[Prevalence of Overweight and Obesity in Adult Populations in Mianyang,Sichuan Province].

OBJECTIVE: To determine the prevalence of overweight and obesity in adult populations in Mianyang,Sichuan province. METHODS: A questionnaire survey involving physical examinations were conducted in 262 434 adults (≥18 yr.) selected through multi-stage random sampling from November 2014 to September 2015 in Mianyang city. RESULTS: Among the people surveyed,79 981 (30.48%) were overweight,and 23 010 (8.77%) had obesity. The male participants had a higher percentage (32.28%) of overweight than females (29.10%, P<0.01),but lower obesity rate (8.53%) than females (8.95%, P<0.01). Those aged 50-59 yr. had the highest prevalence of overweight (39.26%) and obesity (12.07%). The participants with up to junior middle school education were most likely to be overweight (35.02%) and obese (10.57%). Overweight and obesity were most prevalent in the unemployed: 36.87% and 12.65%,respectively. Fucheng had higher prevalence of overweight (30.01%) and obesity (10.14%) than Jiangyou (29.97% and 7.46% respectively,all P<0.01). The prevalence of overweight and obesity was higher in the smokers (32.88% and 9.46%) than in the non-smokers (30.02% and 8.64%,all P<0.01). Those who drank alcohols had higher prevalence of overweight and obesity (33.43% and 9.72%) than those who did not drink alcohols (29.78% and 8.54% respectively,all P<0.01). CONCLUSION: High prevalence of overweight and obesity in adult populations in Mianyang is evident,especially in those who are 50-59 years old,unemployed,drinking alcohols,smoking,and have low educational level.

Regional and epidemiological characteristics of tuberculosis and treatment outcomes in West China.

Objective: To understand the prevalence and treatment outcome of tuberculosis in a typically regional County from 2016 to 2021, so as to provide reference and basis for the prevention and treatment of tuberculosis in this area. Methods: Descriptive epidemiological methods were used to analyze the population, time and location distribution of pulmonary tuberculosis in Dazhu County from 2016 to 2021. The incidence rates were compared by Chi-square test and trend test, time distribution combined with seasonal index analysis, and the test level was α = 0.05. Results: A total of 2,899 cases of pulmonary tuberculosis were reported in Dazhu County from 2016 to 2021, with an average annual incidence rate of 44.29/100,000 and standardized reported incidence rate was 36.77/100,000, showing a downward trend year by year (χ2 trend = 124.629, p < 0.001). A total of 955 cases of pathogen positive were reported, showing an increasing trend year by year (χ2 trend = 59.773, p < 0.001). In terms of time distribution, the incidence rate was high in autumn and winter, and September and December were the peak of the disease in the whole year, and the overall trend increased first, then decreased and once again increased (F = 5.861, p < 0.05). In regional distribution, the highest annual average reported incidence rate was in concentrated population. The incidence rate of male was higher than female in population distribution. After standardization, the overall incidence rate increased from 34 to 45 years old (χ2 trend = 6963.101, p < 0.001), and decreased after 45 years old (χ2 trend = 1104.393, p < 0.001). The occupation distribution is mainly farmers (82.75%). The overall arrival rate and cure rate of patients showed an upward trend year by year (χ2 trend = 4.306, χ2 trend = 5.772, p < 0.001). Conclusion: The incidence rate of pulmonary tuberculosis in this regional county is decreasing year by year. Male patients are higher than female patients and have certain seasonal characteristics. Attention should be paid to male, older adult, farmers and other groups, and corresponding measures should be taken to strengthen the prevention and treatment of tuberculosis in high incidence areas.

[Prevalence of mountain-zoonotic type visceral leishmaniasis in Yangquan City of Shanxi Province from 2015 to 2020].

OBJECTIVE: To investigate the prevalence of mountain-type zoonotic visceral leishmaniasis (MT-ZVL) in Yangquan City, Shanxi Province from 2015 to 2020, so as to provide the scientific evidence for formulating the MT-ZVL control strategy. METHODS: The epidemiological data pertaining to MT-ZVL cases in Yangquan City from 2015 to 2020 were collected and descriptively analyzed. A Joinpoint regression model was created to analyze the trend in the MT-ZVL incidence in Yangquan City from 2015 to 2020 using annual percent change (APC). The sandflies surveillance data and the prevalence of Leishmania infections in dogs were collected in Yangquan City in 2020, and the regional distribution of sandflies density and sero-prevalence of Leishmania infections in dogs were calculated. In addition, the associations of sandflies density and sero-prevalence of Leishmania infections in dogs with the incidence of human MT-ZVL were examined using the linear correlation analysis. RESULTS: A total of 162 MT-ZVL cases were reported in Yangquan City, Shanxi Province from 2015 to 2020, with annual mean incidence of 1.9/105, and there were 4, 7, 16, 27, 33 cases and 75 cases with MT-ZVL reported from 2015 to 2020, appearing a tendency towards a rapid rise (APC = 72.79%, t = 11.10, P < 0.01). MT-ZVL cases were reported across the five counties (districts) of Yangquan City, and the cases predominantly occurred in Jiaoqu District (35.2%, 57/162) and Pingding County (33.3%, 54/162). MT-ZVL cases were predominantly detected in residents at ages of 15 years and older (71.6%, 116/162) and at ages of 0 to 2 years (22.2%, 36/162), with farmers (37.4%, 61/162) and diaspora children (24.5%, 40/162) as predominant occupations. The mean density of Phlebotomus chinensis was 6.3 sandflies per trap per night in Yangquan City from during the period from May to September, 2020, with the highest density observed in Jiaoqu District (12.6 sandflies per trap per night) and the lowest in Yuxian County (1.1 sandflies per trap per night), and there was a region-specific mean density of Ph. chinensis in Yangquan City (H = 17.282, P < 0.01). The sero-prevalence of serum anti-Leishmania antibody was 7.4% (2 996/40 573) in domestic dogs in Yangquan City, with the highest sero-prevalence seen in Jiaoqu District (16.6%, 1 444/8 677), and the lowest in Yuxian County (2.3%, 266/11 501), and there was a region-specific sero-prevalence rate of anti-Leishmania antibody in domestic dogs in Yangquan City (χ2 = 1 753.74, P < 0.01). The sero-prevalence of anti-Leishmania antibody was significantly higher in stray dogs (20.0%, 159/794) than in domestic dogs (χ2 = 176.63, P < 0.01). In addition, there were significant associations among the sandflies density, sero-prevalence of anti-Leishmania antibody in domestic dogs and the incidence of human MT-ZVL (r = 0.832 to 0.870, all P values < 0.05). CONCLUSIONS: The prevalence of MT-ZVL appeared a tendency towards a rapid rise in Yangquan City from 2015 to 2020, and systematic interventions are urgently needed for MT-ZVL control.

[Epidemiological features and diagnosis of malaria cases in Nantong City from 2015 to 2020].

OBJECTIVE: To investigate the epidemiological characteristics and diagnosis of malaria cases in Nantong City from 2015 to 2020, so as to provide insights into the prevention of re-establishment of imported malaria and consolidation of malaria elimination achievements in the city. METHODS: The epidemic data of malaria in Nantong City from 2015 to 2020 were captured from the National Notifiable Disease Report System, the Information Management System for Parasitic Disease Control and individual epidemiological survey reports of malaria cases. The malaria parasite species, source of infections, population distribution, temporal distribution, spatial distribution and diagnosis of imported malaria cases were descriptively and statistically analyzed. RESULTS: A total of 241 malaria cases were reported in Nantong City from 2015 to 2020, and all were overseas imported cases, including 191 cases with Plasmodium falciparum malaria (79.25%), 8 cases with P. vivax malaria (3.32%), 33 cases with P. ovale malaria (13.69%) and 9 cases with P. malaria malaria (3.73%). Overseas imported malaria cases acquired infections from 34 countries in Asia, Africa and Latin America, and 97.93% of the cases were infected in Africa, and 90.04% (217/241) were reported in Chongchuan District, Hai'an City and Haimen District. Imported malaria cases were aged from 20 to 68 years, and a median age of 45 (13) years, and 97.10% were male. The median duration between returning to China and malaria onset was 7 (9) days among all imported malaria cases, and the median duration from initial diagnosis to definitive diagnosis was 2 (2) days. There were 167 cases that were initially diagnosed as malaria, with a correct rate of 69.29%, and 53.53 (129/241) of malaria cases were diagnosed at city-level medical institutions and 41.49% (100/241) at county-level medical institutions. In addition, the proportion of malaria cases reported by city-level medical institutions increased from 39.62% in 2015 to 81.25% in 2020 (χ2 = 6.94, P < 0.01). CONCLUSIONS: The accuracy of initial malaria diagnosis requires to be improved in Nantong City. Malaria control knowledge should be specially given to migrant workers to shorten the duration of seeking medical care, and malaria training requires to be intensified among healthcare professionals to improve the diagnostic capability of imported malaria cases and the cure of severe P. falciparum malaria cases.

[Epidemiological characteristics and diagnosis of imported malaria cases in Zhejiang Province from 2017 to 2020].

OBJECTIVE: To analyze the epidemiological features and diagnosis of imported malaria cases in Zhejiang Province from 2017 to 2020, so as to provide the scientific evidence for the management of imported malaria in the province. METHODS: The data of malaria cases reported in Zhejiang Province were captured from the Information Management System for Parasitic Disease Control of China Information System for Disease Control and Prevention from 2017 to 2020, and the temporal, spatial and human distribution, and initial and definitive diagnosis of imported malaria cases were descriptively analyzed. RESULTS: A total of 593 malaria cases were reported in Zhejiang Province from 2017 to 2020, and all were overseas imported cases, including 532 men and 61 women, with a mean age of 41 years. There were 93.93% of the malaria cases from African countries, and the malaria parasites infecting these cases included Plasmodium falciparum, P. vivax, P. ovale, P. malariae and mixed infections, with P. falciparum as the predominant species (76.73%, 455/593). All malaria cases received totally correct initial diagnoses in county- and city-level centers for disease control and prevention (CDC) and entry-exit inspection and quarantine sectors, and the proportion of malaria cases with confirmation at the day of initial diagnosis was 41.48% (207/499) in medical institutions and 66.18% (45/68) in CDC (χ2 = 14.779, P < 0.001). In addition, the median interval [M (QR)] of malaria cases was 1 (2) d from onset to initial diagnosis and 1 (2) d from initial diagnosis to confirmation in Zhejiang Province from 2017 to 2020, and the median interval [M (QR)] of severe malaria cases was significantly longer than that of non-severe cases [2 (3) d vs. 1 (2) d; Z = -3.002, P < 0.05]. CONCLUSIONS: Zhejiang Province faces great challenges of malaria control, and post-elimination surveillance of malaria still requires to be reinforced. Meanwhile, the awareness of seeking medical services requires to be improved among returners from malaria-endemic regions and the diagnostic capability of malaria requires to be improved among medical professionals.

Visceral Leishmaniasis - China, 2015-2019.

WHAT IS ALREADY KNOWN ABOUT THIS TOPIC?: Visceral leishmaniasis (VL) is an important vector-borne disease in rural areas of western China. The spreading of VL made its prevention and control become more complicated. WHAT IS ADDED BY THIS REPORT?: The number of VL cases decreased from 2015 (n=498) to 2019 (n=166). However, the mountain-type zoonotic visceral leishmaniasis (MT-ZVL) cases increased from 2015 (n=82, 16.5%) to 2019 (n=122, 73.5%). In addition, both number and proportion of imported cases increased from 2015 (n=18, 3.6%) to 2019 (n=41, 24.7%). The re-emergence of MT-ZVL was considerable; 13 historically-endemic counties reported 48 indigenous cases. Infants and young children were the high risk population of VL (848, 62.4%) followed by farmers (303, 22.3%). WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE?: Both MT-ZVL and imported cases showed an increasing trend in China. Therefore, two actions are needed to control VL: 1) to prevent re-emergence and spreading of MT-ZVL; and 2) to ensure timely diagnosis and appropriate treatment to avoid fatal VL cases, especially in non-endemic areas.

[Epidemic status of malaria and progress of malaria elimination in Henan Province, 2018].

OBJECTIVE: To understand the epidemic status of malaria and progress of malaria elimination in Henan Province in 2018, so as to provide the scientific evidence for formulating the control strategy of malaria. METHODS: All data pertaining to the epidemic status of malaria and malaria case were captured from Henan Province in 2018, and the epidemic status of malaria and the diagnosis and treatment of malaria cases were analyzed using a descriptive epidemiological method. RESULTS: A total of 174 malaria cases were reported in Henan Province in 2018, with a male-to-female ratio of 33.8∶1. The cases were predominantly found at 30- and 40- years, and farmer was the highest-risk population. All cases were imported for overseas countries and 96.55% (168/174) were from Africa. The cases were reported across 17 cities of the province, and 63.22% (110 cases) were detected in 4 cities of Zhengzhou, Luoyang, Xuchang and Puyang. Both the median duration from onset to initial admission and the median time from the initial admission to definitive diagnosis were 1 d. There were 6 cases (3.45%) with more than 7 days to visit a doctor, and there were 13 cases (7.47%) with definitive diagnosis of over 7 days (delay in definitive diagnosis). All malaria cases were reported within 24 h, and 98.28% (171/174) completed case investigations within 3 d. All 18 cities had achieved malaria elimination by December 2018. CONCLUSIONS: All malaria cases reported in Henan Province in 2018 are imported from overseas countries. Intensifying malaria surveillance among returnees from Africa and Southeast Asia and timely identification and treatment of imported malaria cases are required to prevent the development of secondary malaria cases, so as to ensure the achievement of malaria elimination in Henan Province on schedule.

Contribution to the echinococcosis control programme in China by NIPD-CTDR.

As a zoonotic parasitosis caused by the parasitism of Echinococcus larvae, echinococcosis imposes serious disease and economic burdens on human beings and society, and is thus a global public health issue. Its complex life history, wide distribution, the combined influence of various epidemic factors, coupled with the unique natural environment, customs, and religious beliefs in endemic areas, pose a huge challenge to the national echinococcosis control programme in China. Accurate early detection and confirmation of diagnosis of echinococcosis, the use of effective drugs, real-time surveillance of the infection status of populations and various hosts, controlling the source of infection, and blocking the route of transmission are of enormous significance for control. In this paper, the work by NIPD-CTDR on the prevention and control of echinococcosis in China is reviewed, with a view to providing reference for the further promotion of the national echinococcosis control programme.

[Epidemic status and control of tick-borne parasitic diseases in China].

Recently, both of the species of tick-borne parasites and cases of tick-borne parasitic diseases in human beings are increasing in China. Tick-borne diseases are considered to be an important public health problem affecting the health of Chinese. In this paper, we summarize the epidemic status and control measures of tick-borne parasitic diseases in China, and put forward that the epidemic status of tick-borne parasitic diseases may be greatly underestimated in China, and the systematic surveillance of tick-borne parasitic diseases on population, vectors and animal hosts is urgently needed.

The epidemiological status of schistosomiasis in P. R. China after the World Bank Loan Project, 2002-2017.

World Bank Loan Project (WBLP) for schistosomiasis control conducted from 1992 to 2001, resulted in significant reduction of schistosomiasis morbidity and mortality in People's Republic of China (P.R. China), with implementation of morbidity control. Thereafter, an integrated control strategy, which targeted blocking disease transmission from reservoir hosts to the environment, was initiated in order to conquer schistosomiasis rebound after WBLP completion. Data obtained from the national schistosomiasis control reporting systems was collected and analyzed. The number of confirmed cases and infected cattle decreased significantly from 2002 to 2017, while no infected snails were found by dissection for four consecutive years. However, lake and marshland regions and some parts areas of Yunnan Province require attention for rigorous schistosomiasis control efforts. There is need to strengthen precise interventions and sensitive surveillance to achieve schistosomiasis elimination in P.R. China.

[Current status and research progress of cysticercosis].

Cysticercosis refers to a parasitic infection caused by the larvae of pork tapeworm Taenia solium. It is a parasitic zoonosis and listed by the World Health Organization (WHO) as one of the neglected tropical diseases. Cysticercosis is spreading all over the world through globalization and it mainly epidemic in developing countries. In the southwest and minority nationality areas of China, as a result of the low level of medical and health care, and the unchangeable diet custom, there are still many cases of cysticercosis, which is manifested as a local high prevalence. Neuroimaging is the preferred method for cysticercosis diagnosis, and by using CT and MRI scans it is possible to visualise the infecting cysticerci and assess their number and location within the central nervous system (CNS) . The immunological assay is also required in the diagnosis. At present, the prevention and control of cysticercosis is still relatively weak. In this paper, the current status and research progress of cysticercosis are reviewed, and further suggestions on the prevention and control of cysticercosis are put forward.

[Epidemiological survey on clonorchiasis and awareness of prevention and control knowledge in Xinfeng County of Jiangxi Province].

OBJECTIVE: To understand the epidemic status of clonorchiasis and awareness of prevention and control knowledge in Xinfeng County of Jiangxi Province, so as to provide the evidences for control measures. METHODS: The baseline survey was carried out with a clue in vestigation of raw-fish eating behavior in potential endemic areas in 2016.The residents were examined by stool tests. The metacercariae of Clonorchis sinensis in fish, the rediae and cercariae in freshwater mollusk were detected. The feces samples of cats, dogs and pigs were collected and examined by sedimentation technique. Meanwhile, the epidemic factors, health knowledge and behavior were also surveyed. RESULTS: The residents in 26 villages had the habit of eating raw freshwater fish, and 19.51% of the respondents had this habit. The average infection rates of the population, Parafossarulus striatulus, freshwater fishes and reservoir hosts were 21.56%, 0, 8.24% and 2.27%, respectively. The infection rate of the population increased with age. There was a significant positive correlation between the behavior and the infection rate of the population (r = 0.88, P < 0.01). Only 11.46% of the respondents knew that eating raw-fish might cause C. sinensis infection, and 5.28% of them knew that C. sinensis was harmful to health. CONCLUSIONS: Twenty-six villages in five townships were endemic areas of clonorchiasis in Xinfeng County. The permanent solution of prevention and control of clonorchiasis is to strengthen the health education and change the habit of raw-fish eating gradually.

[Epidemic status of malaria in Zhenjiang City from 2004 to 2017].

OBJECTIVE: To analyze the epidemic situation and epidemiological characteristics of malaria in Zhenjiang City from 2004 to 2017, so as to provide the evidence for formulating the reasonable strategies and measures for malaria prevention and control. METHODS: The epidemiological data of malaria in Zhenjiang City from 2004 to 2017 were collected and analyzed for the epidemic situation, epidemiological characteristics, species of Plasmodium, blood test status for febrile patients. RESULTS: A total of 182 malaria cases were reported in Zhenjiang City between 2004 and 2017, 123 cases (67.58%) were infected with P. vivax, and 55 cases (30.22%) were infected with P. falciparum. Among all the reported cases, 41 (22.53%) were local cases, 66 (36.26%) were imported cases from other provinces in China, 75 (41.21%) were imported cases from abroad. Most of the cases were male (133 cases), and 59.89% of them concentrated in the age groups of 20-50 years. These cases were mainly farmers (24.73%, 45/182) and workers (24.18%, 44/182), and most of the cases occurred from July to September. From 2004 to 2017, the blood tests were conducted for 258 879 febrile patients, with a positive detection rate of 0.007% in the local population and 0.724% in floating population, and there was a statistically significant difference between them (P<0.01). CONCLUSIONS: Since 2011, no indigenous cases have been reported in Zhenjiang City, and therefore, the control of imported malaria from abroad has become the key of malaria prevention and control in this city.

[Survey of human major parasitic diseases in Shixing County from 2002 to 2016].

OBJECTIVE: To analyze the results of 3 investigations (2002-2004, 2008-2009, and 2016) of major parasitic diseases in Shixing County, so as to provide the evidence for formulating further control strategies. METHODS: With the stratified cluster sampling method, 5 administrative villages were investigated. A total of 200 residents aged above 3 years were sampled in each village to investigate the eggs of soil-transmitted nematodes with Kato-Katz technique, and the swab method was applied for detecting the eggs of Enterobius vermicularis in children aged 3-9 years. χ2 test was used for statistical analysis. RESULTS: Totally 3 857 individuals were surveyed for intestinal parasites, and 5 species of parasites were found and the total infection rates were 28.37%, 4.32% and 0.50% in the 3 investigations respectively, and there were statistically significant differences between any two investigations ( χ2 = 287.64, 327.60 and 31.89 respectively, and all P＜ 0.01). The infection rates of Ascaris lumbricoides, hookworm, Trichuris trichiura and Clonorchis sinensis significantly decreased in the third investigation compared with those in the first investigation ( χ2 = 424.55, 55.45, 43.40 and 26.12 respectively, all P＜ 0.01). However, there was no significant difference between the E. vermicularis infection rates of the first investigation and the third investigation ( χ2 =0.16, P ＞0.05). CONCLUSIONS: Compared with the status in the first investigation, the infection rates of A. lumbricoides, hookworm, T. trichiura and C. sinensis are significantly decreased by 90% or more in the third investigation. However, the children's infection rate of E. vermicularis is still very high. Therefore, we should focus on the comprehensive control measures of E. vermicularis infection while formulating further control strategies of parasitic diseases.

[Survey of epidemic status of paragonimiasis in western mountainous areas in Hubei Province].

OBJECTIVE: To understand the current status of paragonimiasis epidemic in western mountain areas in Hubei Province. METHODS: Four counties (cities) of Western Hubei Province (Xingshan, Enshi, Yunxi, Baokang) were selected as the investigation sites for active surveillance. Crabs were captured and the metacercariae of Paragonimus were detected. Meanwhile, the blood samples were collected from the residents in the surveillance sites and the unique IgG and IgM antibodies against Paragonimus in the sera were detected by ELISA. In addition, a questionnaire survey about knowledge and behavior of prevention and control of paragonimiasis was taken among the residents. RESULTS: A total of 1 143 residents were investigated in the active surveillance, the total positive rate of the serology test was 1.84% (21/1 143), while the rates of the male and the female were 1.78% (10/562) and 1.89% (11/581), respectively, with no statistical significance between them ( χ2 = 0.002, P > 0.05). The average weight of 161 fresh-water crabs captured was 11.72 g, with the positive rate of 9.32% (15/161) and the infective density of 7.07 metacercariae per positive crab. The positive rates of the male and female crabs were 11.54% (9/78) and 7.23% (6/83), respectively ( χ2 = 0.884, P > 0.05), and the infective densities were 6.67 and 7.67 metacercariae per positive crab, respectively. Totally 1 143 residents were investigated by questionnaires, and 0.44% of them had the behavior of eating raw or half-done fresh-water crab, and 0.87% of them had the behavior of drinking un-boiled stream water. CONCLUSIONS: The transmission chain of paragonimiasis still exists in the nature environment of mountain area in Western Hubei Province. The positive rate of the second intermediate host rebounds in some investigation sites. Therefore, the measures of continuous surveillance and health education should be taken to avoid the appearance of the prevalence or outbreak.

[Pathogen spectrum and epidemic status of major human parasites in Chenzhou City, Hunan Province].

OBJECTIVE: To understand the pathogen spectrum and epidemic status of major human parasites in Chenzhou City, Hunan Province, so as to provide the evidence for parasitic diseases control. METHODS: The survey sites were selected by the stratified cluster sampling method. The intestinal helminthic eggs were detected by Kato-Katz technique. The trophozoites or cysts of intestinal protozoa were detected by saline smear and iodine staining methods. The eggs of Enterubius vermicularis of children from 3 to 6 years old were detected by the cellophane anal swab method. The species of hookworm were identified by the filter paper strip culture method. RESULTS: A total of 7 031 people were detected with the intestinal helminthic infective rate of 1.83% (129 cases). The major parasite was hookworm and there was a statistically significant difference of the infection rates among various parasites (χ2 = 107.77, P < 0.01). All the hookworm larvae were Necator americanus. No intestinal protozoon was detected. There were statistically significant differences of the infection rates among the counties (χ2 = 25.77, P < 0.01). The age of the patients was mainly focused on 30 and above years old and the infection rate was increased with the growth of age (χ2 = 26.21, P < 0.01). Farmers were the main population of the patients and there was a statistically significant difference of the infection rates between farmer and others (χ2 = 29.67, P < 0.01). CONCLUSIONS: The infection rates of parasites are low and hook-worm is the main parasite in the pathogen spectrum in Chenzhou City. However, the infection factors still exist, therefore, effective and scientific measures should be taken to consolidate the achievement.

Epidemiological features and diagnosis of malaria cases in Nantong City from 2015 to 2020 / 中国血吸虫病防治杂志

Objective To investigate the epidemiological characteristics and diagnosis of malaria cases in Nantong City from 2015 to 2020, so as to provide insights into the prevention of re-establishment of imported malaria and consolidation of malaria elimination achievements in the city. Methods The epidemic data of malaria in Nantong City from 2015 to 2020 were captured from the National Notifiable Disease Report System, the Information Management System for Parasitic Disease Control and individual epidemiological survey reports of malaria cases. The malaria parasite species, source of infections, population distribution, temporal distribution, spatial distribution and diagnosis of imported malaria cases were descriptively and statistically analyzed. Results A total of 241 malaria cases were reported in Nantong City from 2015 to 2020, and all were overseas imported cases, including 191 cases with Plasmodium falciparum malaria (79.25%), 8 cases with P. vivax malaria (3.32%), 33 cases with P. ovale malaria (13.69%) and 9 cases with P. malaria malaria (3.73%). Overseas imported malaria cases acquired infections from 34 countries in Asia, Africa and Latin America, and 97.93% of the cases were infected in Africa, and 90.04% (217/241) were reported in Chongchuan District, Hai’an City and Haimen District. Imported malaria cases were aged from 20 to 68 years, and a median age of 45 (13) years, and 97.10% were male. The median duration between returning to China and malaria onset was 7 (9) days among all imported malaria cases, and the median duration from initial diagnosis to definitive diagnosis was 2 (2) days. There were 167 cases that were initially diagnosed as malaria, with a correct rate of 69.29%, and 53.53 (129/241) of malaria cases were diagnosed at city-level medical institutions and 41.49% (100/241) at county-level medical institutions. In addition, the proportion of malaria cases reported by city-level medical institutions increased from 39.62% in 2015 to 81.25% in 2020 (χ2 = 6.94, P < 0.01). Conclusions The accuracy of initial malaria diagnosis requires to be improved in Nantong City. Malaria control knowledge should be specially given to migrant workers to shorten the duration of seeking medical care, and malaria training requires to be intensified among healthcare professionals to improve the diagnostic capability of imported malaria cases and the cure of severe P. falciparum malaria cases.

A cross-sectional survey of patients with diabetic foot in Jinyang Community of Shanghai / 上海预防医学

Objective:To determine the current situation of patients with diabetic foot and influencing factors in Jinyang community of Shanghai. Methods:A total of 1400 patients with diabetes registered in community management from January 2019 through December 2019 were randomly selected for survey. All patients completed the screen for diabetic foot and then were divided into control group （n=159） and observation group （n=1 241） according to the occurrence of diabetic foot. Patient's demographics and medical history were recorded， including gender， age， history of long-term smoking， course of disease， history of trauma infection， fasting blood glucose， 2 h postprandial blood glucose （2hPG）， glycosylated hemoglobin （HbAlc）， blood lipid level， history of hyperglycemia， diabetic nephropathy， and diabetic retinopathy. Univariate and multivariate logistic analyses were performed with these possible influencing factors. Results:Univariate analysis showed that the incidence of diabetic foot was not significantly associated with gender， age， history of trauma infection， course of disease or blood lipid level （P>0.05）， whereas had statistical significance with long-term smoking history， fasting blood glucose and 2-hour diabetes mellitus PG， HbAlc， history of hypertension， diabetic nephropathy and diabetic retinopathy （P<0.05）. Multivariate logistic analysis showed that the incidence of diabetic foot was not statistically associated with gender， age， history of trauma infection， course of disease or blood lipid level （P>0.05）； it was significantly associated with long-term smoking history， fasting blood glucose and 2-hour diabetes mellitus PG， HbAlc， history of hypertension， diabetic nephropathy and diabetic retinopathy （P<0.05）. Conclusion:There are multiple influencing factors of diabetic foot in Jinyang community. We should take corresponding measures to control the blood glucose level of diabetic patients and reduce the incidence of diabetic foot.

Epidemiological characteristics and diagnosis of imported malaria cases in Zhejiang Province from 2017 to 2020 / 中国血吸虫病防治杂志

Objective To analyze the epidemiological features and diagnosis of imported malaria cases in Zhejiang Province from 2017 to 2020, so as to provide the scientific evidence for the management of imported malaria in the province. Methods The data of malaria cases reported in Zhejiang Province were captured from the Information Management System for Parasitic Disease Control of China Information System for Disease Control and Prevention from 2017 to 2020, and the temporal, spatial and human distribution, and initial and definitive diagnosis of imported malaria cases were descriptively analyzed. Results A total of 593 malaria cases were reported in Zhejiang Province from 2017 to 2020, and all were overseas imported cases, including 532 men and 61 women, with a mean age of 41 years. There were 93.93% of the malaria cases from African countries, and the malaria parasites infecting these cases included Plasmodium falciparum, P. vivax, P. ovale, P. malariae and mixed infections, with P. falciparum as the predominant species (76.73%, 455/593). All malaria cases received totally correct initial diagnoses in county- and city-level centers for disease control and prevention (CDC) and entry-exit inspection and quarantine sectors, and the proportion of malaria cases with confirmation at the day of initial diagnosis was 41.48% (207/499) in medical institutions and 66.18% (45/68) in CDC (χ2 = 14.779, P < 0.001). In addition, the median interval [M (QR)] of malaria cases was 1 (2) d from onset to initial diagnosis and 1 (2) d from initial diagnosis to confirmation in Zhejiang Province from 2017 to 2020, and the median interval [M (QR)] of severe malaria cases was significantly longer than that of non-severe cases [2 (3) d vs. 1 (2) d; Z = −3.002, P < 0.05]. Conclusions Zhejiang Province faces great challenges of malaria control, and post-elimination surveillance of malaria still requires to be reinforced. Meanwhile, the awareness of seeking medical services requires to be improved among returners from malaria-endemic regions and the diagnostic capability of malaria requires to be improved among medical professionals.