海南省疟疾病人诊治和血检情况调查

目的　掌握海南省疟疾病人诊治和血检的实际情况 ,为修订疟防措施提供依据。　方法　选择疟区不同的 4个县部分地区达国家疟疾疫情报告诊断标准的疟疾病例 ,进行个案调查。　结果　个案调查 160 6例 ,疟疾病人选择县级医院、乡级医院、村队诊所、个体诊所、自己购药治疗的比例分别是 7 1%、41 0 %、2 0 7%、2 2 2 %、9 0 % ,疟疾病人对各级医疗机构的选择有显著性差异 (P <0 0 0 1) ;县级医院、乡级医院、村级诊所、个体诊所的疟疾病人血检率分别为 68 4%、3 4 0 %、1 2 %、16 2 %。统计分析不同疟区、不同级别的医疗机构疟疾病人血检确诊率有显著性差异(P <0 0 0 1)。　结论　疟疾病人对医疗机构多样化选择 ,各级医疗机构疟疾病人血检率低和差异大 ,是疟疾疫情漏报和缺乏正规治疗的重要原因     

HIV prevalence,incidence and risk behaviours among men who have sex with men in Yangzhou and Guangzhou,China: a cohort study

Introduction

In China, the prevalence and incidence of HIV among men who have sex with men (MSM) in large-sized cities have drawn much attention. In contrast, there has been a paucity of research focussing on the sexual health of MSM of medium-sized cities. This study fills this important gap in the knowledge by investigating the sexual health of MSM in a medium-sized city (Yangzhou) and a large-sized city (Guangzhou).

Methods

A baseline survey and a prospective cohort study were conducted among MSM in Yangzhou and Guangzhou from July 2009 to September 2010. A total of 622 MSM (317 from Yangzhou and 305 from Guangzhou) were screened for eligibility. Prevalence and incidence of HIV infection, as well as its risk factors, were investigated.

Results

Baseline HIV prevalence was 14.5%, and overall HIV incidence density was 6.78 per 100 person-years (PY) among Yangzhou MSM. Risk factors for HIV prevalence that were significant in multivariate models were older age, married status, unprotected sex with female partners, sexually transmitted disease (STD)-associated symptoms and syphilis positivity. Risk factors for HIV incidence that were significant in multivariate models were STD-associated symptom and syphilis positivity. Compared to Yangzhou MSM, Guangzhou MSM had a lower HIV prevalence (6.2%; p<0.05) and lower overall HIV incidence density (5.77 per 100 PY). Risk factors for HIV prevalence that were significant in multivariate models were married status, unprotected anal sex with men and syphilis positivity. The single risk factor for HIV incidence that was significant in multivariate models was unprotected anal sex with men.

Conclusions

This study showed a high prevalence and incidence of HIV among Yangzhou MSM, which suggest a more serious HIV epidemic than that in large-sized cities. Further investigation targeting MSM in medium-sized cites is urgently needed to prevent the spread of the HIV epidemic in China.     

Epidemic status of Angiostrongylus cantonensis in Hainan island, China

ObjectiveTo understand the current epidemiological status of Angiostrongylus cantonensis in Hainan island and provide the scientific evidences for prevention and control of the disease.MethodsThe investigation on nature infection condition of intermediate hosts and final hosts of Angiostrongylus cantonensis were carried out in five counties, Hainan Province, and enzyme linked immunosorbent assay (ELISA) was employed to detect antibodies of Angiostrongylus cantonensis in human hosts.ResultsA total of 1612 molluscs were examined, 21.3% of which harbored L3 of Angiostrongylus cantonensis. Among them, the infection rates of Pomacea canaliculata, Achatina fulica, Cepaea and Phlegm bilineatus were 12.36%(64/518), 22.66%(121/534), 20.93%(9/43), and 28.24%(146/517), respectively. Of the 118 rats trapped, 13 Rattus norvegicus were found to be infected with Angiostrongylus cantonensis. A total of 459 serum samples were collected and tested. 92 serum samples were Angiostrongylus cantonensis antibody-positive.ConclusionsThe survey revealed a wide distribution of Angiostrongylus cantonensis in Hainan island. Pomacea canaliculata and Achatina fulica are main intermediate hosts of Angiostrongylus cantonensis. Rattus novegicus is a nature definitive host, indicating that a considerable number of people are at risk of angiostrongyliasis. Health education, rigorous food inspection and surveillance are all needed to prevent angiostrongyliasis outbreaks in future.     

登革热、疟疾和丝虫病蚊媒的传播动力学比较及其与防治效应的研究

目的 为进一步了解登革热、疟疾和丝虫病三种蚊传疾病在传播动力学上的差异及其与防治效应的关系。方法 通过数学模型，对三种疾病的传播动力学进行定量分析和比较。结果 登革热的传播速率（即媒介能量）和流行速率最高，但传播潜能（即基本繁殖率）较低，维持最低传播所需的叮人率（即临界叮人率）也较高，提示通过降低蚊群数量即有可能较容易地达到控制传播的目的；疟疾的传播和流行速率略低于登革热，但传播潜能比登革热高得多，临界叮人率也很低，表明疟疾不但容易引发地方性流行和暴发性流行，而且较难以控制和消灭，必须采取严密的综合性防治措施；丝虫病的传播速率和流行速率非常慢，传播潜能也非常低，提示有可能通过单一的控制传染源措施，容易地控制甚至阻断其传播。结论 三种蚊传疾病在传播动力学上存在明显的差异，这是导致三种疾病不同的流行病学特征和不同的防治效应的根本原因。     

Genetic diversity of Plasmodium vivax malaria in China and Myanmar

Genetic diversity and population structure of Plasmodium vivax parasites are valuable to the prediction of the origin and spread of novel variants within and between populations, and to the program evaluation of malaria control measures. Using two polymorphic genetic markers, the merozoite surface protein genes PvMSP-3α and PvMSP-3β, we investigated the genetic diversity of four Southeast Asian P. vivax populations, representing both subtropical and temperate strains with dramatically divergent relapse patterns. PCR amplification of PvMSP-3α and PvMSP-3β genes detected three and four major size polymorphisms among the 235 infections examined, respectively, while restriction analysis detected 15 and 19 alleles, respectively. Samples from different geographical areas differed dramatically in their PvMSP-3α and PvMSP-3β allele composition and frequency. Samples tended to cluster on the basis of their PCR-RFLP polymorphism. These results indicated that different parasite genotypes were circulating in each endemic area, and that geographic isolation may exist. Multiple infections were detected in all four parasite populations, ranging from 20.5% to 31.8%, strongly indicating that P. vivax populations were highly diverse and multiple clonal infections are common in these malaria-hypoendemic regions of Southeast Asia.     

海南省寄生虫病综合防治示范区基线调查结果分析

目的了解寄生虫病综合防治示范区人群土源性线虫感染基本情况，为示范区综合防治工作提供科学依据。方法全县分东、西、南、北、中5片进行随机抽样，采用改良加藤厚涂片法（Kato—Katz法）检查土源性线虫卵。结果共调查2542人，检出4种土源性线虫，总感染率为55.27％；其中钩虫、蛔虫、鞭虫感染率分别为：42.01％、9．24％、18．14％。钩虫和蛔虫均以轻度感染为主，不同人群感染率分别为：学龄前儿童：49.75％，小学生59．92％，中学生56.21％，成人54.73％。结论示范区人群土源性线虫感染率较高，主要以钩虫感染率为主，钩虫病的防治工作亟待加强。     

海南省布鲁氏菌病疫情特征研究

目的 分析海南省布鲁氏菌病（布病）流行病学特征。方法 对2012-2017年海南省收集的16株布鲁氏菌采用Vitek 2 compact进行布鲁氏菌初步鉴定,再用传统生物学分型方法进行确证,结合饲养家畜血清学和病原学检测结果分析患者的流行病学特征。结果 Vitek 2 compact鉴定12株为羊种布鲁氏菌,4株为人苍白杆菌。传统生物学分型方法鉴定11株为羊种布鲁氏菌3型,5株为猪种布鲁氏菌3型。菌株对应的16例病例中2012年1例,2013年2例,2014年4例,2015年1例,2016年2例,2017年6例,分布在东方市、临高县、海口市、万宁市、乐东县、定安县等地。同时对疫区东方市745份羊血清进行布鲁氏菌血清抗体检测,阳性47例（6.3%）,从东方市病羊采集的标本中分离到羊种布鲁氏菌3型。结论 Vitek 2 compact是一种简单、方便的布鲁氏菌鉴定方法,但不能替代传统生物学分型方法;海南地区布病主要流行的菌种为羊种3型及猪种3型,通过东方市2017年布病疫情,说明海南省有布病疫畜传染人的疫情,布病防控形势严峻。