needs to be extended everywhere the disease occurs. However, the geographic scope of the disease is unknown. We aimed to synthesise published and unpublished work to update the reported number of people with yaws at national and subnational levels and to estimate at-risk populations. METHODS: We searched PubMed and WHO databases to identify published data for prevalence of active and latent yaws from Jan 1, 1990, to Dec 31, 2014. We also searched for ongoing or recently completed unpublished studies from the WHO yaws surveillance network. We estimated yaws prevalence (and 95% CIs). We collected yaws incidence data from official national surveillance programmes at the first administrative level from Jan 1, 2010, to Dec 31, 2013, and we used total population data at the second administrative level to estimate the size of at-risk populations. FINDINGS: We identified 103 records, of which 23 published articles describing 27 studies and four unpublished studies met the inclusion criteria. Prevalence of active disease ranged from 0·31% to 14·54% in yaws-endemic areas, and prevalence of latent yaws ranged from 2·45% to 31·05%. During 2010-13, 256â343 yaws cases were reported to WHO from 13 endemic countries, all of which are low-income and middle-income countries. 215â308 (84%) of 256â343 cases reported to WHO were from three countries-Papua New Guinea, Solomon Islands, and Ghana. We estimated that, in 2012, over 89 million people were living in yaws-endemic districts. INTERPRETATION: Papua New Guinea, Solomon Islands, and Ghana should be the focus of initial efforts at implementing the WHO yaws eradication strategy. Community-based mapping and active surveillance must accompany the implementation of yaws eradication activities. FUNDING: None.
Assuntos
Países em Desenvolvimento , Doenças Endêmicas , Saúde Global , Bouba/epidemiologia , Gana/epidemiologia , Humanos , Renda , Melanesia/epidemiologia , Papua Nova GuinéRESUMO
Objective To investigate the relationship between programmed death 1 (PD-1) and programmed death ligand 1(PD-L1) with clinicopathological characteristics in the patients with laryngeal carcinoma.Methods The expression levels of PD-1 and PD-L1 in 45 samples of laryngeal carcinoma tissue(laryngeal carcinoma group) and 37 samples of vocal cord polyp tissues(polyp group) were detected by using the immunohistochemical method.Then the relationship between PD-1 and PD-L1 with clinicopathological characteristics in the patients with laryngeal carcinoma was analyzed.Results The positive expression rates of PD-1 and PD-L1 in the laryngeal carcinoma group were 57.78% and 66.67 % respectively.PD-1,PD-L1 mainly located in cytoplasm or cell membrane of laryngeal carcinoma cells or interstitial lymphocyte.The positive expression rates of PD-1 and PD-L1 in the polyp group were 8.11% and 13.51% respectively.The positive expression rates of PD-1 and PD-L1 in the laryngeal carcinoma group were significantly higher than those in the polyp group(P<0.01).The expression of PD-1 and PD-L1 in laryngeal carcinoma tissue had a correlation.The positive expression rates of PD-1 and PD-L1 in the laryngeal carcinoma tissue of stage Ⅲ and Ⅳ were significantly higher than those of stage Ⅰ and Ⅱ (P<0.05).The positive expression rates of PD-1 and PD-L1 in highly differentiated laryngeal carcinoma tissue were significantly higher than those in moderately and lowly differentiated carcinoma tissue(P<0.05).Conclusion PD-1 and PD-L1 play an important role in the occurrence and development of laryngeal carcinoma.The expression of PD-1 and PD-L1 is closely correlated to the clinical stage and differentiation degree of laryngeal carcinoma.
RESUMO
Objective To study the changes of hearing function and cochlear morphology on diffuse brain in-jury model in rat .Methods One hundred and fifty SD rats with normal hearing were randomly divided into five groups ,each group consisted of 30 SD rats ,including a control group and four experimental groups which endured diffuse brain injury(DBI) from one to four weeks .Diffuse brain injury model of rats were established ,then ABR , 40 Hz AERP and ASSR examination ,light microscopy ,electron microscopy were used to evaluate the change of hearing function and morphology .Results The difference of ABR ,40 Hz AERP and ASSR thresholds between the experimental and the normal control group were significant (P<0 .05) .The thresholds of ABR ,40HzAERP and AS-SR were increased in the first week of DBI ,then the threshold continuously increased in the second and third week , at last the threshold decreased in the fourth week .The results under scaning electron microscope demonstrated that the ciliums of the majority of outer hair cells lodged in the first week of DBI .The results under transmission electron microscope showed that in the first week of DBI ,there were edema and denuration of mitochondrial ,mitochondrial cristaes were obscured or disappeared .The changes were deteriorate in the second and third week ,whereas the changes were mitigatal in the fourth week .Conclusion Cochlear morphology and hearing damage were observed in diffuse brain injury model of rats .
RESUMO
Rho/Rho-kinase signaling pathway is a ubiquitous one in eukaryotic cells and plays a part in various biologic behaviors.Studies showed that it was expressed in pancreatic acinar,ductal and endocrine cells,as well as related to the pancreatic endocrine and exocrine functions.Moreover,the evidence showed that there was a close relationship the pathway and pancreatic cancer,pancreatitis,diabetes mellitus.
RESUMO
Objective To explore the effects of Zinc Protoporphyrin and Heme on the expression of HO-1 in cochlear and the change of auditory brainstem response on diffuse traumatic brain injury model of rats.Methods Diffuse traumatic brain injury model of rats were established and randomly divided into thirteen groups.Then auditory brainstem response examination,light microscope,immunohistochemistry technique were used to evaluate the change of auditory brainstem response and the expression of HO-1 in cochlear.Results The differences of auditory brainstem response threshold and latency of wave between the experimental and the normal control group were obvious(P<0.05).The expression of HO-1 in the control group was normal,whereas there were obvious changes of inner ear HO-1 expression in the traumatic groups.The grey value of HO-1 expression in trauma group,Znpp group and heme group was significantly associated with auditory function change(P<0.05).Conclusion There were influence of Zinc Protoporphyrin and Hemeon the inner ear HO-1 expression and the change of auditory brainstem response with diffuse traumatic brain injury model of rats.The protective effect of heme on auditory function may be associated with the increased expression of HO-1.
RESUMO
Objective To investigate the gene point mutation in the dihydrofolate reductase thymidylate synthase (dhfr) gene of Plasmodium falciparum isolate from Yunnan Province strongly associated with pyrimethamine and cycloguanil resistance. Methods Nested PCR and restriction endonuclease digestion were applied to detect the gene mutation using dried blood filter paper collected from the fields in Yunnan Province. Results Different mutations were found in 4 amino acids at positions 16, 51, 108 and 164 of dhfr gene, particularly, Asn 108 and Ile 51, the mutaiton frequency being 94.1% and 90.1%, respectively. The frequency of the wild type genotype (3D7 type) Ser 108 appeared lower ( 9.1%) , while the frequency of the Ala 16 was high( 61.8%); the mutation type was very high, the ratio of HB3 type, 7G8 type/FCR3 type and Cambodian type was 1∶21∶7.5. Conclusion The investigation first demonstrated that Plasmodium falciparum Yunnan isolate dihydrofolate reductase thymidylate synthase gene(dhfr) at positions 16, 51 ,108 and 164 exhibited different degrees of point mutation. The frequency of mutation of the 7D8 type involved in pyrimethamine resistance was higher, while that of the FCR3 type involved in cycloquanil resistance was lower.
RESUMO
Fourty-eight patients infected by Plasmodium vivax were randomly divided into chloroquine regimen groups A and B.Each case in group A received a total dosage of 1 200 mg(base) over a 3-day period(600 mg on the first day then 300 mg daily).Cases in group B each received total dosage of 1 500 mg(base) in 3 days(750 mg on the first day then 375 mg daily).Body temperature and blood smears were examined on days 0, 1, 2, 3, 7, 14, 21 and 28, respectively.All patients were negative for asexual parasites within 3 days.The cure rate on day 28 was 100%.Results showed that P.vivax is sensitive to chloroquine in Laza, Myanmar, and chloroquine can still be used for the imported vivax malaria cases at the China-Myanmar border.
RESUMO
Objective To investigate the failure of treatment with chloroquine in Yunnan in order to help formulate adequate antimalarial drug policy. Methods A World Health Organization 28-day in vivo test on therapeutic response for uncomplicated falciparum malaria in area with low or moderate transmission was adopted. Patients of age ≥ 6 months old were admitted without limitation in density of parasitaemia and body temperature. Clinical and parasitological observation was conducted for patients on day 0, 1, 2, 3, 4, 7, 14, 21, 28 and 35. Results Of 62 patients identified as malaria cases infected by Plasmodium falciparum only, Plasmodium vivax only or by both species, 52 cases infected by Plasmodium falciparum only were included in the study. The overall treatment failure rate was 40.7%, with early treatment failure (ETF) rate of 1.8% and late treatment failure rate (LTF) of 38.9%. Conclusion The treatment failure rate was much higher than the rate of 25% recommended by WHO. It is suggested that use of single chloroquine should be stopped in the treatment of falciparum malaria cases in such area. No relationship was found between the failure rate and the density of malaria parasites.
RESUMO
Objective To detect circumsporozoite protein (CSP) in anopheline vectors from south Yunnan and to evaluate ELISA in the detection. \ Methods\ Salivary glands of the anopheline mosquitoes were taken for finding sporozoites by microscopy and part of the glands was used for detecting CSP by ELISA. An. minimus was experimentally infected by blood from vivax malaria patient (with Plasmodium vivax) and examined for sporozoites and CSP. Eight species of anopheline mosquitoes were caught in the field and examined. Monoclonal antibodies to P.falciparum (Pf2A10) and P.vivax (Pv210, Pv247) were used in ELISA for detecting CSP. \ Results\ Sporozoites were found in the salivary glands of 27 out of 36 An. minimus experimentally infected (75^0%), 29 were ELISA CSP positives (80^6%), and 26 of the 27 mosquitoes showed Pv210 CSP positive. Among \{1 010\} parous anopheline mosquitoes from the field, 7 were found sporozoite positive (0^69%), 8 were ELISA CSP positive (0^79%), and 6 of the 7 mosquitoes showed CSP positive. Of \{4 675\} wild mosquitoes in 8 anopheline species with different ages, 11 were found CSP positive (0^24%) including An.minimus, An.sinensis and An.maculatus with a positive rate of 0^20%, 0^24% and 0^39% respectively.Among the 11 mosquitoes, 9 were Pv210 positive and 2 were Pf2A10 positive. Conclusion CSP detection by ELISA is a useful method to monitor the malaria transmission capacity of anopheline vectors.