INTRODUCTION:The China-UK-Tanzania pilot project of 1,7-malaria reactive community-based testing and response (1,7-mRCTR) approach was implemented in Tanzania between 2015 and 2018. This project targeted villages with the highest malaria incidence to conduct screening and treatment. While socioeconomic factors are known to be strongly associated with malaria burden, their specific impacts on malaria prevention behaviours during the 1,7-mRCTR implementation period remained unclear. This study aimed to construct a household wealth index and investigate its association with malaria prevention outcomes within the context of 1,7-mRCTR. METHODS:We used data from two cross-sectional household surveys conducted in 2015 (baseline) and 2018 (endline), covering 19 686 households. A 12-item wealth index was constructed using Mokken scale analysis, with weighted wealth scores calculated via multiple correspondence analysis to categorise households into wealth tertiles. Using logistic regression within a Difference-in-Differences (DID) framework, we assessed the association between household wealth and the household ownership of useful long-lasting insecticidal nets (LLINs), use of LLINs and use of antimalarial drugs. RESULTS:Analysis of the pooled data showed that households in the first (poorest) tertile had significantly lower odds of owing LLINs (OR=0.62, 95% CI 0.54 to 0.70, p<0.001) and using LLINs (OR=0.53, 95% CI 0.45 to 0.62, p<0.001) compared to the third (wealthiest) tertile. The DID analysis, accounting for the interaction between the intervention period (2018 vs 2015) and wealth tertile, showed a significantly greater increase in the odds of owing LLINs (OR=1.26, 95% CI 1.03 to 1.56) and using LLINs (OR=1.88, 95% CI 1.25 to 2.82) among households in the first tertile compared with the third tertile. CONCLUSION:The wealth index effectively differentiated household socioeconomic status, revealing significant wealth-based disparities in malaria prevention behaviours. Importantly, the implementation of the 1,7-mRCTR approach appears to have had a disproportionately positive effect on poorer households, leading to a reduction in wealth-based inequalities related to key malaria prevention measures.

What is already known about this topic?:Echinococcosis remains a critical public health challenge in western China. Conventional routine health education (RHE) strategies have consistently proven insufficient in achieving the sustained behavioral modifications necessary to reduce disease transmission and burden. What is added by this report?:This study provides the first large-scale experimental evidence that a Smart Health Education Pillbox (SHEP) significantly enhances knowledge, corrects misconceptions, and improves practice conversion efficiency regarding echinococcosis control among dog owners in endemic pastoral areas. These findings demonstrate the substantial value of precise, automated health education tools in controlling zoonotic diseases. What are the implications for public health practice?:The SHEP represents a scalable, precise health education tool that effectively bridges the knowledge-practice gap in resource-limited settings. Its demonstrated efficacy supports integration into national echinococcosis control programs as a cost-effective digital intervention that promotes sustainable behavior change and reduces zoonotic disease transmission.

Background. Avian influenza virus (AIV) H9N2 has a major role in the emergence of influenza pandemic. We assessed the risk of AIV H9N2 to the human population and public health. Method. The hemagglutination inhibition method was used to screen for hemagglutinin antibodies. Microneutralization tests were performed to confirm neutralizing antibodies against the AIV H9N2 subtype. Real-time polymerase chain reaction was conducted to detect the H9 subtype in environmental samples. GraphPad Prism software was used for mapping, and STATA software was used for statistical analysis. Results. The nationwide seroprevalence among these populations was 0.76%. Seroprevalence was compared across regions, genders, and occupational exposure sites. The seroprevalence rates for males and females showed no significant difference. Significant differences were found across regions and occupational exposure environments (P < .05). The south and southwest regions had the highest seroprevalence rates at 1.58% and 1.38%, respectively. The highest seroprevalence was observed in individuals exposed to live poultry market (1.51%). Significant regional differences in H9 nucleic acid positive rates (NAPRs) were found (P < .05), with the southwest and central regions showing the highest rates at 25.99% and 24.35%, respectively. H9 NAPR in live poultry markets (LPMs), farms, and slaughterhouses varied significantly by region (P < .05). Conclusions. Poultry-related environments have become a key factor in AIV H9N2 infection among occupational populations. Exposure to LPM showed the highest seroprevalence among occupational groups. The distribution characteristics of H9N2 across different poultry environments increased the risk of infection in occupationally exposed populations.

Malaria remains a significant global health challenge, particularly in Africa, which continues to bear the greatest burden. The transboundary nature of malaria necessitates regional collaboration, yet transcontinental knowledge-sharing mechanisms remain limited. The World Health Organization's (WHO) certification of China as malaria-free in 2021 presents an opportunity to leverage its expertise, cost-effective products, and elimination strategies to support Africa's malaria control efforts. The Institution-based Network on China-Africa Cooperation for Malaria Elimination (INCAM) was established in 2018 to bridge this gap, fostering cross-continental collaboration through knowledge exchange, product innovation, and policy advocacy. Between 2019 and 2025, INCAM has convened six fora, facilitated to promote the adaptation of China's anti-malaria practices to African contexts. These fora promoted the exploration of demand-driven research, the development of innovative anti-malarial products, and the advancement of evidence-based policies. INCAM exemplifies the potential of China-Africa collaboration to accelerate malaria control and elimination in Africa through solutions tailored to local contexts. To sustain this progress, there is an urgent need for stronger Public-Private-Academic Partnerships, and enhanced capacity-building programs. By addressing these gaps, INCAM can maximize its role as a leading transcontinental hub for malaria control and elimination for China and Africa.

Background Cystic echinococcosis (CE), caused by Echinococcus granulosus sensu lato (E. granulosus s.l.), is a major zoonotic disease causing substantial health and economic losses, particularly in pastoral communities. WHO and WOAH recommend combining regular dog deworming with sheep vaccination (EG95) for control. However, genotype data are important for vaccination planning, as EG95 mainly targets G1/G3 in sheep and evidence of protection against other genotypes is limited. In Mongolia, molecular data from livestock, especially sheep, remain scarce despite the large sheep population. We therefore aimed to determine the genotype distribution of E. granulosus s.l. among livestock, particularly sheep, across Mongolia's endemic provinces.Methods From August to December 2024, we conducted an abattoir-based cross-sectional survey in four provinces (Umnugobi, Bayankhongor, Dundgobi, and Tuv). Sheep, goats, and camels were examined for hydatid cysts. DNA was extracted, the COX1 gene was amplified by PCR and sequenced using the Sanger method, and published diagnostic COX1 sites were used to refine G6/G7 assignments; phylogenetic and haplotype analyses were performed with regional reference data.Results Cysts were detected in 2.5% (115/4,578) of animals, and 0.31% (14/4,578) were molecularly confirmed as E. granulosus s.l. Among them, 93% (13/14; 10 sheep, 2 goats, 1 camel) were Echinococcus canadensis (G6/G7) and 7% (1/14; 1 sheep) were Echinococcus granulosus s.s. (G1/G3). Five COX1 haplotypes were identified: four E. canadensis haplotypes (H1-H4) and one E. granulosus s.s. haplotype (H5). Haplotypes H1-H3 were consistent with G6, whereas H4 was consistent with G7a. These haplotypes grouped with reference isolates from Mongolia and neighbouring countries, as well as from other endemic regions included in the network.Conclusions This study strengthens evidence that E. granulosus s.l. infections in Mongolian livestock are predominantly caused by Echinococcus canadensis G6/G7 and shows, for the first time, that this taxon predominated among successfully genotyped isolates from sheep in the surveyed areas. These findings support genotype-informed surveillance for vaccination planning, particularly in mixed-genotype settings, while underscoring the importance of dog deworming and safe offal disposal. Our findings further clarify CE transmission patterns in Mongolia and the wider region, highlight the transboundary nature of CE, and support the need for coordinated cross-border surveillance and control.

Objective: It aims to provide a preliminary analysis of the epidemiological characteristics and trends of 40 notifiable infectious diseases in the mainland of China over the past ten years, serving as a valuable reference for public health policies and interventions related to infectious diseases. Methods: Using data from the monthly analysis reports of the National Infectious Disease Surveillance System, we obtained information on reportable infectious diseases in China from 2013 to 2022. The data were analyzed using Excel 2010 software, and a joinpoint regression model was employed to examine trends in incidence and case-fatality ratios during this period. Results: From 2013 to 2022, a total of 76 874 318 cases of notifiable infectious diseases were reported in the mainland of China, resulting in an average yearly incidence of 551.26/100000 persons, with an average annual percentage change (AAPC) was 0.23% (95%CI: -3.81 to 4.37). The infectious diseases with the highest yearly incidence include hand, foot and mouth disease, hepatitis B, infectious diarrhea, tuberculosis, and influenza. There were 207216 deaths with an average annual case-fatality rate of 2.70/1000, with an AAPC of 5.53% (95%CI: 2.16 to 9.30). The diseases with the highest mortality rates were acquired immune deficiency syndrome (AIDS), tuberculosis, rabies, infectious diarrhea, and COVID-19. The incidence of notifiable infectious diseases was predominantly attributed to category C diseases, accounting for 54.50% of total cases, while intestinal infectious diseases were the most prevalent, comprising 40.64% of the total morbidity. The monthly incidence trend of 40 notifiable infectious diseases in China’s mainland exhibited a "W" distribution, whereas the monthly case-fatality ratio trend displayed an "M" distribution. Conclusions: It is crucial to continuously reinforce the prevention and control of key infectious diseases, including AIDS, tuberculosis, and viral hepatitis, as well as highly prevalent diseases such as hand, foot and mouth disease, influenza, and infectious diarrhea. Additionally, enhancing surveillance and response to emerging infectious diseases is essential to safeguarding public health and safety.

What is already known about this topic?:Echinococcosis remains a significant zoonotic threat in western China, with canines serving as the primary reservoir for Echinococcus transmission. Despite monthly praziquantel (PZQ) deworming programs, challenges in compliance persist in remote pastoral regions due to logistical constraints. What is added by this report?:The smart health education pillbox (SHEP) demonstrated a 22.62% reduction in the overall cost of dog deworming, an increase of 52.59% in the proportion of dogs receiving the recommended annual deworming frequency of 9-12 times, a 35.45% decrease in the risk of Echinococcus infection, and a 1.55-fold higher protective efficacy against canine echinococcosis transmission compared to conventional manual deworming (CMD) approaches. What are the implications for public health practice?:These results indicate that SHEP reduces labor costs and mitigates echinococcosis transmission risk, highlighting its potential as a valuable tool for disease control.

OBJECTIVES:Malaria remains a critical public health challenge, especially in regions like southeastern Tanzania. Understanding the intricate relationship between environmental factors and malaria incidence is essential for effective control and elimination strategies. STUDY DESIGN:Cohort study. METHODS:This cohort study, conducted between Jan 2016 and October 2021 across three districts in southeastern Tanzania, utilized advanced machine learning techniques, specifically the Extreme Gradient Boosting (XGBoost) model, to examine the impact of climate factors on malaria incidence. SHapley Additive exPlanations (SHAP) values were applied to interpret model predictions, highlighting the roles of normalized difference vegetation index (NDVI), temperature, and rainfall in shaping malaria transmission dynamics. RESULTS:Analysis revealed considerable heterogeneity in malaria incidence across southeastern Tanzania, with Kibiti experiencing the highest number of cases (15,308) over the study period. Seasonal peaks corresponded with rainy periods, though incidence rates varied by district. Incorporating lagged climate variables and seasonal trends significantly improved forecast accuracy, with the one-month lag model achieving the lowest mean absolute error (MAE = 175.46) and root mean squared error (RMSE = 228.24). SHAP analysis identified seasonality (mean SHAP 29.6), followed by lagged temperature (13.8), rainfall (12.4), and NDVI (5.96), as the most influential factors, reflecting the biological underpinnings of malaria transmission. CONCLUSIONS:This study demonstrates the utility of machine learning and explainable SHAP in malaria epidemiology, providing a data-driven framework to guide targeted, climate-informed malaria control strategies. By capturing seasonal and climate-linked risks, these methods hold promise for enhancing public health planning and adaptive response in malaria-endemic regions.

Background:Echinococcosis constitutes a major zoonotic parasitic disease with profound public health and socioeconomic implications. Dog deworming remains a cornerstone intervention endorsed by World Health Organization. This study comparatively assessed automated vs. manual praziquantel (PZQ) bait delivery systems for dog echinococcosis control. Methods:A prospective, randomized, double-blinded field trial employing a One Health framework was conducted in Tianzhu Zangzu Zizhixian, China-a cystic echinococcosis endemic region. Township-level cluster randomization allocated dogs to smart collar deworming group (SCDG) with monthly automated PZQ delivery and manual deworming group (MDG) with conventional bait administration. Intervention assignment remained masked between groups. Laboratory personnel were blinded during fecal antigen analysis using enzyme linked immunosorbent assay (ELISA). Generalized Estimating Equations (GEE) evaluated efficacy via odds ratios (ORs) over 24 months, SPSS software (version 27.0) was used for data processing. Metrics included parasitological outcomes, deworming frequency, collar deployment and recovery rates. Results:From June 2021 to July 2023, 1920 dogs (800 from SCDG, 1120 from MDG) were enrolled with owner consent. Among the 5119 fecal samples analyzed (2320 from SCDG, 2799 from MDG), 33 were antigen-positive (8 from SCDG, 25 from MDG). Baseline positivity showed no intergroup difference (SCDG: 0.8 % [6/792] vs. MDG: 1.2 % [13/1099], P = 0.36). At 24 months, SCDG achieved 0 % positivity (0/661) while MDG's was 0.6 % (5/789). Smart collars conferred significant protection (OR = 0.432, 95 % confidence interval [CI]: 0.194-0.959, P < 0.0001)-equivalent to 56.8 % infection risk reduction. At 12 months, the recycling rate and integrity rate of smart collars were 83.3 % (666/800) and 74.3 % (495/666), respectively; and the proportion of dogs dewormed 6-12 times per year was 86.7 % (577/666). At 24 months, the recycling rate and integrity rate of smart collars were up to 93.6 % (749/800, χ 2 = 42.106, P < 0.001) and 94.1 % (705/749, χ 2 = 107.269, P < 0.001), respectively. During this period, 91.6 % (1202/1312) of dogs received deworming 6-12 times per year. In 2023, a total of 647 smart collars were distributed, with the recycling rate and integrity rate of 99.8 % (646/647) and 96.4 % (623/646), respectively. The proportion of dogs dewormed 6-12 times per year increased to 96.6 % (625/646, χ 2 = 34.969, P < 0.001). Conclusions:Field deployment of smart collars proves operationally viable, sustainably enhancing deworming frequency while reducing dog infection rates more effectively than manual methods. The 56.8 % protective effect advancement mitigates environmental egg contamination, thereby lowering zoonotic transmission risk.

Introduction:Surveys from the China-Tanzania Malaria Control Project demonstrated that the 1,7-malaria Reactive Community-Based Testing and Response (1,7-mRCTR) approach significantly reduced malaria incidence rates. However, implementation was disrupted by security concerns, infectious disease outbreaks, and supply shortages. This study evaluates how these interruptions affected intervention effectiveness to inform future malaria control strategies. Methods:The study employed a two-phased design: Phase I (2016-2018) and Phase II (2019-2021). Weekly malaria incidence rates per 100 people were calculated from cases reported by local health facilities in the intervention areas during both phases. Seasonal and trend decomposition using loess (STL) and interrupted time series modeling with piecewise linear regression were used to evaluate the impact of disruptions on 1,7-mRCTR implementation effectiveness. Results:In Tanzania's 1,7-mRCTR areas, malaria incidence peaked during November-December and June-July. Phase I's 8-month interruption reversed the weekly trend from a 0.17% decline to a 0.58% increase (P=0.001). After resumption, incidence dropped 8.96% (P=0.039) and maintained a 0.39% long-term decline (P=0.003). Even with seasonal adjustment, the interruption slowed the weekly decline from 0.08% to 0.07% (P=0.003). Phase II showed a similar pattern: a one-week interruption caused a 0.70% drop (P=0.007) but shifted the trend from a 0.02% decline to a 0.08% increase (P=0.001). After resumption, interventions stabilized the decline at 0.11% weekly (P=0.001). Conclusions:This research demonstrates that Tanzania's malaria incidence is closely linked to seasonal patterns and consistent intervention efforts. Phase I's 8-month security-related interruption reduced 1,7-mRCTR effectiveness by 12.5%, while Phase II's 3-month pandemic-induced interruption caused only short-term fluctuations with minimal long-term impact. Rapid resumption of interventions after disruptions allowed for prompt recovery, highlighting the importance of adaptive strategies to maintain progress toward malaria control goals.

Echinococcosis is a group of chronic zoonotic parasitic diseases caused by the larval stage of Echinococcus tapeworms, which infect both humans and animals. Due to the complex life cycle, broad geographic distribution and wide range of host species of Echinococcus, controlling and eliminating echinococcosis remains highly challenging. Source control and the interruption of transmission pathways are critical but difficult, which always impede prevention and control efforts. Therefore, accurate detection, differentiation, diagnosis, and effective treatment, along with real-time monitoring of infections across various hosts, are essential prerequisites. This paper provides a comprehensive review of the current epidemiological status of echinococcosis, research progress, prevention and control measures, and the main challenges in efforts from control toward elimination of the disease in China, with the aim of providing reference for further optimization of present control strategies and surveillance methods.

OBJECTIVE:To evaluate the effectiveness of the central government-funded echinococcosis control programme in Tianzhu Tibetan Autonomous County, Gansu Province from 2007 to 2022, so as to provide insights into echinococcosis control.METHODS:Administrative villages were sampled using a multi-stage cluster random sampling method from Tianzhu Tibetan Autonomous County, Gansu Province from 2007 to 2022, and all residents at ages of 12 years and older in the sampled villages were screened for echinococcosis, and schools were sampled using a cluster sampling method, and all children at ages of 12 years and older in the sampled schools were screened for echinococcosis. Domestic dogs were sampled using a systematic random sampling method, and one domestic dog stool sample was collected from each household. Stray dog stool samples were collected outside the villages, and Echinococcus coproantigens were detected using enzyme-linked immunosorbent assay in domestic and stray dogs. In addition, echinococcosis was screened in sheep and cattle in designated slaughterhouses in Tianzhu Tibetan Autonomous County. The trends in the prevalence of echinococcosis in humans and livestock and the positive rate of Echinococcus coproantigens in dogs were examined with the Cochran-Armitage trend test. In addition, individuals screened for echinococcosis were randomly sampled from 2007 to 2022 for survey on the awareness of echinococcosis control knowledge.RESULTS:A total of 290 356 person-times were screened for echinococcosis among residents at ages of 12 years and older in Tianzhu Tibetan Autonomous County, Gansu Province from 2007 to 2022, with 1 094 residents detected with cystic echinococcosis, and the detection of echinococcosis appeared a tendency towards a gradual decline over years (χ2 = 358.602, P < 0.001). A total of 32 931 person-times were screened for echinococcosis among children at ages of 12 years and older in Tianzhu Tibetan Autonomous County, Gansu Province from 2007 to 2022, with 296 children detected with echinococcosis, and the detection of echinococcosis appeared a tendency towards a gradual decline over years (χ2 = 267.673, P < 0.001). A total of 33 230 domestic dog stool samples were tested for Echinococcus coproantigens in Tianzhu Tibetan Autonomous County, Gansu Province from 2007 to 2022, with 1 777 Echinococcus coproantigens-positive samples tested, and the positive rate of Echinococcus coproantigens appeared a tendency towards a decline in domestic dogs over years (χ2 = 2 210.428, P < 0.001), while the positive rate of Echinococcus coproantigens showed a tendency towards a rise in domestic animals from 2016 to 2022 (χ2 = 37.745, P < 0.001). The positive rate of Echinococcus coproantigens remained relatively stable in stray dogs in Tianzhu Tibetan Autonomous County, Gansu Province from 2019 to 2022 (χ2 = 0.315, P = 0.575). A total of 10 973 sheep were screened for echinococcosis in Tianzhu Tibetan Autonomous County from 2007 to 2022, with 334 sheep detected with echinococcosis, and the detection of echinococcosis appeared a tendency towards a decline in sheep over years (χ2 = 53.579, P < 0.001); however, there was no significant change in the detection of echinococcosis during the period from 2015 through 2022 (χ2 = 1.520, P = 0.218). A total of 2 400 cattle were screened for echinococcosis in Tianzhu Tibetan Autonomous County from 2017 to 2022, with 231 cattle detected with echinococcosis, and the detection of echinococcosis showed a tendency towards a decline over years (χ2 = 5.579, P < 0.05). The awareness of echinococcosis control knowledge increased from 44.37% in 2007 to 94.00% in 2022 among residents at ages of 12 years and older and from 52.50% in 2007 to 92.50% in 2022 among children at ages of 12 years and older in Tianzhu Tibetan Autonomous County, respectively.CONCLUSIONS:There has been a reduction in the detection of echinococcosis in humans and domestic animals and the positive rate of Echinococcus coproantigens in dogs and a rise in the awareness of the echinococcosis control knowledge following the implementation of the central government-funded echinococcosis control programme in Tianzhu Tibetan Autonomous County, Gansu Province; however, integrated echinococcosis control measures are still required for further control of the prevalence of echinococcosis.

Abstract Objective To conduct an in-depth analysis of the epidemiological characteristics of 45 notifiable infectious diseases in mainland China the past decade, in order to comprehensively understand and grasp the epidemic situation, as well as to provide references and foundations for the development of effective prevention and control strategies and measures. Method Based on the monthly analysis report of the National Infectious Disease Surveillance System (NIDSS), data on reportable infectious diseases in China from 2013 to 2022 were obtained. The data were processed using IBM SPSS 22.0 and Excel 2010 software, and a joint-point regression model was used to analyze incidence and case-fatality ratios trends from 2013 to 2022. Results From 2013 to 2022, a total of 76,874,318 cases of notifiable infectious diseases were reported in mainland China, with an average annualized incidence rate of 551.26/100,000, and 207,216 deaths from notifiable infectious diseases, corresponding to an average annualized case-fatality rate of 2.70 /1,000. Throughout this period, the overall incidence rate showed a downward trend, with an average annual percentage changes (AAPC) of -0.14% (95% CI: -3.75–3.51%), while the overall case-fatality rate showed an upward trend, with an AAPC of 5.41% (95% CI: 2.29–8.61%). In this decade, HFMD, hepatitis B, infectious diarrhea, tuberculosis, and influenza were the prevalent infectious diseases in terms of morbidity among 45 notifiable infectious diseases, while acquired immune deficiency syndrome (AIDS), tuberculosis, rabies, infectious diarrhea, and COVID-19 were the diseases with high numbers of deaths. According to the classification of A, B and C, the incidence of notifiable infectious diseases in mainland China from 2013 to 2022 was primarily dominated by C infectious diseases, accounting for 54.50%. Based on different transmission routes, intestinal infectious diseases were the most prevalent, accounting for 40.64% of the total morbidity. The overall monthly incidence trend of notifiable infectious diseases in mainland China exhibited a "W" distribution, while the monthly case-fatality ratios trend shows a "M" distribution. During the COVID-19 epidemic period (2020–2022), compared with the pre-epidemic period (2017–2019), the incidence rate of 6 infectious diseases increased and the incidence rate of 34 infectious diseases decreased; the case-fatality ratios of 18 diseases increased and 14 diseases decreased. Conclusion It is very crucial to continuously reinforce the prevention and control of key infectious diseases, including AIDS, tuberculosis and viral hepatitis as well as highly prevalent infectious diseases, such as hand-foot-mouth disease, influenza and infectious diarrhoeal diseases. Concurrently, we should enhance our surveillance and response to emerging infectious diseases to safeguard public health and safety.

Background Geographical and meteorological factors have been reported to influence the prevalence of echinococcosis, but there's a lack of indicator system and model.Objective To provide further insight into the impact of geographical and meteorological factors on AE prevalence and establish a theoretical basis for prevention and control.Methods Principal component and regression analysis were used to screen and establish a three-level indicator system. Relative weights were examined to determine the impact of each indicator, and five mathematical models were compared to identify the best predictive model for AE epidemic levels.Results By analyzing the data downloaded from the China Meteorological Data Service Center and Geospatial Data Cloud, we established the KCBIS, including 50 basic indicators which could be directly obtained online, 15 characteristic indicators which were linear combination of the basic indicators and showed a linear relationship with AE epidemic, and 8 key indicators which were characteristic indicators with a clearer relationships and fewer mixed effects. The relative weight analysis revealed that monthly precipitation, monthly cold days, the difference between negative and positive temperature anomalies, basic air temperature conditions, altitude, the difference between positive and negative atmospheric pressure anomalies, monthy extremely hot days, and monthly fresh breeze days were correlated with the natural logarithm of AE prevalence, with sequential decreases in their relative weights. The multinomial logistic regression model was the best predictor at epidemic levels 1, 3, 5, and 6, whereas the CART model was the best predictor at epidemic levels 2, 4, and 5.

The proportion of human isolates with reduced neuraminidase inhibitors (NAIs) susceptibility in highly pathogenic avian influenza (HPAI) H7N9 virus was high. These drug-resistant strains showed good replication capacity without serious loss of fitness. In the presence of oseltamivir, R229I substitution were found in HA1 region of the HPAI H7N9 virus before NA R292K appeared. HPAI H7N9 or H7N9/PR8 recombinant viruses were developed to study whether HA R229I could increase the fitness of the H7N9 virus bearing NA 292K. Replication efficiency was assessed in MDCK or A549 cells. Neuraminidase enzyme activity and receptor-binding ability were analyzed. Pathogenicity in C57 mice was evaluated. Antigenicity analysis was conducted through a two-way HI test, in which the antiserum was obtained from immunized ferrets. Transcriptomic analysis of MDCK infected with HPAI H7N9 24hpi was done. It turned out that HA R229I substitution from oseltamivir induction in HA1 region increased (1) replication ability in MDCK(P < 0.05) and A549(P < 0.05), (2) neuraminidase enzyme activity, (3) binding ability to both alpha 2,3 and alpha 2,6 receptor, (4) pathogenicity to mice(more weight loss; shorter mean survival day; viral titer in respiratory tract, P < 0.05; Pathological changes in pneumonia), (5) transcriptome response of MDCK, of the H7N9 virus bearing NA 292K. Besides, HA R229I substitution changed the antigenicity of H7N9/PR8 virus (>4-fold difference of HI titre). It indicated that through the fine-tuning of HA-NA balance, R229I increased the fitness and changed the antigenicity of H7N9 virus bearing NA 292K. Public health attention to this mechanism needs to be drawn. [GRAPHICS]

Background Progress in malaria control has stalled in recent years and innovative surveillance and response approaches are needed to accelerate malaria control and elimination efforts in endemic areas of Africa. Building on a previous China-UK-Tanzania pilot study on malaria control, this study aimed to assess the impact of the 1,7-malaria Reactive Community-Based Testing and Response (1,7-mRCTR) approach implemented over two years in three districts of Tanzania. Methods The 1,7-mRCTR approach provides community-based malaria testing via rapid diagnostic tests and treatment in villages with the highest burden of malaria incidence based on surveillance data from health facilities. We used a difference-in-differences quasi-experimental design with linear probability models and two waves of cross-sectional household surveys to assess the impact of 1,7-mRCTR on malaria prevalence. We conducted sensitivity analyses to assess the robustness of our results, examined how intervention effects varied in subgroups, and explored alternative explanations for the observed results. Results Between October 2019 and September 2021, 244,771 community-based malaria rapid tests were completed in intervention areas, and each intervention village received an average of 3.85 rounds of 1-7mRCTR. Malaria prevalence declined from 27.4% at baseline to 11.7% at endline in the intervention areas and from 26.0% to 16.0% in the control areas. 1,7-mRCTR was associated with a 4.5-percentage-point decrease in malaria prevalence (95% confidence interval: − 0.067, − 0.023), equivalent to a 17% reduction from the baseline. In Rufiji, a district characterized by lower prevalence and where larviciding was additionally provided, 1,7-mRCTR was associated with a 63.9% decline in malaria prevalence. Conclusions The 1,7-mRCTR approach reduced malaria prevalence. Despite implementation interruptions due to the COVID-19 pandemic and supply chain challenges, the study provided novel evidence on the effectiveness of community-based reactive approaches in moderate- to high-endemicity areas and demonstrated the potential of South-South cooperation in tackling global health challenges. Graphical Abstract

Since 2022, three human cases of a novel H3N8 avian influenza virus infection have been reported in three provinces in China. Specific vaccines are important means of preparing for the potential influenza pandemic. Thus, H3N8 viruses [A/Henan/cnic410/2022 (HN410) and A/Changsha/1000/2022(CS1000)] were isolated from the infected patients as prototype viruses to develop candidate vaccine viruses (CVVs) using the reverse genetics (RG) technology. Five reassortant viruses with different HA and NA combinations were constructed based on the two viruses to get a high-yield and safe CVV. The results showed that all viruses had similar antigenicity but different growth characteristics. Reassortant viruses carrying NA from CS1000 exhibited better growth ability and NA enzyme activity than the ones carrying HN410 NA. Furthermore, the NA gene of CS1000 had one more potential N-glycosylation site at position 46 compared with HN410. The substitution of position 46 showed that adding or removing N-glycosylation sites to different reassortant viruses had different effects on growth ability. A reassortant virus carrying HN410 HA and CS1000 NA with high growth ability was selected as a CVV, which met the requirements for a CVV. These data suggest that different surface gene combinations and the presence or absence of potential N-glycosylation sites on position 46 in the NA gene affect the growth characteristics of H3N8 CVVs.