The landscape epidemiology of echinococcoses

Echinococcoses are parasitic diseases of major public health importance globally.Human infection results in chronic disease with poor prognosis and serious medical,social and economic consequences for vulnerable populations.According to recent estimates,the geographical distribution of Echinococcus spp.infections is expanding and becoming an emerging and re-emerging problem in several regions of the world.Echinococcosis endemicity is geographically heterogeneous and over time it may be affected by global environmental change.Therefore,landscape epidemiology offers a unique opportunity to quantify and predict the ecological risk of infection at multiple spatial and temporal scales.Here,we review the most relevant environmental sources of spatial variation in human echinococcosis risk,and describe the potential applications of landscape epidemiological studies to characterise the current patterns of parasite transmission across natural and human-altered landscapes.We advocate future work promoting the use of this approach as a support tool for decision-making that facilitates the design,implementation and monitoring of spatially targeted interventions to reduce the burden of human echinococcoses in disease-endemic areas.

Comparative evaluation of the diagnosis, reporting and investigation of malaria cases in China, 2005–2014: transition from control to elimination for the national malaria programme

Background:The elimination of malaria requires high-quality surveillance data to enable rapid detection and response to individual cases.Evaluation of the performance of a national malaria surveillance system could identify shortcomings which,if addressed,will improve the surveillance program for malaria elimination.Methods:Case-level data for the period 2005–2014 were extracted from the China National Notifiable Infectious Disease Reporting Information System and Malaria Enhanced Surveillance Information System.The occurrence of cases,accuracy and timeliness of case diagnosis,reporting and investigation,were assessed and compared between the malaria control stage(2005–2010)and elimination stage(2011–2014)in China's Mainland.Results:A total of 210730 malaria cases were reported in China's Mainland in 2005–2014.The average annual incidence declined dramatically from 2.5 per 100000 people at the control stage to 0.2 per 100000 at the elimination stage,but the proportion of migrant cases increased from 9.8%to 41.0%.Since the initiation of the National Malaria Elimination Programme in 2010,the overall proportion of cases diagnosed by laboratory testing consistently improved,with the highest of 99.0%in 2014.However,this proportion was significantly lower in non-endemic provinces(79.0%)than that in endemic provinces(91.4%)during 2011–2014.The median interval from illness onset to diagnosis was 3 days at the elimination stage,with one day earlier than that at the control stage.Since 2011,more than 99%cases were reported within 1 day after being diagnosed,while the proportion of cases that were reported within one day after diagnosis was lowest in Tibet(37.5%).The predominant source of cases reporting shifted from town-level hospitals at the control stage(67.9%cases)to city-level hospitals and public health institutes at the eliminate stage(69.4%cases).The proportion of investigation within 3 days after case reporting has improved,from 74.6%in 2010 to 98.5%in 2014.Conclusions:The individual case-based malaria surveillance system in China operated well during the malaria elimination stage.This ensured that malaria cases could be diagnosed,reported and timely investigated at local level.However,domestic migrants and overseas populations,as well as cases in the historically malarial non-endemic areas and hard-to-reach area are new challenges in the surveillance for malaria elimination.

Clinical predictors of severe dengue:a systematic review and meta-analysis

Background:Severe dengue is a life-threatening complication;rapid identifcation of these cases,followed by adequate management is crucial to improve the clinical prognosis.Therefore,this study aimed to identify risk factors and predictors of severe dengue.Methods:A literature search for studies reporting risk factors of severe dengue among individuals with dengue virus infection was conducted in PubMed,Scopus and Web of Science database from inception to December 31,2020.Pooled odds ratios(ORs)for patients’demographic characteristics,co-morbidities,and warning signs were estimated using an inverse variance heterogeneity model.Results:We included 143 articles in the meta-analysis from a total of 13090 articles retrieved from the literature search.The risk factors of severe dengue were:being a child[OR=1.96;95%confdence interval(CI):1.22–3.13],secondary infection(OR=3.23;95%CI:2.28–4.57),and patients with pre-existing diabetes(OR=2.88;95%CI:1.72–4.81)and renal disease(OR=4.54;95%CI:1.55–13.31).Warning signs strongly associated with severe disease were increased haematocrit with a concurrent decrease in platelet count(OR=5.13;95%CI:1.61–16.34),abdominal pain(OR=2.00;95%CI:1.49–2.68),lethargy(OR=2.73;95%CI:1.05–7.10),vomiting(OR=1.80;95%CI:1.43–2.26),hepa‑tomegaly(OR=5.92;95%CI:3.29–10.66),ascites(OR=6.30;95%CI:3.75–10.60),pleural efusion(OR=5.72;95%CI:3.24–10.10)and melena(OR=4.05;95%CI:1.64–10.00).Conclusions:Our meta-analysis identifed children,secondary infection,diabetes and renal disease(s)as important predictors of severe dengue.Our fnding also supports the predictive ability of the WHO warning signs to iden‑tify severe dengue.These fndings are useful for clinicians to identify severe dengue for management and timely interventions.

The COVID-19 vaccination campaign in Bhutan: strategy and enablers

Bhutan has reported a total of 2596 COVID-19 cases and three deaths as of September 15,2021.With support from India,the United States,Denmark,the People’s Republic of China,Croatia and other countries,Bhutan was able to conduct two rounds of nationwide vaccination campaign.While many countries struggle to overcome vaccine refusal or hesitancy due to complacency,a lack of trust,inconvenience and fear,escalated in some countries by anti-vaccine groups,Bhutan managed to inoculate more than 95%of its eligible populations in two rounds of vaccination campaign.Enabling factors of this successful vaccination campaign were strong national leadership,a well-coordinated national preparedness plan,and high acceptability of vaccine due to effective mass communication and social engagement led by religious figures,volunteers and local leaders.In this short report,we described the national strategic plan and enabling factors that led to the success of this historical vaccination campaign.

The control of soil-transmitted helminthiases in the Philippines: the story continues

Background:Soil-transmitted helminth(STH)infections have long been an important public health concern in the Philippines.In this review,we describe the current status of STH infections there and highlight the control efforts undertaken to reduce STH burden.Main text:A nationwide STH mass drug administration(MDA)programme was started in 2006 but the overall STH prevalence remains stubbornly high across the Philippines,rangi ng from 24.9%to 97.4%.

Erratum to:Comparative evaluation of the diagnosis,reporting and investigation of malaria cases in China,2005-2014:transition from control to elimination for the national malaria programme

Erratum After publication of this article[1]it was noticed that the wrong figure was used for Fig.3.Please see the correct Fig.3 below.