后腹膜包虫病1例

目的 研究疟史对健康人和发热病人原虫血症的作用。方法 1989年5月和10月在中国云南省沧源县班老化作了两次横断面调查。专业人员在对健康人采血、涂片、镜检的同时，进行问卷调查，调查内容包括疟史、性别、居住地海拔及村名5个方面。在4月和10月期间收集发热病人的情况，用EPI INFO 6.0和STATA 5.0软件对数据进行处理。结果 单因素分析发现疟史和年龄是无症状带虫者[MLH比值比为3．98％（95％可信限为2．48－6．40），年龄21－40的比值比为0．19（95％可信限为0．09－0．39），年龄≥40的比值比为0．38（95％可信限为0．16－0．90）]的危险因素。多因素分析发现年龄是混杂因素，冲淡了疟史的作用；而疟史是原虫血症发热病人的保护因素[比值比为0.37(95%可信限为0．21－0．65）]。结论 有疟史者很有可能是无症状的带虫者，是传播疟疾的传染源，应在早期阶段就对其重新治疗。疟史对健康人再次感染疟疾有抑制作用。     

浙江舟山市灭疟后期监测报告

舟山市是以群岛组成的拥有95万人口的沿海城市,原是以间日疟为主的高中度疟区。自1981年起,年发病率降至万分之一以下。现将1985～1987年灭疟后期监测措施及结果报告如下。一、传染源监测:发热病人血检,对象以四热(初诊疟疾,疑似疟疾,感冒及原因不明发热)病人为主,1985～1987年共血检50 140人,年血检率均在5％以上,三年的原虫阳性率分别为0.04％、0.07％和0。年带虫发病率分别为0.03/1000、0.07/1000和0。血检流动人口发热病人1866人,查出原虫阳性8人,阳性率为0.43％,为当地人口发热病人血检阳性率0.02％的21.5倍。在灭疟后期,病人呈点状散在分布于各海岛的个     

元江县热带经济作物开发区流动人员疟疾监测

元江县东峨乡为热带经济作物开发区,近年大量流动人员涌入,疟疾发病率上升。1991年和1992年对流动人员进行了疟疾监测。流动人员发热病人血检各诊疗所均对发热病人血涂片送乡卫生院镜检疟原虫。1991年发热病人原虫率45.66％(100/219),间日疟占94％,恶性疟占6％,1992年原虫率38.89％(84/216),间日疟占95.24％,恶性疟4.76％。流动人员带虫率 1991和1992年5和6月血检来自浙江、四川及本省红河县、墨江县民工共578人,带虫率为:修水电者13％(49/377),修路者4.12％(7/170),建房者9.69％(3/31),平均带虫     

发热病人血检疟原虫在疟疾防治工作中的意义

1980～1981年疟疾流行季节,调查荆门县团林公社四个大队居民中发热病人的带虫情况。结果: 两年共有发热病人1,596人,其中疟原虫阳性者144人,原虫感染率9.02％,均为间日疟。1980年原虫感染率为19.27％,1981年为3.15％;发病率则分别     

云南省边境地区19911999年流动人口疟疾监测

目的对我省边境地区流动人口的疟疾发病进行监测分析并提出疟疾防治对策.方法对流动人员进行发热病人血检和居民带虫血检监测.结果 1991-1999年流动人口发热病人血检平均阳性率为6.77%,带虫率为2.10%,同期流动到边境地区不同人群的发热病人血检阳性率和居民带虫率均高于当地人群.流动人口的疟疾发病是我省边境地区疟疾控制工作的主要难题之一,加强疟防知识宣传,提高流动人口的自我保护意识,可收到一定效果.     

缅甸克钦邦芒温区疟疾流行情况调查

目的了解与我国相邻的缅甸克钦邦芒温区疟疾流行情况,指导我国云南省对输入性疟疾的防治。方法对芒温区3个村寨的所有居民和区中心学校学生询问疟史,同时采血,涂制血片,镜检疟原虫。结果共调查424人,居民带虫率16.3%(95%CI:12.9%~20.1%);1年内2次及以上疟史率和1次疟史率分别为56.8%(95%CI:52.0%~61.6%)和99.1%(95%CI:97.6%~99.7%);低年龄组人群带虫率显著高于高年龄组(P<0.01),但带虫率与性别无关(P>0.05)。结论缅甸芒温区为稳定超高度地方性疟疾流行区,对我国2020年消除疟疾是一个巨大的挑战。     

勐腊县关累港橡胶农场开发区疟疾暴发流行调查

2000年7-10月在勐腊县关累港橡胶农场开发区开展了疟疾暴发流行调查,结果显示2000年疟史率为68.96%、发热病人血检阳性率为42.77%、恶性疟比例高达54.48%,总发病率18.57%,特别是一、二队发热病人血检阳性率分别为74.68%和68.66%,流行季节末居民带虫率为8.18%,结果证实,该开发区发生以恶性疟为主的点状暴发流行.     

新疆察布查尔县疟疾发病现状

伊犁地区是新疆疟疾发病最严重的地区 ,察布查尔县疟疾流行已久 ,上世纪 5 0年代就属于稳定性高疟区。 195 4年调查的 2～ 9岁脾肿率为 6. 42 % ,居民带原虫率为 2 . 2 3 %。自195 9年全伊犁地区采取大规模地普查普治疟疾现症病人、DDT滞留喷洒灭蚊的综合抗疟措施后 ,疟疾发病率大幅度下降 ,到 1986年察布查尔县疟疾带虫发病率已降到 2 . 3 /万。 1992年我县进行了居民原虫率和人群间接荧光抗体 (IFA)水平调查。血检 2 15人 ,原虫率为 0。IFA血清抗体滴度为 6. 5 0 % ( 13 /2 0 0 ) ,结果表明 ,察布查尔县疟疾发病已处于休止期 ,但疟疾…     

邳州市疟疾残存病例发病因素探讨

目的探讨邳州市灭疟后期疟疾残存病例的发病因素。方法按1:1匹配,对50例疟疾确诊病例和50例对照采用病例对照研究方法,用预先设计的问卷收集人口学信息、疟疾知识、使用蚊帐、输血史和流动史等信息。先采用单因素logistic回归分析,对有统计学意义的变量再进行多因素logistic回归分析。结果单因素分析结果显示,防蚊设施、使用蚊帐、露宿习惯、输血史、外出疟区史、家人发热等6个因素与疟疾发病有显著关系(P均<0.05)。多因素分析结果显示,影响本市疟疾残存病例的发病因素有使用蚊帐、露宿习惯、输血史、外出疟史、家人发热5个方面,其比值比分别为0. 41、3.67、1.21、1.13、1.43。结论疟疾控制措施应重氖放在献血人员和流动人口管理、发热病人血检及野外住宿人员的个人防护上。     

尼日利亚疟疾的再调查

为了评价未经疟原虫镜检的发热病人一律给予抗疟药治疗的合理性,作者于1987年1月～1988年10月研究了尼日利亚西南部农村和城市小学生无症状带虫者情况、群众性治疗对再感染率的影响及临床诊断为疟疾并经血检证实所占的比率。研究分2部分。第1部分:(a)212名6～12岁的农村小学生,1987年查血4次;(b)644名城市小学生,1988年4,6,7和10月各血检1次,并计数恶性疟原虫无性体密度;(c)309名城市小学生,按有无原虫血症分为2组,阳性组20人服氯喹10mg/kg单     

The relationship of skin test positivity, high serum total IgE levels, and peripheral blood eosinophilia to symptomatic and asymptomatic airway hyperresponsiveness

The relationships of skin test positivity, high serum total IgE levels (> 100 kU/L), and peripheral blood eosinophilia (>/= 275 cells/microliter) to symptomatic (either chronic cough, chronic phlegm, bronchitis episodes, dyspnea, wheeze, or asthma) and asymptomatic bronchial hyperresponsiveness (BHR) were studied cross-sectionally in 620 adult subjects who participated in the Vlagtwedde-Vlaardingen Study of 1989 and 1990. Eosinophilia (OR = 2.06, 95% CI = 1.28 to 3.31) and skin test positivity (OR = 1.66, 95% CI = 1.02 to 2.71) were both significantly associated with BHR independent of age, sex, smoking, and urban area of residence. High serum total IgE levels were not associated with BHR (OR = 1.29, 95% CI = 0.81 to 2.03). Separate analyses for symptomatic and asymptomatic subjects showed that the higher risk of BHR with skin test positivity applied only to symptomatic subjects (OR = 5.78, 95% CI = 1.63 to 20.51), independent of eosinophilia and high serum total IgE levels. The higher risk of BHR with eosinophilia was not different between symptomatic and asymptomatic subjects, and independent of skin test positivity and high serum total IgE levels. The results of this study show that, in the general adult population, eosinophilia is associated with BHR both in symptomatic and asymptomatic persons, whereas skin test positivity is associated with BHR only in symptomatic subjects.     

Risk factors associated with hepatitis C among patients co-infected with human immunodeficiency virus: a case-control study

A case-control study was carried out to assess the risk factors associated with hepatitis C in patients infected with human immunodeficiency virus. One hundred eighteen patients tested positive for hepatitis C virus (HCV) and were included as cases, and 117 tested negative for HCV and were included as controls. Information was collected through a questionnaire. The risk factors that showed a significant association with co-infection by multivariate analysis were an age of 30-39 years (odds ratio [OR] = 4.65, 95% confidence interval [CI] = 1.31-16.43), an age of 40-49 years (OR = 6.48, 95% CI = 1.70-24.78), an age > 50 years (OR = 7.50, 95% CI = 1.54-36.68), use of intravenous drugs (OR = 25.46, 95% CI = 4.91-131.88), use of inhaled illicit drugs (OR = 3.56, 95% CI = 1.22-10.44), anal intercourse (OR = 3.93, 95% CI = 1.27-12.13), a sexual partner with a history of liver disease (OR = 5.45, 95% CI = 1.33-22.32), a sexual partner with a history of blood transfusions (OR = 4.79, 95% CI = 0.95-24.19), and sexual partner with a history of intravenous drug use (OR = 3.46, 95% CI = 1.24-9.65).     

Asymptomatic parasitaemia as a risk factor for symptomatic malaria in a cohort of Ugandan children

OBJECTIVES:To assess the prevalence of asymptomatic parasitaemia, determine its association with symptomatic malaria, and identify independent predictors of asymptomatic parasitaemia in a cohort of children from Kampala, Uganda. METHODS:A total of 316 children aged 6 months to 5 years were recruited from the community. The prevalence of asymptomatic parasitaemia was assessed at enrollment and approximately every 30 days during follow-up. Participants received all of their health care in our clinic, including a standardized approach to the diagnosis and treatment of symptomatic malaria. RESULTS:A total of 283 (90%) subjects completed the full 1-year follow-up and were included in this study, yielding 2557 routine smears. The prevalence of asymptomatic parasitaemia was 17% at enrollment, but 5-8% for the remainder of the study. The risk of developing symptomatic malaria within 30 days was significantly higher in those with a positive routine than in those with a negative one (50%vs. 9%, P < 0.001). Higher parasite densities were associated with increased odds of developing symptomatic malaria within 30 days (P = 0.003). Only 11% of episodes of asymptomatic parasitaemia, involving 6% of subjects, arose and cleared without therapy. In multivariate analysis the only significant risk factor for asymptomatic parasitaemia was whether a child had any episode of symptomatic malaria during the course of the study (OR = 3.0, P = 0.02). CONCLUSION:In our cohort of children from an urban meso-endemic environment, asymptomatic parasitaemia was uncommon and frequently followed by symptomatic malaria. This suggests that presumptive treatment of asymptomatic parasitaemia in such settings would be an efficient means of preventing symptomatic malaria.     

Risk factors for presentation to hospital with severe anaemia in Tanzanian children: a case-control study

In malaria endemic areas anaemia is a usually silent condition that nevertheless places a considerable burden on health services. Cases of severe anaemia often require hospitalization and blood transfusions. The objective of this study was to assess risk factors for admission with anaemia to facilitate the design of anaemia control programmes. We conducted a prospective case-control study of children aged 2-59 months admitted to a district hospital in southern Tanzania. There were 216 cases of severe anaemia [packed cell volume (PCV) < 25%] and 234 age-matched controls (PCV > or = 25%). Most cases [55.6% (n = 120)] were < 1 year of age. Anaemia was significantly associated with the educational level of parents, type of accommodation, health-seeking behaviour, the child's nutritional status and recent and current medical history. Of these, the single most important factor was Plasmodium falciparum parasitaemia [OR 4.3, 95% confidence interval (CI) 2.9-6.5, P < 0.001]. Multivariate analysis showed that increased recent health expenditure [OR 2.2 (95% CI 1.3-3.9), P = 0.005], malnutrition [OR 2.4 (95%CI 1.3-4.3), P < 0.001], living > 10 km from the hospital [OR 3.0 (95% CI 1.9-4.9), P < 0.001], a history of previous blood transfusion [OR 3.8 (95% CI 1.7-9.1), P < 0.001] and P. falciparum parasitaemia [OR 9.5 (95% CI 4.3-21.3), P < 0.001] were independently related to risk of being admitted with anaemia. These findings are considered in terms of the pathophysiological pathway leading to anaemia. The concentration of anaemia in infants and problems of access to health services and adequate case management underline the need for targeted preventive strategies for anaemia control.     

Depressed-type (O-Ⅱc) colorectal neoplasm in patients with family history of first-degree relatives with colorectal cancer: A cross-sectional study

AIM: To investigate the correlation of depressed-type (0-Ⅱc) colorectal neoplasm and family history of firstdegree relatives (FDR) with colorectal cancer (CRC).METHODS: This cross-sectional study was conducted from June 2000 to October 2002 at National Cancer Center Hospital East. Eligible patients undergoing initial total colonoscopy were surveyed regarding family history of CRC among FDR by a questionnaire prior to colonoscopic examinations. All endoscopic findings during colonoscopy were recorded and the macroscopic classification of the early stage neoplasm/cancer was classified into two types (0-Ⅱc vs non 0-Ⅱc). Odds ratios (OR) and 95% confidence intervals (CI) were calculated by univariate and multivariate logistic regression to estimate the association between macroscopic features and clinicopathological data including gender, age, and family history of FDR with CRC.RESULTS: The OR of an association between family history of FDR with CRC and overall early stage neoplasm adjusted by gender and age was 1.85 (95% CI: 1.31-2.61, P = 0.0004), that for non 0-Ⅱc neoplasm was 1.71 (95% CI: 1.22-2.41, P = 0.0017) and for 0-Ⅱc colorectal neoplasm was 2.78 (95% CI: 1.49-5.16, P = 0.0031).CONCLUSION: Our study shows a significant association between a family history of FDR with CRC and 0-Ⅱc colorectal neoplasm. When patients with a family history of FDR with CRC undergo colonoscopy,colonoscopists should check carefully for not only polypoid, but also depressed-type (0-Ⅱc) lesions.     

Protective immunity after natural rotavirus infection: a community cohort study of newborn children in Guinea-Bissau,west Africa

To study the natural history of rotavirus infection and to determine the protection it confers against reinfection and diarrhea, 200 newborns in Guinea-Bissau were prospectively followed for up to 2 years. Rotavirus was detected in stool specimens collected weekly. By age 2 years, the incidence of primary rotavirus infection was 74%. In the first 3 months of life, 17% of the infections were diarrhea associated, compared with 60% at 9-11 months; after age 18 months, all infections were asymptomatic. A primary infection conferred 52% (95% confidence interval [CI], 16% to 73%) and 70% (95% CI, 29% to 87%) protection against subsequent rotavirus infection and rotavirus diarrhea, respectively. The protection was 66% (95% CI, 24% to 85%) against reinfection within the same epidemic, compared with 34% (95% CI, -29% to 67%) against reinfection in any subsequent epidemic. The high level of protection against symptomatic rotavirus infection provides an important incentive for development of a rotavirus vaccine.     

Norwalk virus infection and disease is associated with ABO histo-blood group type

Some people are resistant to Norwalk virus (NV) infection; however, the factor(s) responsible for resistance or susceptibility to NV infection has not been identified. This study investigated the relationship between a person's ABO histo-blood group type and the risk of NV infection and symptomatic disease after clinical challenge. ABO phenotypes were identified by using serum samples from volunteers who participated in an NV challenge study (n=51). Individuals with an O phenotype were more likely to be infected with NV (odds ratio [OR], 11.8; 95% confidence interval [CI], 1.3-103), whereas persons with a B histo-blood group antigen had decreased risk of infection (OR, 0.096; 95% CI, 0.16-0.56) and symptomatic disease (OR, 0; 95% CI, 0-0.999). This is the first report demonstrating an association between a genetic factor and the risk of NV infection and symptomatic disease.     

Utility of history, examination and laboratory tests in screening those returning to Europe from the tropics for parasitic infection

OBJECTIVES: To examine the utility of the different elements of screening expatriates and travellers returned from the tropics for parasitic disease (exposure history, symptoms, examination and laboratory tests). METHODS: In phase 1 (conducted prospectively 1990-91), 1029 asymptomatic returnees had a detailed questionnaire and interview on risk-behaviour, physical examination and laboratory tests. In phase 2 (1997-98), 510 consecutive patients referred for routine screening (276 symptomatic and 234 asymptomatic) were screened with laboratory tests. RESULTS: Exposure history did not correlate reliably with parasite burden. In phase 1 physical examination revealed 387 abnormalities, only three of which indicated parasitic disease. Schistosomal serology was positive in 11% (CI 9-13) of these asymptomatic cases including patients with light or no reported freshwater exposure. Stool microscopy was positive in 19% (CI 16-22) of cases not correlated with reported eating habits, and eosinophilia was present in 8% (CI 6-10). In phase 2 reported symptoms did not correlate with parasitic disease. Schistosomiasis was present in 15% (CI 13-24) of asymptomatic and 18% (CI 13-22) of symptomatic individuals (OR 1.2 P = 0.46); stool microscopy was positive in 14% of both symptomatic and asymptomatic patients, and eosinophilia in 9% of symptomatic and 6% of asymptomatic individuals. CONCLUSION: Potentially serious asymptomatic infection is common in travellers. Detailed exposure history, symptom history and physical examination added little to detecting cases. Stool microscopy, schistosomal serology and eosinophil count all had good yield. Filarial serology had low yield in patients without eosinophilia.     

Seroprevalence of SARS-CoV-2 in Mazandaran province,Iran

Objective: To determine the seroprevalance of severe acute respiratory syndrome coronavirus 2(SARS-Co V-2) antibodies in the general population of Mazandaran province in Iran and to estimate the percentage of asymptomatic, mild, and severe infections. Methods: We chose 1 588 inhabitants of Mazandaran province with cluster sampling. We measured their SARS-Co V-2 immunoglobulin M(Ig M) and immunoglobulin G(Ig G) serum levels. Demographics, risk factors, and symptoms were collected. The seroprevalence of SARS-Co V-2 was calculated by age and city and the World Health Organization(WHO) protocol and further stratified by demographic variables and risk factors. Finally, we identified the symptoms and factors related to COVID-19 with logistic regression. Results: Two hundred subjects(12.59%) were tested positive for either Ig G or Ig M. Until May 23, 2020, the prevalence of COVID-19 was 15.26%(95% CI: 12.97%-17.79%) based on direct standardization and WHO's standardized age groups. Based on multivariate logistic regression, the incidence of getting an infection increased by an average of 11.6% for every 10-year increase in age(OR=1.116, 95% CI: 1.008-1.236, P=0.035). Furthermore, those in contact with COVID-19 patients had a 66.1% higher risk of developing the disease(OR=1.661, 95% CI: 1.104-2.497, P=0.015). In addition, the chance of getting SARS-Co V-2 infection was almost four times higher in people who had consulted a doctor during the pandemic than those who had not(OR=3.942, 95% CI: 2.813-5.524, P0.001). Conclusions: The prevalence of COVID-19 in Mazandaran province could be higher than the officially reported statistics based on diagnostic tests and clinical cases. There seems to be more asymptomatic or mild symptom cases than what was previously reported.     

Outcomes and risk factors in 1,609 carotid endarterectomies

Severe carotid stenosis is typically treated with carotid endarterectomy (CEA), but there is debate about the safety of this procedure in patients with occlusion of the contralateral artery, previous CEA in the same artery, and other risk factors. To evaluate the association of these factors with outcomes in standard CEA with Dacron patch angioplasty, we examined the records of 1,609 consecutive isolated CEAs performed at our institution over a 10-year period on 1,400 patients (851 men and 549 women; mean age, 69.5 yr) with symptomatic or high-grade asymptomatic carotid lesions. Twenty-three patients (1.4%) had perioperative strokes, of which 2 were fatal. The overall same-admission mortality was 0.2% (4 patients). Same-admission stroke/death was more likely in patients with any history of tobacco use (odds ratio [OR], 4.6; 95% confidence interval [CI], 1.6-13.6), contralat-eral occlusion (OR, 3.3; 95% CI, 1.2-9.1), angina with a Canadian Cardiovascular Society classification of 2 or greater (OR, 3.2; 95% CI, 1.4-7.6), or transient ischemic attack within the 6 weeks before surgery (OR, 2.4; 95% CI, 1.05-5.3). A total of 9 patients (0.6%) died within 30 days of CEA; our multivariate analysis did not reveal any significant predictors of 30-day mortality. We conclude that standard CEA with patch angioplasty is associated with low rates of death and morbidity for most patients, but patients with any history of tobacco use, substantial angina, contralateral occlusion, or preoperative transient ischemic attack may have an elevated risk of adverse outcomes.