Japanese Encephalitis in China in the Period of 1950–2018:From Discovery to Control

Japanese encephalitis(JE)was first discovered in Japan in 1871;in 1924,a major outbreak occurred,with 6,000 JE cases reported and a mortality rate of approximately 60%[1,2].Later studies showed that JE is caused by the Japanese encephalitis virus(JEV),which is spread by mosquitoes.

The global epidemiology of clonorchiasis and its relation with cholangiocarcinoma

This paper reviews the epidemiological status and characteristics of clonorchiasis at global level and the etiological relationship between Clonorchis sinensis infection and cholangiocarcinoma(CCA).A conservative estimation was made that 15 million people were infected in the world in 2004,of which over 85%distributed in China.The epidemiology of clonorchiasis is characterized by rising trend in its prevalence,variability among sexes and age,as well as endemicity in different regions.More data indicate that C.sinensis infection is carcinogenic to human,and it is predicted that nearly 5000 CCA cases attributed to C.sinensis infection may occur annually in the world decades later,with its overall odds ratio of 4.47.Clonorchiasis is becoming one major public health problem in east Asia,and it is worthwhile to carry out further epidemiological studies.

Prevalence of and risk factors associated with Cryptosporidium infection in an underdeveloped rural community of southwest China

Background:Cryptosporidium spp.is an important intestinal protozoan causing diarrhea in humans,livestock,and wild animals.Cryptosporidium infection remains a major public health issue,but its epidemiology in humans is still unclear,particularly in rural China.This study was designed to determine the prevalence of and risk factors associated with Cryptosporidium infection in a rural southwestern Chinese community.Methods:A community-based cross-sectional survey was conducted among 687 residents of a small town in a Yi autonomous prefecture of southwest China in 2014.Blood samples were examined using a broad set of quality-controlled diagnostic methods for hepatitis B virus(HBV)and human immunodeficiency virus(HIV).Stool specimens were processed using the modified acid-fast staining method,and microscopically examined for Cryptosporidium infection.Univariable and multivariable analyses were performed to determine the risk factors associated with Cryptosporidium infection.Results:The majority of the participants were Yi people with poor living conditions and unsatisfactory hygiene habits,and the study area was of very low socioeconomic status.Of the 615 individuals included in the analysis,14(2.3%)were HIV positive,51(8.3%)were infected with HBV,and 74(12.0%)had Cryptosporidium infection.The prevalences of HIV/HBV,HIV/Cryptosporidium,and HBV/Cryptosporidium co-infections were 0.3%,0.3%,and 1.8%,respectively.The prevalence of HBV infection was higher in individuals with Cryptosporidium infection(χ^(2)=5.00,P=0.03).Owning livestock or poultry was an important risk factor for Cryptosporidium infection(aOR=2.27,95%CI:1.01-5.08,P<0.05).Cryptosporidium infection was significantly associated with HBV infection(aOR=3.42,95%CI:1.47-7.92,P<0.01),but not with HIV infection(aOR=0.57,95%CI:0.07-4.39,P=0.59).Conclusions:The prevalence of Cryptosporidium infection was high in the rural area of southwestern China that was investigated,and there was a significant association between HBV infection and Cryptosporidium infection.Further investigations are needed to determine the significance of Cryptosporidium infection in patients infected with HBV.

Biogeographical characteristics of Schistosoma mansoni endemic areas in Ethiopia: a systematic review and meta analysis

Background:In Ethiopia,schistosomiasis is caused by Schistosoma mansoni and 5.haematobium with the former being widespread and more than 4 million people are estimated to be infected by S.mansoni annually with 35 million at risk of infection.Although many school-and community-based epidemiological surveys were conducted over the past decades,the national distribution of schistosomiasis endemic areas and associated socio-environinental determinants remain less well understood.In this paper,we review 5.mansoni prevalence of infections and describe key biogeographical characteristics in the endemic areas in Ethiopia.

“One Health”和人兽共患病

"One Health"是一个新的涉及多学科、跨领域的研究方法和理念,它是针对人类、动物和环境卫生保健等各个方面的一个跨学科协作和交流的全球拓展战略,致力于结合人类医学、兽医学和环境科学以改善人和动物的生存、生活质量。近年来人兽共患病的疫情在世界各地有所回升,对人类和动物的生存都构成了极大威胁。为此,很多国家和地区已开始应用"One Health"理念来解决人兽共患病问题。本文以畜牧业中发生的人兽共患病为立足点,阐明如何利用"One Health"方法解决人兽共患病问题及其产生的巨大成效。

The Three Gorges Dam:Does it accelerate or delay the progress towards eliminating transmission of schistosomiasis in China?

The Three Gorges Dam,located in the largest endemic area of schistosomiasis in China,is one of the world’s largest hydroelectric projects to date.Some large-scale hydro projects have resulted in schistosomiasis emergence or re-emergence.Therefore,the dam’s potential impact on the transmission of Schistosoma japonicum has raised concerns from medical researchers worldwide.A systematic literature review,coupled with an analysis of data on the water level and snail density in the Yangtze River was conducted to assess the impact of the dam on schistosomiasis transmission after more than 10 years of operation.The dam has significantly altered the water levels in the Yangtze River according to different seasons.These changes directly impact the ecology of the schistosome snail host.Due to the dam,there has been a reduction in the density of Oncomelania snails and/or changes in the distribution of snails.The prevalence of infection with S.japonicum has decreased in the downstream areas of the dam,including in the Dongting and Poyang Lakes.The prevalence of infection with S.japonicum in humans has decreased from 6.80%in 2002(before the dam began operating)to 0.50%in 2012,and the number of people infected with S.japonicum have decreased from 94208 in 2002 to 59200 in 2011 in the Poyang Lake region.The presence of the dam does not seem to affect snail breeding or the prevalence of schistosomiasis in the Three Gorges Reservoir.Overall,the Three Gorges Dam has significantly contributed to changes in hydrology after more than 10 years of the dam operating.The changes caused by the dam,together with integrated control of schistosomiasis,might be accelerating the progress towards eliminating the transmission of S.japonicum in the middle and lower reaches of the Yangtze River.Despite the positive effect the dam is having in controlling S.japonicum transmission,continued surveillance is required to monitor the future ecological impacts of the dam over the long term.

Integrating ecological approaches to interrupt schistosomiasis transmission:opportunities and challenges

Background:The development of agenda for global schistosomiasis elimination as a public health problem generates enthusiasms among global health communities,motivating great interests in both research and practice.Recent China-Africa schistosomiasis control initiatives,aiming to enhance collaboration on disease control in African countries,reflect in part that momentum.Yet there is a pressing need to know whether the Chinese experiences can be translated and applied in African settings.Main body:China’s remarkable achievements in schistosomiasis control programme,associated experiences and lessons,have much to offer to those combating the disease.Central to the success of China’s control programmes is a strategy termed“integrated control”-integrating environmental approaches(e.g.improved sanitation,agricultural and hydrological development and management),which target different phases of the parasite transmission system,to chemical-based drug treatment and mollusciciding.Yet,despite significant measurable public health benefits,such integration is usually based on field experience and remains largely uncharacterized in an ecological context.This has limited our knowledge on relative contributions of varying components of the integrated control programme to the suppression of disease transmission,making it challenging to generalize the strategy elsewhere.In this opinion article,we have described and discussed these challenges,along with opportunities and research needs to move forward.Conclusions:There is an urgent need to formalize an ecological framework for the integrated control programme that would allow research towards improved mechanistic understanding,quantification,and prediction of the control efforts.

Tocilizumab treatment for COVID-19 patients: a systematic review and meta-analysis

Background:Coronavirus disease 2019(COVID-19)has killed over 2.5 million people worldwide,but effective care and therapy have yet to be discovered.We conducted this analysis to better understand tocilizumab treatment for COVID-19 patients.Main text:We searched major databases for manuscripts reporting the effects of tocilizumab on COVID-19 patients.A total of 25 publications were analyzed with Revman 5.3 and R for the meta-analysis.Significant better clinical outcomes were found in the tocilizumab treatment group when compared to the standard care group[odds ratio(OR)=0.70,95%confidential interval(CI):0.54-0.90,0.007].Tocilizumab treatment showed a stronger correlation with good prognosis among COVID-19 patients that needed mechanical ventilation(OR=0.59,95%CI:0.37-0.93,P=0.02).

Assessing the nonhuman primate reservoir of Schistosoma mansoni in Africa:a systematic review

Background:Reports of natural infections of Schistosoma mansoni in a number of species of nonhuman primates(NHPs)in Africa,coupled with the substantial overlap of NHP habitats and human schistosomiasis endemic areas,has led to concerns about the role of NHPs in the transmission of human schistosomiasis.We conducted a systematic review of the literature to describe the current scope of knowledge for Africa,for the NHP species implicated,their geographical distribution,infection rates with 5.mansoni,and to discuss the implications for public health and conservation.Main text:A systematic search of the literature was performed using PubMed,Web of Science,Google Scholar,the World Health Organization(WHO)library database,World Cat,and ScienceDirect without any language restriction.Studies examining 5.monsoni infeaion of any African NHP species were included.Study types,primate species,their geographical distribution,and parasite diagnostic techniques reported in the studies were qualitatively summarized.Data for species with sample sizes>10 were included in the meta-analysis.We assessed the reported infection rate,and used a random-effeas model to estimate the summary infeaion rates and 95%confidence intervals(C/s).We assessed heterogeneity among studies using the I2 statistics.Twenty-nine publications,from 1960 to 2018,were identified and included in the review.The studies examined a total of 2962 primates belonging to 22 species in 11 genera across ten countries(Cameroon,Eritrea,Ethiopia,Gabon,Kenya,Nigeria,Senegal,Tanzania,Uganda,and Zimbabwe),and 5.mansoni infeaions were found in nine species of five genera in all countries.When we excluded studies with sample sizes<10,data from 24 studies on 11 species of primates in three genera in ten countries remained in the meta-analysis.The overall pooled estimate of infection rate was 10%(95%Cl:6-16%)with high heterogeneity(I^2=9477%)across countries and species/genera.Among the three genera,Pan had the highest infection rate of 15%(95%CI:0-55%),followed by Popio at 11%(95%Cl:6-18%),and Cercopithecus at 5%(95%CI:0-14%).The association between NHP and human infections was positive,but not significant,due to low study sample matches and high variation.Conclusions:Our findings suggest that 5.mansoni infection rate is high in African NHPs,with substantial heterogeneities across spedes/genera and countries in Africa.Given the evidence for potential spillover and spillback of S.mansoni between African NHPs and humans,further research is urgently needed to understand ecology and mechanisms of transmission of the parasite between NHP and human hosts,in order to inform control strategies of this important neglected tropical disease.

Transmission of Schistosoma mansoni in Yachi areas,southwestern Ethiopia:new foci

Background:Schistosoma mansoni,causing intestinal schistosomiasis,is widely distributed in Ethiopia and new transmission foci are continually reported.Here we report new transmission sites and prevalence ofS.mansoni infection among school children in Yachi areas,southwestern Ethiopia.Methods:A cross-sectional survey was conducted among school children of Yachi Yisa and Yachi Efo elementary schools,southwestern Ethiopia,from April 2017 to June 2017.Three hundred seventeen school children aged six to 15 years were randomly selected to provide stool specimens for helminth infection examination by Kato-Katz and formol-ether concentration techniques.Snail survey was carried out to assess schistosome infection inBiomphalaria pfeifferi.Laboratory bred mice were also exposed to schistosome cercariae shed byB.pfeifferi en masse for definite identification ofSchistosoma species.Results:From the 317 stool specimens examined using double Kato-Katz thick smear and single formol-ether concentration techniques,224(70.7%)were found positive for at least one intestinal helminth species.The most prevalent parasite wasS.mansoni(42.9%)followed byTrichuris trichiura(34.1%)andAscaris lumbricoides(14.2%).The prevalence ofS.mansoni infection was significantly higher among the children attending Yachi Yisa School(49.4%)than those in Yachi Efo School(35.6%)(P=0.002).The study also revealed that there was a significantly higher prevalence ofS.mansoni infection among males(51.2%)than females(33.1%)(P<0.001).However,the prevalence ofS.mansoni infection was not significantly associated with age categories(P=0.839).B.pfeifferi snails infected with schistosomes were collected from the water bodies found in the study area.After six weeks post exposure,adultS.mansoni worms were harvested from the mesenteric veins of laboratory bred mice.Conclusions:The study revealed establishment of newS.mansoni transmission foci and moderate prevalence of schistosomiasis in Yachi areas.Hence,treatment of all school-age children once every two years is recommended.Snail control and non-specific control approaches including provision of clean water supply and health education should also complement mass drug administration of praziquantel.

人兽共患病疫情防控新观念

人兽共患病（zoonoses）是指在脊椎动物与人类之间自然传播的疾病或感染症,由人类和脊椎动物的共同或相似病原体引起,在流行病学上有密切相关。很多人兽共患病既是畜禽的严重疾病,也是人类的烈性传染病。随着政治经济的发展,文化的融合,人类、动物和环境联系越来越紧密,人兽共患传染病问题已比以往更复杂、更棘手。到2020年,肉类蛋白质需求将增加50%[1]。

Geographical variations in risk factors associated with HIV infection among drug users in a prefecture in Southwest China

Background:Previous studies have shown inconsistent or even contradictory results for some risk factors associated with HIV infection among drug users,and these may be partially explained by geographical variations.Methods:Data were collected from 11 methadone clinics in the Liangshan Yi Autonomous Prefecture from 2004 to 2012.A non-spatial logistical regression model and a geographically weighted logistic regression model were fitted to analyze the association between HIV infection and specific factors at the individual level.Results:This study enrolled 6,458 patients.The prevalence of HIV infection was 25.1%.The non-spatial model indicated that being divorced was positively associated with HIV infection.The spatial model also showed that being divorced was positively associated with HIV infection,but only for 49.4%of individuals residing in some northern counties.The non-spatial model suggested that service sector work was negatively associated with HIV infection.However,the spatial model indicated that service work was associated with HIV infection,but only for 23.0%of patients living in some western counties.The non-spatial model did not show that being married was associated with HIV infection in our study field,but the spatial model indicated that being married was negatively associated with HIV infection for 12.0%of individuals living in some western counties.For other factors,the non-spatial and spatial models showed similar results.Conclusion:The spatial model may be useful for improving understanding of geographical heterogeneity in the relationship between HIV infection and individual factors.Spatial heterogeneity may be useful for tailoring intervention strategies for local regions,which can consequently result in a more efficient allocation of limited resources toward the control of HIV transmission.

迈向人类健康和文明的新境界：星球健康

2015年7月16日，Lancet杂志发表了由洛克菲勒基金会（Rockefeller Foundation）和该杂志共同委托全球19家高校、研究所和基金会，22位公共健康、环境科学、生态学、

采用分析方法、毒理学和风险评估研究评估多环芳烃：以石油泄漏后海产品安全为案例

[背景]多环芳香烃(PAHs)是一种大量蔓延的环境化学物质。它们可通过自然和人为过程产生,通常存在于有机介质(包括石油)中。有几种PAHs是有毒的,其中一些还表现出致癌活性。PAHs以含有两个及以上苯环的一系列化学结构为特征,根据它们的来源,可以通过氧化、氮化和烷基化表现出多种侧链修饰。[目的]讨论当代分析方法日益增加的能力,其不仅可以分辨PAHs中不同的化学结构,而且可以识别它们在环境介质中的浓度。本文以深水地平线事故后海产品污染为例,确定由于个别PAHs的分析灵敏度增加而在PAHs风险评估过程中出现的一些问题,并描述其中许多化合物的毒理学文献缺乏的现状。[讨论]PAHs,包括种类繁多的经化学修饰或取代的PAHs,是自然产生的,如果人群暴露于有害水平就可能会遭受健康风险。然而,目前的毒性评估并没有跟上现代分析方法及其对于被替代的PAHs不断增加的检测能力。因此,尽管我们可以在海产品和其他媒介中检测这些化合物,但并没有足够的关于这些化合物的潜在毒性信息,无法将它们用于人类健康风险评估和特征描述。[结论]今后的研究工作应该尝试从战略上填补这一毒理学知识欠缺,从而更好地进行环境介质或食物中关于PAHs的人体健康风险评估。这对于石油泄漏之后的影响尤为重要。