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Yin J.-H.,National Institute of Parasitic Diseases | Yin J.-H.,Key Laboratory of Parasite and Vector Biology | Yin J.-H.,Collaborating Center for Malaria | Yang M.-N.,National Institute of Parasitic Diseases | And 12 more authors.
PLoS ONE | Year: 2013

Background:Towards the implementation of national malaria elimination programme in China since 2010, the epidemiology of malaria has changed dramatically, and the lowest malaria burden was achieved yearly. It is time to analyze the changes of malaria situation based on surveillance data from 2010 to 2012 to reconsider the strategies for malaria elimination.Methods and Principal findings:Malaria epidemiological data was extracted from the provincial annual reports in China between 2010 and 2012. The trends of the general, autochthonous and imported malaria were analyzed, and epidemic areas were reclassified according to Action Plan of China Malaria Elimination (2010-2020). As a result, there reported 2743 malaria cases with a continued decline in 2012, and around 7% autochthonous malaria cases accounted. Three hundred and fifty-three individual counties from 19 provincial regions had autochthonous malaria between 2010 and 2012, and only one county was reclassified into Type I (local infections detected in 3 consecutive years and the annual incidences ≥ 1/10,000) again. However, the imported malaria cases reported of each year were widespread, and 598 counties in 29 provinces were suffered in 2012.Conclusions/Significance:Malaria was reduced significantly from 2010 to 2012 in China, and malaria importation became an increasing challenge. It is necessary to adjust or update the interventions for subsequent malaria elimination planning and resource allocation. © 2013 Yin et al.

Zhang H.-W.,U.S. Center for Disease Control and Prevention | Liu Y.,U.S. Center for Disease Control and Prevention | Zhang S.-S.,National Institute of Parasitic Diseases | Zhang S.-S.,Key Laboratory of Parasite and Vector Biology | And 8 more authors.
Advances in Parasitology | Year: 2014

This chapter reviews the patterns of malaria re-emergence and outbreak that occurred in the Huang-Huai Plain of China in 2006, and the way of quick response to curtail the outbreak by mass drug administration and case management. The contribution of the each intervention in quick response is discussed. Particularly due to the special ecological characteristics in the Huang-Huai Plain, the intervention of vector control is not implemented. Finally, the challenges in the elimination of malaria in this region are highlighted. © 2014 Elsevier Ltd.

Feng X.-Y.,National Institute of Parasitic Diseases | Feng X.-Y.,Key Laboratory of Parasite and Vector Biology | Feng X.-Y.,Collaborating Center for Malaria | Xia Z.-G.,National Institute of Parasitic Diseases | And 8 more authors.
Advances in Parasitology | Year: 2014

The national action plan for malaria elimination in China (2010-2020) was issued by the Chinese Ministry of Health along with other 13 ministries and commissions in 2010. The ultimate goal of the national action plan was to eliminate local transmission of malaria by the end of 2020. Surveillance and response are the most important components driving the whole process of the national malaria elimination programme (NMEP), under the technical guidance used in NMEP. This chapter introduces the evolution of the surveillance from the control to the elimination stages and the current structure of national surveillance system in China. When the NMEP launched, both routine surveillance and sentinel surveillance played critical role in monitoring the process of NMEP. In addition, the current response strategy of NMEP was also reviewed, including the generally developed "1-3-7 Strategy". More effective and sensitive risk assessment tools were introduced, which cannot only predict the trends of malaria, but also are important for the design and adjustment of the surveillance and response systems in the malaria elimination stage. Therefore, this review presents the landscape of malaria surveillance and response in China as well as their contribution to the NMEP, with a focus on activities for early detection of malaria cases, timely control of malaria foci and epidemics, and risk prediction. Furthermore, challenges and recommendations for accelerating NMEP through surveillance are put forward. © 2014 Elsevier Ltd.

Shi B.,Hong Kong Baptist University | Liu J.,Hong Kong Baptist University | Zhou X.-N.,National Institute of Parasitic Diseases | Zhou X.-N.,Key Laboratory of Parasite and Vector Biology | And 2 more authors.
PLoS Neglected Tropical Diseases | Year: 2014

Background:The transmission networks of Plasmodium vivax characterize how the parasite transmits from one location to another, which are informative and insightful for public health policy makers to accurately predict the patterns of its geographical spread. However, such networks are not apparent from surveillance data because P. vivax transmission can be affected by many factors, such as the biological characteristics of mosquitoes and the mobility of human beings. Here, we pay special attention to the problem of how to infer the underlying transmission networks of P. vivax based on available tempo-spatial patterns of reported cases.Methodology:We first define a spatial transmission model, which involves representing both the heterogeneous transmission potential of P. vivax at individual locations and the mobility of infected populations among different locations. Based on the proposed transmission model, we further introduce a recurrent neural network model to infer the transmission networks from surveillance data. Specifically, in this model, we take into account multiple real-world factors, including the length of P. vivax incubation period, the impact of malaria control at different locations, and the total number of imported cases.Principal Findings:We implement our proposed models by focusing on the P. vivax transmission among 62 towns in Yunnan province, People's Republic China, which have been experiencing high malaria transmission in the past years. By conducting scenario analysis with respect to different numbers of imported cases, we can (i) infer the underlying P. vivax transmission networks, (ii) estimate the number of imported cases for each individual town, and (iii) quantify the roles of individual towns in the geographical spread of P. vivax.Conclusion:The demonstrated models have presented a general means for inferring the underlying transmission networks from surveillance data. The inferred networks will offer new insights into how to improve the predictability of P. vivax transmission. © 2014 Shi et al.

Feng J.,National Institute of Parasitic Diseases | Feng J.,Key Laboratory of Parasite and Vector Biology | Feng J.,Collaborating Center for Malaria | Xia Z.-G.,National Institute of Parasitic Diseases | And 11 more authors.
Advances in Parasitology | Year: 2014

Malaria is the most important parasitic protozoan infection that has caused serious threats to human health globally. China has had success in reducing the morbidity and mortality of malaria to the lowest level through sustained and large-scale interventions. Although the total number of malaria cases declined gradually, the burden of the imported malaria cases mainly from Southeast Asian and African countries has increased substantially since 2000, posing a severe threat to public health in China. This review explores and analyses the epidemiological characteristics of the imported malaria based on data from 2000 to 2012, in order to provide theoretical bases and insights into effective prevention, avoid the resurgence of malaria in malaria-susceptible areas and develop appropriate strategies to protect people's health in China. This review also intends to offer the useful information of innovative approaches and tools that are required for malaria elimination in various settings. © 2014 Elsevier Ltd.

Qian M.-B.,National Institute of Parasitic Diseases | Qian M.-B.,Key Laboratory of Parasite and Vector Biology | Qian M.-B.,World Health Organization | Utzinger J.,Swiss Tropical and Public Health Institute | And 4 more authors.
The Lancet | Year: 2016

On Aug 21, 1875, James McConnell published in The Lancet his findings from a post-mortem examination of a 20-year-old Chinese man - undertaken at the Medical College Hospital in Calcutta, India - in whom he found Clonorchis sinensis in the bile ducts. Now, exactly 140 years later, we have a sound understanding of the lifecycle of this liver fluke, including key clinical, diagnostic, and epidemiological features. Developments in the so-called -omics sciences have not only advanced our knowledge of the biology and pathology of the parasite, but also led to the discovery of new diagnostic, drug, and vaccine targets. C sinensis infection is primarily related to liver and biliary disorders, especially cholangiocarcinoma. Clonorchiasis mainly occurs in east Asia, as a result of the region's social-ecological systems and deeply rooted cultural habit of consuming raw freshwater fish. The Kato-Katz technique, applied on fresh stool samples, is the most widely used diagnostic approach. Praziquantel is the treatment of choice and has been considered for preventive chemotherapy. Tribendimidine showed good safety and therapeutic profiles in phase 2 trials and warrants further investigation. Still today, the precise distribution, the exact number of infected people, subtle morbidities and pathogenesis, and the global burden of clonorchiasis are unknown. Integrated control strategies, consisting of preventive chemotherapy; information, education, and communication; environmental management; and capacity building through intersectoral collaboration should be advocated. © 2016 Elsevier Ltd.

Lu G.,University of Heidelberg | Zhou S.,National Institute of Parasitic Diseases | Zhou S.,Key Laboratory of Parasite and Vector Biology | Zhou S.,Collaborating Center for Malaria | And 5 more authors.
Malaria Journal | Year: 2014

Background: China has already achieved remarkable accomplishments in shrinking the malaria burden since the mid-20th Century. The country now plans to eliminate malaria by the year 2020. Looking at the dynamics of malaria outbreaks during the last decades might provide important information regarding the potential challenges of such an elimination strategy and might help to avoid mistakes of the past. Methods. A systematic review of the published literature (English and Chinese) was conducted to identify malaria outbreaks during the period 1990 until 2013 in China. The main causes of outbreaks as described in these papers were categorized according to whether they were related to population migration, environmental factors, vector and host related factors, and operational problems of the health services. Results: The review identified 36 malaria outbreaks over the 23-year study period, on which sufficient information was available. They mainly occurred in southern and central China involving 12 provinces/autonomous regions. More than half of all outbreaks (21/36, 58%) were attributed at least in part to population migration, with malaria importation to non- or low-endemic areas from high-endemic Chinese areas (13/15) or endemic countries (2/15) having been the most frequent reason (15/21, 71%). Other main causes were problems of the health services (15/36, 42%), in particular poor malaria case management (10/15, 67%), environmental factors (7/36, 19%), and vector and host related factors (5/36, 14%). Conclusions: Beside a number of other challenges, addressing population movement causing malaria appears to be of particular importance to the national malaria programme. Strengthening of surveillance for malaria and early radical treatment of cases should thus be considered among the most important tools for preventing malaria outbreaks and for the final goal of malaria elimination in China. © 2014 Lu et al.; licensee BioMed Central Ltd.

Shi B.,Hong Kong Baptist University | Xia S.,Hong Kong Baptist University | Yang G.-J.,Chinese University of Hong Kong | Zhou X.-N.,National Institute of Parasitic Diseases | And 3 more authors.
Infectious Diseases of Poverty | Year: 2013

Background: In view of the rapid geographic spread and the increasing number of confirmed cases of novel influenza A(H7N9) virus infections in eastern China, we developed a diffusion model to spatiotemporally characterize the impacts of bird migration and poultry distribution on the geographic spread of H7N9 infection. Methods: Three types of infection risks were estimated for 12 weeks, from February 4 to April 28, 2013, including (i) the risk caused by bird migration, (ii) the risk caused by poultry distribution, and (iii) the integrated risk caused by both bird migration and poultry distribution. To achieve this, we first developed a method for estimating the likelihood of bird migration based on available environmental and meteorological data. Then, we adopted a computational mobility model to estimate poultry distribution based on annual poultry production and consumption of each province/municipality. Finally, the spatiotemporal risk maps were created based on the integrated impacts of both bird migration and poultry distribution. Results: In the study of risk estimation caused by bird migration, the likelihood matrix was estimated based on the 7-day temperature, from February 4 to April 28, 2013. It was found the estimated migrant birds mainly appear in the southeastern provinces of Zhejiang, Shanghai and Jiangsu during Weeks 1 to 4, and Week 6, followed by appearing in central eastern provinces of Shandong, Hebei, Beijing, and Tianjin during Weeks 7 to 9, and finally in northeastern provinces of Liaoning, Jilin, and Heilongjiang during Weeks 10 to 12.In the study of risk caused by poultry distribution, poultry distribution matrix was created to show the probability of poultry distribution. In spite of the fact that the majority of the initial infections were reported in Shanghai and Jiangsu, the relative risk of H7N9 infection estimated based on the poultry distribution model predicted that Jiangsu may have a slightly higher likelihood of H7N9 infection than those in Zhejiang and Shanghai, if we only take the probability of poultry distribution into consideration. In the study of integrated risk caused by both bird migration and poultry distribution, the higher risk in southeastern provinces occurred during the first 8 weeks, and that in central eastern provinces appeared during Weeks 8 to 12, and that in northeastern provinces since Week 12. Therefore, it is necessary to regulate the poultry markets as long as the poultry-to-poultry transmission is not so well understood. Conclusion: With reference to the reported infection cases, the demonstrated risk mapping results will provide guidance in active surveillance and control of human H7N9 infections by taking intensive intervention in poultry markets. © 2013 Shi et al.; licensee BioMed Central Ltd.

Wang R.-B.,National Institute of Parasitic Diseases | Wang R.-B.,Collaborating Center for Malaria | Wang R.-B.,Key Laboratory of Parasite and Vector Biology | Zhang J.,Yunnan Office of Health Poverty Action HPA | And 3 more authors.
Malaria Journal | Year: 2014

Background: Epidemiological data in the border area of the northern Myanmar near China are either of little accuracy or sparse of information, due to the poor public health system in these areas, and malaria cases may be severely underestimated. This study aimed to investigate malaria prevalence and health facilities for malaria services, and to provide the baseline information for malaria control in these areas. Methods. A cluster, randomized, cross-sectional survey was conducted in four special regions of northern Myanmar, near China: 5,585 people were selected for a malaria prevalence survey and 1,618 households were selected for a mosquito net-owning survey. Meanwhile, a total of 97 health facilities were surveyed on their malaria services. The data were analysed and descriptive statistics were used. Results: A total of 761 people were found positive through microscopy test, including 290 people for Plasmodium falciparum, 460 for Plasmodium vivax, two for Plasmodium malariae, and nine for mixed infection. The average prevalence of malaria infection was 13.6% (95% CI: 12.7-14.6%). There were significant differences of prevalence of malaria infection among the different regions (P < 0.01); 38.1% (95% CI: 28.3-48.0%) of health facilities had malaria microscope examination service, and 35.1% (95% CI: 25.4-44.7%) of these had malaria treatment services, 23.7% (95% CI: 15.1-32.3%) had malaria outreach services. 28.3% (95% CI: 26.1-30.6%) of households owned one or more long-lasting insecticidal bed nets (LLINs). Conclusion: The prevalence of malaria infection was high in the four special regions of northern Myanmar, near China. Malaria services in health facilities in these areas were weak. ITNs/LLINs owning rate was also low. The cross-border cooperation mechanism should be further strengthened to share the epidemical data about malaria, support technical assistance, and conduct joint malaria control or elimination activities. © 2014 Wang et al.; licensee BioMed Central Ltd.

Xiao F.-Z.,U.S. Center for Disease Control and Prevention | Zhang Y.,National Institute of Parasitic Diseases | Zhang Y.,Key Laboratory of Parasite and Vector Biology | Zhang Y.,Collaborating Center on Malaria | And 7 more authors.
Archives of Virology | Year: 2014

Dengue fever is an acute mosquito-borne viral disease caused by dengue virus (DENV). Temperature may affect the efficiency of the mosquito vectors in spreading DENV. Aedes albopictus mosquitoes were infected orally with a DENV2 suspension and incubated at different temperatures. Subsequently, DENV2 antigen was collected from salivary gland and thorax-abdomen samples on different days postinfection and tested using an immunofluorescence assay to determine the extrinsic incubation period and infection rate. As the temperature increased, the extrinsic DENV2 incubation period in Ae. albopictus gradually shortened, and infection rates showed a tendency to initially increase, followed by a subsequent decrease. © 2014, Springer-Verlag Wien.

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