广州番禺区鼠类感染广州管圆线虫调查

目的了解广州市番禺地区鼠类感染广州管圆线虫的情况。方法用电捕鼠器、鼠笼或粘鼠板等方法捕捉野栖或家栖老鼠,确定鼠种后将其处死,取其心肺组织,检查广州管圆线虫成虫。结果共检查鼠类113只,其广州管圆线虫感染率为3.54%。其中施氏屋顶鼠、褐家鼠和板齿鼠的感染率分别为5.26%(2/38)、3.23%(1/31)和6.67%(1/15),而从捕获的黄胸鼠、黄毛鼠和小家鼠体内未能查到广州管圆线虫成虫。结论广州市番禺地区是广州管圆线虫的自然疫源地,终宿主鼠类存在一定程度的感染。     

中国大陆广州管圆线虫病首例死亡病区终宿主鼠类的调查研究

目的　了解中国大陆广州管圆线虫病首例死亡病区终宿主种类及鼠类自然感染情况。方法　采用药械诱捕鼠类 ,解剖心肺 ,收集统计虫体。结果　褐家鼠、黄毛鼠、板齿鼠、黄胸鼠和小家鼠自然感染率分别为 8 33% (6 / 72 ) ,6 2 5 % (3/4 6 ) ,5 2 6 % (2 / 38) ,3 33% (1/ 30 )和 0 % (0 / 35 )。平均自然感染率为 5 4 3% (12 / 2 2 1)。结论　存在广州管圆线虫阳性鼠类 ,表明该地是广州管圆线虫自然疫源地。小家鼠不是广州管圆线虫的适宜终宿主。     

南安市广州管圆线虫媒介宿主密度及感染率季节性变化的调查

目的了船南安市广州管圆线虫媒介宿主密度及感染率。方法在广州管圆线虫病疫源地选择调查点，在不同季节捕捉广州管圆线虫媒介宿主谒云玛瑙螺、福寿螺、蛞蝓及终末宿主鼠类等动物，进行密度和感染率调查，并分析其季节变化。结果褐云玛瑙螺、福寿螺、蛞蝓均检出广州管圆线虫Ⅲ期幼虫。其中，褐云玛瑙螺感染率最高，为36．12％（108／299），且感染高峰在秋季，感染率为63、24％（43／68）。终末宿主鼠的心肺成虫检出率为9．56％（13／136）。结论南安市是广州管圆线虫严重的自然疫源地，媒介宿主密度及感染率随季节变化。     

我国南方部分地区螺类感染广州管圆线虫的调查分析

目的 了解目前我国南方部分地区螺类中广州管圆线虫的感染情况和特点。方法 2017年4-10月在我国南方8个省份采集鲜活螺1 517只,用消化法检验广州管圆线虫3期幼虫。结果 螺类中广州管圆线虫的平均感染率为9.62%(146/1 517),其中褐云玛瑙螺的感染率最高,达16.78%(24/143),其次为福寿螺13.91%(79/568),环棱螺和圆田螺中的感染率在6%左右,其他螺类未检出。在6-9月采集的螺中,广州管圆线虫的感染率在10.11%~14.02%,显著高于其他月份的检测结果(4.24%~6.22%),不同月份的感染率差异有统计学意义(χ²=19.031,P<0.05)。直接从自然环境采集的螺类,其广州管圆线虫的感染率为22.28%(43/193),而采自流通环节和餐饮环节的感染率分别为8.11%(97/1196)和6.19%(6/97)。结论 我国南方部分地区螺类中存在广州管圆线虫的感染,生食螺肉类食品存在潜在感染的风险,建议在这类有螺地区开展灭鼠工作、加大螺类食品的监督管理、规范食品操作、加强食品安全教育。     

广东省南澳岛福寿螺和鼠类密度及其广州管圆线虫感染现状调查

目的了解广东省南澳岛广州管圆线虫(Angiostronglyus cantonensis)中间宿主福寿螺(Pomacea canaliculata)和终末宿主鼠类的分布密度及感染现状。方法于2015年12月-2016年9月采用分层随机抽样法分别从南澳岛抽取宫前村、金山村、六都村等3个行政村作为调查点。采集福寿螺、捕获鼠类,GPS仪记录各采样点的数据。福寿螺经形态学鉴定后,提取基因组DNA进行PCR检测复核螺种。福寿螺感染情况先用肺检法检测肺囊,再用酶消化法和匀浆法检查螺肉和肺囊。鼠类经形态学初步鉴定鼠种及性别后,再解剖采集肝脏用于PCR检测复核鼠种,剖检心、肺组织检查有无广州管圆线虫成虫感染。采集到的广州管圆线虫经形态学鉴定后,再进行PCR检测鉴定虫种。采用SAS9.3统计学软件对福寿螺、鼠类密度和感染情况进行统计分析。结果共采集福寿螺2 192只,随机选取1 190只用于检测,其中阳性螺72只,阳性率为6.1%。共捕获鼠类110只,包括褐家鼠(Rattus norvegicus)、黄胸鼠(R.flavipectus)、黄毛鼠(R.losea)和臭鼩(Suncus murinus)4个鼠种,其中阳性鼠32只,感染率为29.1%(32/110),褐家鼠感染率为36.5%(31/85),黄胸鼠有1只感染,黄毛鼠和臭鼩均为阴性;福寿螺和鼠类线粒体DNA细胞色素氧化酶Ⅰ亚基(COⅠ)扩增片段长度分别约670、706 bp,广州管圆线虫核糖体DNA内转录间隔区2(ITS2)扩增片段长度约693 bp,与预期大小相符。不同季节福寿螺密度(H=11.603 5,P0.01)和感染率(χ~2=65.1 441,P0.01)差异均有统计学意义,不同季节鼠的密度差异也有统计学意义(H=19.268 2,P0.01);河道环境福寿螺密度最高(8.8只/m~2),但不同孶生环境下福寿螺的密度差异无统计学意义(H=3.909 3,P0.05)。沟渠环境福寿螺平均感染率最高(7.5%,42/429),且福寿螺和鼠类感染率与离居民区距离密切相关,呈现离居民区越近感染率越高的趋势。体质量大的鼠类平均感染率要高于体质量小的鼠类,不同体质量鼠类感染率差异有统计学意义(χ~2=17.530 4,P0.01)。结论广州管圆线虫重要中间宿主福寿螺和终末宿主鼠类在南澳岛分布广泛,且均存在不同程度的感染。     

中国大陆地区流行性乙型脑炎后遗症的系统评价

目的 评价中国大陆地区流行性乙型脑炎(JE)的后遗症发生率。方法 系统检索 CNKI、CQVIP、WanFang、CBM、PubMed、EMbase 和 Web of science 数据库,收集有关中国大陆地区 JE后遗症发生率的观察性研究。按照纳入与排除标准选择文献、提取数据,应用AHRQ推荐的横断面研究评价标准对纳入的研究进行方法学质量评价,采用广义倒方差模型对JE后遗症发生率进行合并,并进行敏感性分析和发表偏倚分析。结果 共纳入17篇文献,整体质量均在中等以上。加权合并的JE存活病例后遗症发生率为 35.48%(95%CI:29.08%~42.20%),其中,成人后遗症发生率40.48%(95%CI:34.21%~47.09%),儿童后遗症发生率35.90%(95%CI:30.56%~41.86%)。敏感性分析显示结果稳定可靠;Egger检验未发现有明显发表偏倚。结论 我国大陆地区JE的预后差、后遗症重,应当引起政府和社会的关注。     

广东阳春螺类和鼠类广州管圆线虫感染情况调查

目的了解阳春市螺类和鼠类广州管圆线虫的自然感染情况。方法采集当地螺类,用人工消化法查广州管圆线虫幼虫;捕获当地鼠类.剖检广州管圆线虫成虫。结果共检查褐云玛瑙螺350只,福寿螺465只,广州管圆线虫感染率分别为7.71%和0.86%。捕获鼠类192只,平均感染率为5.73%(11/192),其中褐家鼠、施氏屋顶鼠、板齿鼠和臭鼩鼱感染率分别为5.41%(4/74)、3.33%(2/60)、8.93%(5/56)和0(0/2)。结论阳春市为广州管圆线虫病自然疫源地。     

深圳市鼠类广州管圆线虫感染状况调查

目的 了解深圳市广州管圆线虫鼠类终宿主自然感染的情况,为该地区广州管圆线虫病的预防控制提供依据.方法 采用分层随机抽样法采样,对捕获鼠的血清进行广州管圆线虫IgG抗体检测,解剖其心、肺组织进行虫体检查.用卡方检验比较各组感染状况.结果 共调查深圳市4个行政区鼠类331只,检出广州管圆线虫IgG抗体阳性鼠50只,阳性率为...     

福建省漳州市鼠类宿主感染广州管圆线虫调查

目的调查漳州市鼠类感染广州管圆线虫(Angiostrongylus cantonensis)的情况,为预防控制广州管圆线虫病提供科学依据。方法 2013-2015年,按鼠类孳生环境选取漳州沿海(平原和丘陵组)和山区(丘陵和山地组)的4个县18个村,采用笼捕法捕鼠,鉴定鼠种、性别后,解剖心、肺,查找广州管圆线虫成虫,计算鼠类感染率,分析捕鼠点的不同自然生态环境与鼠类感染率的相关性。结果共捕获鼠类动物1 551只,分属黄胸鼠(Rattus flavipectus)、褐家鼠(R.norvegicus)、臭鼩鼱(Sorex araneus)、小家鼠(Mus musculus)和黄毛鼠(R.lossea),其中黄胸鼠最多,占41.8%(649/1 551),其次为褐家鼠和臭鼩鼱,分别占28.4%(441/1 551)和20.9%(324/1 551)。广州管圆线虫总感染率为9.2%(142/1 551),其中褐家鼠和黄胸鼠的感染率分别为13.2%(58/441)和11.4%(74/649),与臭鼩鼱[1.5%(5/323)]、小家鼠[1.4%(1/74)]和黄毛鼠[6.3%(4/63)]差异有统计学意义(P0.05)。沿海地区鼠类感染率为12.4%(83/668),明显高于山区的6.68%(59/883)(χ~2=15.083,P0.05)。其中沿海平原组与沿海丘陵组感染率分别为12.7%(53/416)和11.9%(30/252),差异无统计学意义(P0.05);山区丘陵组与山区山地组感染率分别为9.2%(46/499)和3.4%(13/384),差异有统计学意义(χ~2=12.890,P0.05)。142只感染鼠共检获成虫696条,成虫主要寄生于肺动脉,占总虫数94.3%;其次为心脏,占总虫数5.7%。雄性与雌性鼠感染率分别为9.2%(73/795)和9.1%(69/756),差异无统计学意义(P0.05)。结论黄胸鼠和褐家鼠为漳州市广州管圆线虫重要保虫宿主。各类生态环境鼠类的广州管圆线虫感染率有一定的差异。     

云南省广州管圆线虫病自然疫源地调查

目的调查云南省是否存在广州管圆线虫病自然疫源地，了解人群感染广州管圆线虫的状况，为云南省防治广州管圆线虫病提供科学依据。方法选择云南省南部5个县，开展广州管圆线虫中间宿主、终末宿主感染调查和动物感染实验；用ELISA法进行人群血清流行病学调查。结果1）分别从软体动物和鼠体肺部检获广州管圆线虫幼虫和成虫，大鼠人工感染成功；2）采集5县人群耳垂滤纸血1653份，ELISA法测定广州管圆线虫抗体，平均阳性率6．59％（109／1653），学生阳性率8．98％，成人阳性率3．48%，差异有极显著性（P〈0．01）；男性阳性率5．81％，女性阳性率7．28％，差异无显著性（P〉0．05）。结论1）云南省存在广州管圆线虫病的自然疫源地，褐云玛瑙螺和拟阿勇蛞蝓科（未定种）是广州管网线虫重要的中间宿主，褐家鼠、黄胸鼠是自然终末宿主；2）动物实验证明小鼠、豚鼠和家兔不是广州管圆线虫的适宜终末宿主，SD大鼠可作为广州管圆线虫理想的实验动物模型。     

福建省鼠类感染广州管圆线虫调查

目的调查福建省鼠类自然感染广州管圆线虫情况,为开展预防控制该病提供依据。方法采用笼捕法。每d将捕获的鼠类,以村为单位,进行逐一编号、鉴定鼠种、♀、♂和成、幼鼠后,取出心、肺,置生理盐水玻皿内将其撕碎,发现虫体再逐条取出置另一生理盐水玻皿内,计算成虫条数和鉴别♀♂。结果共调查9个地、市23个县(市、区)35乡(镇)67个村,除龙岩市的上杭县和福州市辖平潭(海岛县)未发现鼠类感染外,其余21个县(市、区)均发现感染。共检查鼠类4890只,发现感染鼠434只,感染率为8.90%。其中,以褐家鼠感染率最高,为17.75%(315/1775);黄胸鼠其次为6.21%(49/789);臭鼩鼱和小家鼠较低仅为2.81%(29/1032)与2.52%(3/119)(χ2=185.06,P<0.001)。不同鼠龄的感染率,成鼠为21.37%(222/1039),远远高于幼鼠的11.11%(30/270)(χ2=14.50,P<0.05)。结论福建鼠类感染广州管圆线虫已遍及全省9个市和绝大多数的县、市、区的农村和城镇周围。其感染鼠的分布与当地福寿螺的分布一致。     

First provincial survey of Angiostrongylus cantonensis in Guangdong Province, China

The rat lungworm Angiostrongylus cantonensis is a zoonotic nematode with a wide distribution. We report the first provincial survey of the prevalence of A. cantonensis infection among wild rodents and snails in Guangdong Province, China. A total of 2929 Pomacea canaliculata and 1354 Achatina fulica were collected from fields in 22 survey sites with a larval infection rates ranging from 0-26.6% to 0-45.4%. In addition, 114 Cipangopaludina sp and 252 Bellamya sp were bought from markets; larvae were found only in Bellamya snails from two survey sites with an infection rate of 1.4% (1/70) and 3.3% (3/91), respectively. Four hundred and ninety-one rodents were captured in nine sites (Rattus norvegicus, R. flavipectus, Suncus murinus, Mus musculus, Bandicota indica, R. losea and R. rattus). Adult worms were found in R. norvegicus, R. flavipectus and Bandicota indica. Our survey revealed a wide distribution of A. cantonensis and its intermediate hosts P. canaliculata and A. fulica in Guangdong. The prevalence of A. cantonensis in wild snails and rats poses a substantial risk for angiostrongyliasis in humans.     

长乐市广州管圆线虫集体感染的流行病学研究

目的查明长乐市8名集体发病学生是否系感染广州管圆线虫引起。方法①病人脑脊液病原与嗜酸粒细胞检查。②鼠粪病原检查:现场采集鼠粪,溶解后,镜检广州管圆线虫1期幼虫。③福寿螺病原检查:取头部组织,用绞肉机绞碎,过滤沉淀,取上清液加入20％甲醛,离心,取渣检查广州管圆线虫3期幼虫。④临床表现与体征检查:着重中枢神经系统的临床表现与体征。结果①1例脑脊液中查见广州管圆线虫3期幼虫2条。8例嗜酸粒细胞为47％～83％,平均68％。③鼠粪广州管圆线虫1期幼虫感染率为39.3％(44/112)。③福寿螺广州管圆线虫3期幼虫感染率为40.0％(82/205)。④病人临床表现与体征,以剧烈头痛(8/8)、头晕(8/8)、恶心(8/8)、呕吐(8/8)、嗜睡(7/8)、下肢乏力(7/8)为主要特征。结论证实长乐市8名集体发病学生是因广州管圆线虫重度感染引起,且当地是该虫的严重自然疫源地。     

刚地弓形虫在我国男性人群的流行及其与男性生殖障碍关系的Meta分析

目的 评价弓形虫在我国男性人群的流行及其对男性生殖的影响,为研究弓形虫致男性生殖损伤提供重要依据及参考数据。方法 计算机检索PubMed、Science Direct、Google Scholar、Ovid、CNKI、维普、万方、CMB数据库,并辅以参考文献追溯和手工检索方法,检索1990年1月至2015年12月发表的有关国内男性弓形虫流行及弓形虫致男性不育的文献及学位论文。按照纳入、剔除标准与质量评价筛选文献、提取资料后,采用Stata13.0软件进行Meta分析。结果 获得关于弓形虫在男性流行的文献33篇,共调查36 442人。Meta分析结果显示男性弓形虫总感染率为6.96%[95%CI(5.81~8.18)],亚组分析显示地区间总体差异有统计学意义(Qint=62.19,P=0.002),其中东北(5.00%)、华北(5.35%)感染率最低(P<0.05),西南地区最高(11.18%,P<0.05),华南(7.77%)、华东(7.09%)、华中(6.12%)、西北(6.94%)差异无统计学意义(P=0.713)。获得弓形虫与男生不育关系文献16篇,首先对正常及不育男性人群弓形虫感染情况的对照研究数据进行meta分析,OR为2.9[95%CI(2.25,3.75)];其次对其中涉及AsAb对照研究数据的7篇文献进行meta分析,OR为5.62[95%CI(3.49,9.04)];最后,将以上7项研究的AsAb数据及其弓形虫感染数据合并为两个亚组进行分析,两组的OR(95%CI)差异并无统计学意义(Qint=3.37,P=0.066)。结论 我国男性弓形虫感染率在各地区差异较大,弓形虫感染及其诱生的AsAb与男性不育关系密切,需引起社会重视和进一步防治措施的研究。     

中国居民心血管疾病危险因素分布报告

全面了解相关可改变的危险因素及其在不同地区的分布差异,可为制定公共卫生政策提供理论依据。本报告定量评价了我国31个省152个农村地区的县和100个城市地区的区人群的12种心血管疾病危险因素的分布特征,包括血压升高(≥140/90 mmHg,1 mmHg=0.133 kPa)、总胆固醇升高(≥5.0 mmol/L)、血糖升高(≥7.0 mmol/L),超重或肥胖(体重指数≥25 kg/m2),以及吸烟、饮酒、不健康膳食(水果、蔬菜、全谷物或豆类摄入过少,红肉摄入过多)、缺乏体育锻炼等;将预计十年心血管疾病发生风险大于20%的研究对象定为心血管疾病高风险对象。我国心血管疾病的人群风险存在显著的地区差异,而导致各地区人群风险的主要危险因素也并不相同。基于2010年全国人口普查的年龄和性别进行标化后,我国高危人群的比例为10.3%(95%CI:10.2~10.3)。高危人群比例在东北地区为12.6%(95%CI:12.4~12.8)和华北地区为11.4%(95%CI:11.3~11.6)较高(95%CI均超过11),在华南地区为8.0%(95%CI:7.8~8.2)较低。     

Hepatic steatosis in hepatitis B virus infected patients: meta-analysis of risk factors and comparison with hepatitis C infected patients

Background and Aims: Although hepatic steatosis (HS) has an association with hepatitis C virus (HCV) infection, an association with hepatitis B virus (HBV) is controversial. We performed a meta‐analysis to evaluate HS prevalence and risk factors, in HBV infection. Methods: Standard guidelines for performance of meta‐analyses were followed. Studies with HS assessed by histology were included. Pooled odd ratios (OR) and standardized mean differences (SMD) were obtained with the random‐effects model and DerSimonian‐Laid method. Results: Seventeen out of 21 studies were included, comprising 4100 HBV infected patients. Overall HS prevalence was 29.6%. Eight studies also included 945 HCV infected patients, showing decreased risk of HS in HBV versus HCV patients (OR 0.55, 95%CI [0.45–0.67], P < 0.001). In HBV, HS positively associated with male gender (OR 1.74, 95%CI [1.28–2.38], P < 0.001), body mass index (SMD 2.17, 95%CI [1.23, 3.11], P < 0.001), obesity (OR 6.59, 95%CI [3.51–12.257], P = 0.003), diabetes (OR 2.62, 95%CI [1.37–4.00], P = 0.004), glycemia (SMD 0.84, 95%CI [0.00, 1.67], P = 0.049), triglycerides (SMD 1.18, 95%CI [0.48, 1.89], P = 0.001), cholesterol (SMD 0.88, 95%CI [0.31, 1.45], P = 0.003), moderate alcohol consumption (OR 1.54, 95%CI [1.10–2.15], P = 0.011) and negatively with HBV DNA (SMD ?74.12, 95%CI [?82.93, ?65.31], P < 0.001). HS had no association with aminotransferases, HBeAg, genotype or hepatic histology, necroinflammation or fibrosis. Conclusion: HS in HBV seems to be as frequent as in the general population, and lower than in HCV infected patients, relating to metabolic factors but not with hepatic histology severity. A puzzling strong negative association between viral load and HS, may even suggest a protective effect of the virus on HS.     

The seroprevalence of SARS-CoV-2 infection in Malaysia: 7 August to 11 October 2020

Background

From the beginning of the COVID-19 pandemic until mid-October 2020, Malaysia recorded ~15,000 confirmed cases. But there could be undiagnosed cases due mainly to asymptomatic infections. Seroprevalence studies can better quantify underlying infection from SARS-CoV-2 by identifying humoral antibodies against the virus. This study was the first to determine the prevalence of SARS-CoV-2 infection in  Malaysia's general population, as well as the proportion of asymptomatic and undiagnosed infections.

Methods

This cross-sectional seroprevalence study with a two-stage stratified random cluster sampling design included 5,131 representative community dwellers in Malaysia aged ≥1 year. Data collection lasted from 7 August to 11 October 2020 involving venous blood sampling and interviews for history of COVID-19 symptoms and diagnosis. Previous SARS-CoV-2 infection was defined as screened positive using the Wantai SARS-CoV-2 Total Antibody enzyme-linked immunosorbent assay and confirmed positive using the GenScript SARS-CoV-2 surrogate Virus Neutralization Test. We performed a complex sampling design analysis, calculating sample weights considering probabilities of selection, non-response rate and post-stratification weight.

Results

The overall weighted prevalence of SARS-CoV-2 infection was 0.49% (95%CI 0.28–0.85) (N = 150,857). Among the estimated population with past infection, around 84.1% (95%CI 58.84–95.12) (N = 126 826) were asymptomatic, and 90.1% (95%CI 67.06–97.58) (N = 135 866) were undiagnosed.

Conclusions

Our study revealed a low pre-variant and pre-vaccination seroprevalence of SARS-CoV-2 infection in Malaysia up to mid-October 2020, with a considerable proportion of asymptomatic and undiagnosed cases. This led to subsequent adoption of SARS-CoV-2 antigen rapid test kits to increase case detection rate and to reduce time to results and infection control measures.     

Occult hepatitis C virus infection in the Middle East and Eastern Mediterranean countries: A systematic review and meta-analysis

BACKGROUND The presence of hepatitis C virus(HCV) RNA in liver tissue or peripheral blood mononuclear cells with no identified virus genome in the serum has been reported worldwide among patients with either normal or elevated serum liver enzymes. The characterization of occult HCV infection(OCI) epidemiology in the Middle East and Eastern Mediterranean(M and E) countries, a region with the highest incidence and prevalence rates of HCV infection in the world, would be effective for more appropriate control of the infection.AIM To estimate the pooled prevalence of OCI in M and E countries using a systematic review and meta-analysis.METHODS A systematic literature search was performed using international, regional and local electronic databases. Some conference proceedings and references from bibliographies were also reviewed manually. The search was carried out during May and June 2020. Original observational surveys were considered if they assessed the prevalence of OCI among the population of M and E countries by examination of HCV nucleic acid in peripheral blood mononuclear cells in at least 30 cases selected by random or non-random sampling methods. The meta-analysis was performed using Comprehensive Meta-analysis software based on heterogeneity assessed by Cochran's Q test and I-square statistics. Data were considered statistically significant at a P value 0.05.RESULTS A total of 116 non-duplicated citations were found in electronic sources and grey literature. A total of 51 non-overlapping original surveys were appraised, of which 37 met the inclusion criteria and were included in the analysis. Data were available from 5 of 26 countries including Egypt, Iran, Pakistan, Saudi Arabia, and Turkey. The overall prevalence rate of OCI was estimated at 10.04%(95%CI: 7.66%-13.05%). The lowest OCI rate was observed among healthy subjects(4.79%, 95%CI: 2.86%-7.93%). The higher rates were estimated for patients suffering from chronic liver diseases(12.04%, 95%CI: 5.87%-23.10%), and multi-transfused patients(8.71%, 95%CI: 6.05%-12.39%). Subgroup analysis indicated that the OCI rates were probably not associated with the studied subpopulations, country, year of study, the detection method of HCV RNA, sample size, patients' HCV serostatus, and sex(all P 0.05). Meta-regression analyses showed no significant time trends in OCI rates among different groups.CONCLUSION This review estimated high rates of OCI prevalence in M and E countries, especially among multi-transfused patients as well as patients with chronic liver diseases.