西非埃博拉疫情对我国传染病防控体系能力建设的启示

通过回顾2014年在西非国家流行的埃博拉疫情,分析突发传染病大规模流行的主要原因和应急防控中面临的主要挑战,进一步从复杂系统的视角提出传染病防控体系框架,以及我国加强重大传染病防控能力建设的建议。     

Invasive Non-typhoidal Salmonella Infections in Asia: Clinical Observations,Disease Outcome and Dominant Serovars from an Infectious Disease Hospital in Vietnam

Invasive non-typhoidal Salmonella (iNTS) infections are now a well-described cause of morbidity and mortality in children and HIV-infected adults in sub-Saharan Africa. In contrast, the epidemiology and clinical manifestations of iNTS disease in Asia are not well documented. We retrospectively identified >100 cases of iNTS infections in an infectious disease hospital in Southern Vietnam between 2008 and 2013. Clinical records were accessed to evaluate demographic and clinical factors associated with iNTS infection and to identify risk factors associated with death. Multi-locus sequence typing and antimicrobial susceptibility testing was performed on all organisms. Of 102 iNTS patients, 71% were HIV-infected, >90% were adults, 71% were male and 33% reported intravenous drug use. Twenty-six/92 (28%) patients with a known outcome died; HIV infection was significantly associated with death (p = 0.039). S. Enteritidis (Sequence Types (ST)11) (48%, 43/89) and S. Typhimurium (ST19, 34 and 1544) (26%, 23/89) were the most commonly identified serovars; S. Typhimurium was significantly more common in HIV-infected individuals (p = 0.003). Isolates from HIV-infected patients were more likely to exhibit reduced susceptibility against trimethoprim-sulfamethoxazole than HIV-negative patients (p = 0.037). We conclude that iNTS disease is a severe infection in Vietnam with a high mortality rate. As in sub-Saharan Africa, HIV infection was a risk factor for death, with the majority of the burden in this population found in HIV-infected adult men.     

Zoonotic Emerging Infectious Disease in Selected Countries in Southeast Asia: Insights from Ecohealth

Most emerging diseases of humans originate in animals, and zoonotic emerging infectious diseases (EIDs) threaten human, animal, and environment health. We report on a scoping study to assess actors, linkages, priorities, and needs related to management of these diseases from the perspective of key stakeholders in three countries in Southeast Asia. A comprehensive interview guide was developed and in-depth interviews completed with 21 key stakeholders in Vietnam, Lao People’s Democratic Republic, and Cambodia. We found numerous relevant actors with a predominance of public sector and medical disciplines. More capacity weaknesses than strengths were reported, with risk analysis and research skills most lacking. Social network analysis of information flows showed policy-makers were regarded as mainly information recipients, research institutes as more information providers, and universities as both. Veterinary and livestock disciplines emerged as an important “boundary-spanning” organization with linkages to both human health and rural development. Avian influenza was regarded as the most important zoonotic EID, perhaps reflecting the priority-setting influence of actors outside the region. Stakeholders reported a high awareness of the ecological and socioeconomic drivers of disease emergence and a demand for disease prioritization, epidemiological skills, and economic and qualitative studies. Evaluated from an ecohealth perspective, human health is weakly integrated with socioeconomics, linkages to policy are stronger than to communities, participation occurs mainly at lower levels, and equity considerations are not fully considered. However, stakeholders have awareness of ecological and social determinants of health, and a basis exists on which transdisciplinarity, equity, and participation can be strengthened.     

传染病医院检验科生物安全管理及防护措施探讨

目的:探讨传染病医院检验科生物安全管理及防护措施.方法:对传染病医院检验科实验室相关人员的职责进行明确分工,使其进一步了解实验室生物操作风险的种类及来源,并在实验室配备必要的安全防护措施,对标本施行严格的管理制度.结果:严格施行检验科实验室生物安全管理,增加防护措施,可以有效的避免生物安全事故的发生.结论:对检验科实验室生物安全管理进行规范后可以有效地减少实验室工作人员的风险,同时也有效避免了病源微生物的外泄,最大限度的保障了实验室的生物安全.     

Donor issues in Indonesia: A developing country in South East Asia

In most developing countries in South East Asia blood services have not been treated properly as an important service to support health program. Indonesia as a large archipelago country in South East Asia has specific obstacles in managing a blood service. To position the country blood service profile especially in term of donor issues, we compared our blood service with that in other South East Asia countries.Indonesia has 17 thousand islands with 220 million inhabitants. Blood services have been mostly run by the Indonesian Red Cross as a government assignment since 1950. Donor recruitment programs have been directed toward 100% of Voluntary Non Remunerated Blood Donor (VNRD), which now have reached 81.3%. Dissemination of information on VNRD, donor recruiter's training and VNRD appreciation programs are strategies to increase and maintain the VNRD.Limited female donors and insufficient blood supply during the fasting month and holidays constitute major challenges. Low hemoglobin level, low body weight and fear are reasons for low number of female donors. Poor management of blood stock during fasting month, long holidays and also poor networking of blood supply are reasons for insufficient blood supply during the year.Considering the great size of Indonesia with different ethnic groups and cultures, worsened by lack of infrastructure, decisive and effective strategies in donor recruitment and retention programs are needed.     

Transposing from the Laboratory to the Classroom to Generate Authentic Research Experiences for Undergraduates

Large lecture classes and standardized laboratory exercises are characteristic of introductory biology courses. Previous research has found that these courses do not adequately convey the process of scientific research and the excitement of discovery. Here we propose a model that provides beginning biology students with an inquiry-based, active learning laboratory experience. The Dynamic Genome course replicates a modern research laboratory focused on eukaryotic transposable elements where beginning undergraduates learn key genetics concepts, experimental design, and molecular biological skills. Here we report on two key features of the course, a didactic module and the capstone original research project. The module is a modified version of a published experiment where students experience how virtual transposable elements from rice (Oryza sativa) are assayed for function in transgenic Arabidopsis thaliana. As part of the module, students analyze the phenotypes and genotypes of transgenic plants to determine the requirements for transposition. After mastering the skills and concepts, students participate in an authentic research project where they use computational analysis and PCR to detect transposable element insertion site polymorphism in a panel of diverse maize strains. As a consequence of their engagement in this course, students report large gains in their ability to understand the nature of research and demonstrate that they can apply that knowledge to independent research projects.     

Chromosomal polymorphism in species of the Drosophila nasuta complex in East and South East Asia

This paper is presented as a review of ten years collection of the D. nasuta complex from the Asian region by Dr. Wharton B. Mather. It incorporates the analysis of chromosomal polymorphisms with regard to their geographical distribution and then uses the polymorphisms to establish phylogenetic relationships between D. sulfurigaster albostrigata, D. albomicans and D. kohkoa.     

A taxonomic study of genus Teleogryllus from East Asia (Insecta: Orthoptera: Gryllidae)

Crickets belonging to Teleogryllus spp. are widely distributed in East Asia and they are difficult to distinguish. In this study, a phylogenetic tree of Teleogryllus is reconstructed by COI gene, and all species can be distinguished well. The possible evolutionary histories of male genitalia, songs and life history are discussed. The result supports establishing subgenera Macroteleogryllus and Brachyteleogryllus of Teleogryllus spp. from East Asia. T. boninensis is moved to Brachyteleogryllus. The calling song of four species includes both long and short chirps, and the rest just have single chirps. The species inhabit sympatrically trend to have different type of calling song. Egg overwinter type evolved several times independently.     

Determinants of Influenza Transmission in South East Asia: Insights from a Household Cohort Study in Vietnam

To guide control policies, it is important that the determinants of influenza transmission are fully characterized. Such assessment is complex because the risk of influenza infection is multifaceted and depends both on immunity acquired naturally or via vaccination and on the individual level of exposure to influenza in the community or in the household. Here, we analyse a large household cohort study conducted in 2007–2010 in Vietnam using innovative statistical methods to ascertain in an integrative framework the relative contribution of variables that influence the transmission of seasonal (H1N1, H3N2, B) and pandemic H1N1pdm09 influenza. Influenza infection was diagnosed by haemagglutination-inhibition (HI) antibody assay of paired serum samples. We used a Bayesian data augmentation Markov chain Monte Carlo strategy based on digraphs to reconstruct unobserved chains of transmission in households and estimate transmission parameters. The probability of transmission from an infected individual to another household member was 8% (95% CI, 6%, 10%) on average, and varied with pre-season titers, age and household size. Within households of size 3, the probability of transmission from an infected member to a child with low pre-season HI antibody titers was 27% (95% CI 21%–35%). High pre-season HI titers were protective against infection, with a reduction in the hazard of infection of 59% (95% CI, 44%–71%) and 87% (95% CI, 70%–96%) for intermediate (1∶20–1∶40) and high (≥1∶80) HI titers, respectively. Even after correcting for pre-season HI titers, adults had half the infection risk of children. Twenty six percent (95% CI: 21%, 30%) of infections may be attributed to household transmission. Our results highlight the importance of integrated analysis by influenza sub-type, age and pre-season HI titers in order to infer influenza transmission risks in and outside of the household.     

Two new species of caddisflies from East Asia （Trichoptera： Philopotamidae, Psychomyiidae）

A new species of Kisaura Ross （Philopotamidae） from Japan and a new species of Psychomyia Latreille （Psychomyiidae） from Russia are described. Kisaura imparis n. sp. is closest to Kisaura aurascens （Martynov, 1934）, but the lateral processes of tergum X are asymmetrical and the apex of tergum X is different. Psychomyia poltavkaensis n. sp. resembles Psychomyia n. sp., but the shape of tergum IX＋X is more rounded, the apex of the basoventral process of each preanal appendage is unforked, and the inferior appendages are branched.     

Pediatric in-Hospital Death from Infectious Disease in Uganda: Derivation of Clinical Prediction Models

Background

Pediatric hospital mortality from infectious diseases in resource constrained countries remains unacceptably high. Improved methods of risk-stratification can assist in referral decision making and resource allocation. The purpose of this study was to create prediction models for in-hospital mortality among children admitted with suspected infectious diseases.

Methods

This two-site prospective observational study enrolled children between 6 months and 5 years admitted with a proven or suspected infection. Baseline clinical and laboratory variables were collected on enrolled children. The primary outcome was death during admission. Stepwise logistic regression minimizing Akaike’s information criterion was used to identify the most promising multivariate models. The final model was chosen based on parsimony.

Results

1307 children were enrolled consecutively, and 65 (5%) of whom died during their admission. Malaria, pneumonia and gastroenteritis were diagnosed in 50%, 31% and 8% of children, respectively. The primary model included an abnormal Blantyre coma scale, HIV and weight-for-age z-score. This model had an area under the curve (AUC) of 0.85 (95% CI, 0.80–0.89) with a sensitivity and specificity of 83% and 76%, respectively. The positive and negative predictive values were 15% and 99%, respectively. Two alternate models with similar performance characteristics were developed withholding HIV and weight-for-age z-score, for use when these variables are not available.

Conclusions

Risk stratification of children admitted with infectious diseases can be calculated based on several easily measured variables. Risk stratification at admission can be used for allocation of scarce human and physical resources and to guide referral among children admitted to lower level health facilities.     

NewLiparis species (Orchidaceae) from South Central and East Africa

Liparis molendinacea is related toL. deistelii and known so far only from the type locality in Kawambwa district in the Northern Province of Zambia.L. nyikana likewise is related toL. deistelii, it is distributed in E. and SW. Tanzania and in N. Malawi.L. chimanimaniensis is related toL. nervosa and known so far only from the Chimanimani Mountains in the Eastern Province of Zimbabwe.