In China, sustained snail control, environmental management, and mass drug administration with praziquantel reduced schistosomiasis to near-elimination levels, yet re-emergence in Sichuan Province during the early 2000s exposed vulnerabilities in elimination efforts. We used population genomics to investigate the multi-scale population processes underlying Schistosoma japonicum re-emergence in Sichuan. We sequenced whole genomes from 270 miracidia collected from 53 human hosts across 17 villages in 2007, one year after re-emergence was documented. Population genomic analyses identified a broadly cohesive regional schistosome population with weak geographic structuring. Genome-wide diversity remained substantial, and demographic reconstructions revealed no recent decline in effective population size, suggesting that parasite populations had not undergone regional demographic collapse prior to re-emergence and were likely maintained in non-human reservoir hosts. At finer spatial scales, several villages exhibited reduced genomic diversity and elevated inbreeding, consistent with localized transmission maintained by relatively small founding populations. Estimates of pairwise genetic relatedness revealed dense within-village sibling clusters alongside second- and third-degree relationships spanning villages, and rare first- and second-degree cross-village links, supporting predominantly local transmission embedded within a connected regional transmission network. Genomic inference of minimum reproducing worm pairs identified substantial heterogeneity in host-level worm burden, ranging from one to eleven adult worm pairs, although uneven sampling limited absolute estimates. Together, these findings indicate that parasite persistence in this near-elimination setting was sustained by interacting processes operating across multiple biological scales, including diverse regional parasite populations, localized transmission networks connecting villages, and marked heterogeneity in host-level worm burden. More broadly, this work demonstrates how population genomics can reconstruct otherwise hidden patterns of parasite persistence and transmission, providing a valuable complement to conventional epidemiological surveillance in complex, multi-host parasite systems.

Background Asian schistosomiasis is projected to be eliminated by 2030 according to World Health Organization road map for neglected tropical diseases 2021-2030.Snail control is an important measure but has not yet been systematically evaluated at a country scale.Here,we report the findings from a nationwide survey to demonstrate the dynamics of Oncomelania and its potential role in transmission interruption of schistisomiasis in the People's Republic of China(P.R.China). Methods Between March 2016 and December 2017,we conducted a nationwide census on Oncomelania snail habi-tats in P.R.China.All historically recorded snail habitats were identified and reviewed.Information on habitat attrib-utes,including the infestation of snails,was collected.The shape of habitats was determined using global positioning system and geographical information system technologies.The relationship between snail control and schistosomia-sis elimination was established in 378 endemic counties.The comparison of accumulated snail-infested range(ASR)and the median ratio of eliminated ASR between the transmission-interrupted and endemic counties was tested by a non-parametric test(Mann-Whitney)with a significance level of 0.05. Results Overall,15,377.7 million m2 of potential snail habitats with a total of 356,550 snail habitats were identified in P.R.China.The ASR amounted to 86.0％ of the total area.Most of the ASR(94.9％)and habitats(68.5％)were dis-tributed in the middle and lower reaches of the Yangtze River.Snail habitats were found up to an altitude of 2859 m above the mean sea level.By 2017,85.1％ of habitats(73.0％ of the ASR)had been eliminated with almost half of them eliminated between 1965 and 1982.The elimination of snail habitats promoted transmission interruption of schistoso-miasis,but showed variable patterns in different landscapes.The ratio of eliminated ASR was 99.6 and 91.4％in water network and hilly areas,respectively,while it was only 64.8％in marshland areas,particularly in Hunan and Jiangxi where the two largest freshwater lakes of P.R.China are located.Marshland habitats were seen as the most difficult for transmission interruption,which calls for additional control measures in these settings. Conclusions Our results support recent recommendations by the World Health Organization to implement snail control and demonstrate that schistosomiasis elimination can be achieved.The nationwide,high-resolution map of Oncomelania snail habitats in P.R.China will support further efforts to eliminate schistosomiasis.

Background To assess health-related quality of life (HRQoL) and identify influencing factors impacting HRQoL among patients with Advanced Schistosomiasis (AS) in Sichuan Province, China, utilizing the EQ-5D-5L scale. Methods A cross-sectional study was conducted among 1,276 AS patients in Sichuan Province. Data on demographic characteristics, clinical history, and EQ-5D-5L responses were collected via structured face-to-face interviews and medical record review. Statistical analyses included reliability and validity assessments (Cronbach's α, exploratory/confirmatory factor analyses), univariate analysis, multivariate linear regression, and interaction analysis using Stata 16.0 and R 4.5.1 . Results The mean utility index (UI) score was 0.85 ± 0.20, with 35.6% of subjects reporting no impairment across all dimensions. The EQ-5D-5L demonstrated acceptable internal consistency ( Cronbach’s α = 0.795) and construct validity (CFA: χ²/df = 2.191, RMSEA = 0.031). The domains most affected were anxiety/depression (62.5% reporting any impairment) and pain/discomfort (54.7% reporting any impairment). Multivariate regression analysis identified advanced age ( β = -0.017, P < 0.001), a history of ascites( β = -0.041, P < 0.001), Upper Gastrointestinal Bleeding (UGIB) ( β = -0.025, P = 0.018), hepatitis ( β = -0.033, P = 0.04), and advanced liver fibrosis ( β = -0.024, P < 0.001) as significant independent predictors for poorer HRQoL. Interaction analysis revealed synergistic effects among risk factors, demonstrating that the detrimental impact of ascites was concentrated in the elderly, co-occurrence of bleeding and ascites compounded HRQoL reduction, and the effect of hepatitis was contingent upon the severity of liver fibrosis. Conclusion The EQ-5D-5L is a valid and reliable instrument for assessing HRQoL in patients with AS. Targeted interventions should address age-related functional decline, comorbidities(particularly ascites and severe fibrosis), and low educational attainment to enhance patient outcomes. Emphasis should be placed on multidisciplinary care strategies for older patients with advanced fibrosis or ascites in endemic regions.

Schistosomiasis, caused by the infection with Schistosoma japonicum, remains a significant public health concern in China. As the sole intermediate host of S. japonicum, the breeding and spread of Oncomelania hupensis contribute significantly to the potential risk of disease occurrence and transmission. Exploring the population genetics of the snail vector is conducive to better understanding its distribution and dispersal patterns, and provides more data for future snail surveillance and control from a molecular perspective. The genetic diversity and population structure of O. hupensis in Sichuan Province were evaluated based on sequencing of mitochondrial cytochrome c oxidase subunit 1. A total of 215 snail isolates were collected from 30 counties, identifying 80 haplotypes with high nucleotide diversity (0.0587 1 +/- 0.00160) and haplotype diversity (0.979 +/- 0.003). Phylogenetic analysis and haplotype network construction identified five distinct clades. Notably, clade 1 was confined within the Panxi region, while clade 5 exhibited a widespread distribution across the studied areas, distinct from the other four clades, but showing a close genetic relationship to individuals from Yunnan. Spatial differentiation was revealed by significant pairwise genetic distance values detected in 313 out of 435 population pairs, ranging from 0.07632 to 1.00000. Analysis of molecular variance (AMOVA) showed that the majority of variance occurred among populations, but significant differences were also observed among landscape groups. AMOVA also provided support for clade separation by exhibiting significant genetic differences among the clades, which explained 78.23% of the overall variation. Geographical distance and precipitation were found to display a significant correlation with the genetic differentiation pattern of O. hupensis in both Mantel and partial Mantel tests. Temporal stability was observed over sampling intervals of 7 years, particularly among snail populations inhabiting the Panxi area, despite prolonged molluscicide treatment. This study provides updated insights into the genetic diversity and population structure of O. hupensis in Sichuan Province, which contribute to a better understanding of the challenges faced in snail control. In light of the findings, the integration of molecular insights into snail monitoring and control, and the reinforcement of collaborative efforts in neighboring regions, in addition to long-distance monitoring, are suggested. (c) 2025 Australian Society for Parasitology. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

Hookworm disease remains a global health issue. In China, it persists with a 0.67

BACKGROUND:Echinococcosis is a zoonotic parasitic disease that significantly endangers public health and hinders socioeconomic development. Sichuan Province is a mixed endemic area of cystic echinococcosis (CE) and alveolar echinococcosis (AE), and it has one of the most severe epidemics of echinococcosis in China. In 2012, the national epidemiological sampling survey of echinococcosis revealed that the prevalence rate of echinococcosis among the population in Sichuan Province was 1.08%, significantly higher than the national average (0.24%). In this study, the spatiotemporal distribution characteristics of newly diagnosed patients with echinococcosis in Sichuan Province from 2013 to 2024 were analyzed, providing a reference for identifying key areas of echinococcosis and developing targeted prevention and control strategies. METHODS:Data on the number of individuals screened for echinococcosis and the number of newly diagnosed patients in endemic counties were obtained from the annual reports of the Sichuan Provincial Echinococcosis Control Program between 2013 and 2024. The detection rate of newly diagnosed echinococcosis patients was calculated for each year. County-level electronic maps of Sichuan Province were downloaded from the National Geographic Information Public Service Platform. The spatial distribution map of the detection rate of newly diagnosed patients with echinococcosis in Sichuan Province was created using ArcGIS software, and global and local spatial autocorrelation analyses were conducted. Spatiotemporal scanning analysis of the detection rate of newly diagnosed echinococcosis patients in Sichuan Province was conducted using SaTScan software. RESULTS:From 2013 to 2024, the total detection rate of newly diagnosed patients with echinococcosis in the endemic areas of Sichuan Province was 55.77/100,000, with the detection rates of CE and AE being 36.71/100,000 and 19.88/100,000, respectively. The total detection rate of newly diagnosed patients with echinococcosis, as well as that of CE and AE, demonstrated a decreasing trend year by year (χ2 = 1,054.785, 925.936, 196.018; P < 0.001). The detection rate of CE was higher than that of AE between 2013 and 2021; however, this trend was reversed between 2022 and 2024. In terms of spatial distribution, areas with higher detection rates were primarily concentrated in the northwestern part of Sichuan Province, whereas areas with lower detection rates were mainly distributed in the southeastern part of the province. The global spatial autocorrelation analysis results revealed that the total detection rate of newly diagnosed echinococcosis patients exhibited spatial clustering in 2013-2016, 2018, 2020, and 2024. The detection rate of newly diagnosed CE patients exhibited spatial clustering in 2013, 2014, and 2022. The detection rate of newly diagnosed patients with AE exhibited spatial clustering in 2013-2018, 2020, and 2023. Local spatial autocorrelation analyses revealed that the "high-high" clustering areas of the total detection rates, CE and AE detection rates were concentrated in the northwestern and northern parts of the endemic areas, while the "low-low" clustering areas were concentrated in the southeastern parts of the endemic areas. Spatiotemporal scanning analysis revealed that the most important clusters of newly total diagnosed echinococcosis and CE patients in Sichuan Province were mainly located in Shiqu, Seda, Baiyu, Ganzi, Dege, Xinlong, Luhuo, Aba, and Rangtang counties. The most important clusters of patients with AE were mainly in Shiqu, Seda, Baiyu, Ganzi, Dege, and Rangtang counties. CONCLUSION:The results demonstrated that the detection rate of newly diagnosed patients with echinococcosis in Sichuan Province decreased annually between 2013 and 2024, exhibiting significant spatial clustering. The western Sichuan Qinghai Tibet Plateau region is a "hot spot" for echinococcosis in the Sichuan Province population. It is recommended that relevant departments develop precise prevention and control strategies for the current areas of clustering.

Background:Hypertension is a critical modifiable risk factor for mortality in the elderly, yet optimal systolic blood pressure (SBP) targets for older adults remain unclear. This study examined the association between SBP trajectories and all-cause mortality in Chinese elderly individuals, aiming to identify age-adjusted SBP ranges for survival benefits. Methods:A population-based prospective cohort study was conducted in Luzhou, China (2017-2023). A total of 390,100 participants aged ≥65 years were followed for 1,994,050 person-years, with 48,013 deaths analyzed. Cox proportional hazards and restricted cubic spline (RCS) Cox regression models were used to evaluate baseline SBP categories, 7-year mean SBP, and longitudinal trajectories (Class 1: ideal to elevated; Class 2: normal-high to elevated; Class 3: mild hypertension to elevated). Results:Baseline SBP: Lowest mortality risk at 100-139 mmHg (HR < 1). 7-year mean SBP: Optimal range at 120-159 mmHg. Trajectories: Class 2 (normal-high to elevated) had the lowest all-cause mortality (HR: 0.90, 95% CI: 0.88-0.92). Class 1 showed the lowest cardiovascular mortality. Class 3 exhibited the lowest non-cardiovascular/cancer mortality. Conclusions:Gradual SBP increases from normal (≤160 mmHg) with age are associated with reduced mortality in the elderly. These findings challenge strict hypertension control guidelines, advocating for age-adjusted SBP targets to optimize survival outcomes. Further validation across different ethnic groups and regions will be needed in the future.

目的 总结四川省在棘球蚴病防控工作中机制和措施的创新实践,以期形成防治经验供政府决策参考.方法 通过文献和资料回顾性分析,逐条梳理和总结.结果 目前已形成了棘球蚴病防控的政府领导、多部门协作、全社会参与的良好形势;在棘球蚴病防治方面取得了重要进展,得益于在理念与机制创新、综合防控措施的落地生根、精准化施策和科学研究方面的持续用力.结论 棘球蚴病防治必须结合流行特点,采取综合施策,多部门协作的模式.

OBJECTIVE:To investigate the prevalence of Echinococcus infection in small mammals in Shiqu County, Sichuan Province from 2015 to 2020, so as to provide insights into echinococcosis control in Shiqu County.METHODS:One setting with frequent activity of small mammals was sampled as the survey site from each of 9 townships where human alveolar echinococcosis was hyperendemic, in Shiqu County, Sichuan Province from 2015 to 2020. Two quadrats measuring 50 m × 50 m were assigned in each survey site during the period between July and August from 2015 to 2020 to capture all small mammals in quadrats, and the species of small mammals were identified by morphological characteristics. All captured small mammals were dissected in the field and Echinococcus infection was identified by visual examinations. The affected organs of Echinococcus - infected small mammals were collected, and Echinococcus infection was detected using PCR assay, with Echinococcus species characterized. The prevalence of Echinococcus infection was calculated in small mammals, and the trends in the prevalence of Echinococcus infection were analyzed during the period from 2015 to 2020. In addition, the prevalence of Echinococcus infection was compared in small mammals using visual examinations and PCR assay.RESULTS:A total of 2 692 small mammals were captured in the survey sites of Shiqu County from 2015 to 2020, and morphology characterized 1 360 Microtus fuscus (50.52%) and 1 332 Plateau pika (49.48%). The prevalence rates of Echinococcus infection were 35.63%, 19.16%, 21.41%, 8.40%, 7.68% and 4.44% by visual examinations and 18.96%, 5.36%, 5.61%, 4.58%, 3.30% and 0.37% by PCR assay in small mammals in Shiqu County from 2015 to 2020, both showing a tendency towards a decline year by year (χ2 = 215.024 and 117.045, both P values < 0.001). The prevalence of Echinococcus infection was significantly higher in small mammals by visual examinations than by PCR assay during the period from 2015 to 2020 except in 2018 (χ2= 33.597, 21.815, 51.373, 17.268 and 9.537, all P values < 0.01). PCR assay detected a reduction in the prevalence of E. multilocularis infection from 10.21% to 0.37% and a reduction in the prevalence of E. shiquicus infection from 8.75% to 0 in small mammals in Shiqu County from 2015 to 2020, both appearing a tendency towards a decline year by year (χ2 = 117.045 and 43.436, both P values < 0.001). In addition, the prevalence of E. multilocularis and E. shiquicus infections reduced from 15.19% to 0.45% and from 8.23% to 0 in M. fuscus, and the prevalence of E. multilocularis and E. shiquicus infections reduced from 7.76% to 0 and from 9.01% to 0 in P. pika in Shiqu County from 2015 to 2020.CONCLUSIONS:M. fuscus and P. pika were dominant species of small mammals in Shiqu County, Sichuan Province from 2015 to 2020, and E. multilocularis infection was mainly found in M. fuscus and E. shiquicus infection mainly found in P. pika. The prevalence of Echinococcus infection appeared a tendency towards a decline in both M. fuscus and P. pika year by year during the period from 2015 to 2020.

Information on age-based Taenia solium taeniasis prevalence is crucial for control of cysticercosis. T. solium taeniasis prevalence was determined for a village in Liangshan Prefecture, Sichuan Province, China that was co-endemic for T. solium, Taenia saginata asiatica, and Taenia saginata. Individuals who were Taenia egg-positive by stool microscopy and/or expelled tapeworms or proglottids post-treatment were diagnosed as having taeniasis. Infecting species was identified via multiplex PCR on tapeworm specimens or coproPCR followed by sequencing. In addition, initial stool samples from 10 children with taeniasis suspected of having spontaneous expulsion of tapeworms within the period between diagnosis and treatment were subject to species confirmation via coproPCR and sequencing. Of the 389 study subjects, 194 (49.9%) were diagnosed with taeniasis. Children (< 16 years of age) had a higher T. solium taeniasis prevalence (8.8%) than older individuals (2.5%) (P = 0.0127). Molecular analysis of initial stool samples from 7 of 10 children suspected of spontaneously passing tapeworms indicated 6 infections due to T. solium and 1 infection due to T. saginata. This study found that young children had a higher T. solium taeniasis prevalence than older individuals, providing additional support for the belief that adult T. solium likely has a relatively short lifespan compared to other Taenia species with human definitive hosts.

OBJECTIVE:To analyze the current status and evaluate the equity of health human resource allocation for echinococcosis control in Ganzi Tibetan Autonomous Prefecture, Sichuan Province, so as to provide the empirical evidence for optimizing the health human resource allocation for echinococcosis control.METHODS:A questionnaire survey was performed to collect the numbers of health human sources for echinococcosis control, including health workers, healthcare professionals, certified/assistant physicians and registered nurses, per 1 000 permanent residents, per 1 000 m2, per 1 000 residents screened using Bmode ultrasonography and per 1 000 echinococcosis patients in two highly endemic counties and three lowly endemic counties in Ganzi Tibetan Autonomous Prefecture, Sichuan Province from 2016 to 2019. The equity of health human resource allocation for echinococcosis control was evaluated by permanent residents and geographical areas using Lorenz curve and Gini index in Ganzi Tibetan Autonomous Prefecture from 2016 to 2019.RESULTS:The numbers of health workers, healthcare professionals, certified/assistant physicians and registered nurses per 1 000 permanent residents, per 1 000 permanent residents, per 1 000 m2, per 1 000 residents screened using B-mode ultrasonography and per 1 000 echinococcosis patients were 0.99-, 1.06-, 1.78- and 1.88-fold; 3.38-, 3.67-, 6.00- and 6.00-fold; 1.64-, 1.74-, 3.22- and 3.18-fold; and 64.92-, 70.39-, 139.34- and 117.44-fold more in lowly endemic counties than in highly endemic countries in Ganzi Tibetan Autonomous Prefecture, Sichuan Province, 2019. The Gini indexes of health human resource allocation for echinococcosis control were 0.371 to 0.397 by permanent residents and 0.477 to 0.591 by geographical areas in Ganzi Tibetan Autonomous Prefecture from 2016 to 2019, and the Gini indexes (0.469 to 0.730) for allocation of certified/assistant physicians and registered nurses were both higher than those of health workers and healthcare professionals (0.302 to 0.451) by both permanent residents and geographical areas.CONCLUSIONS:The health human resource allocation for echinococcosis control showed general equity by permanent residents and poor equity by geographical areas in Ganzi Tibetan Autonomous Prefecture, Sichuan Province from 2016 to 2019.

Currently, the national schistosomiasis control program of China is moving from transmission control and transmission interruption to elimination; however, there is still a threat of schistosomiasis outbreak in area where the transmission of schistosomiasis has not been interrupted, and in areas where transmission interruption and even elimination have been achieved because of the complex factors relating to schistosomiasis transmission, as well as socioeconomic factors and natural environments, which greatly affects the consolidation of schistosomiasis control outcomes and the achievement of the goal of schistosomiasis elimination in the country. Here, we summarized the outbreaks of schistosomiasis in China during the past six decades, evaluated the impact of schistosomiasis outbreak on the national schistosomiasis control program and proposed management of schistosomiasis outbreak and prevention of schistosomiasis resurgence as the key point and difficulty for schistosomiasis control in the current stage. Improving the surveillance-response mechanisms and minimizing the development of schistosomiasis outbreak and the resultant damages and losses are recommended to provide technical supports for elimination of schistosomiasis in China.

The patriotic public health movement, also known as the “public health campaign” which is a mode based on communities participated health movement in China, aims to strengthen health knowledge awareness among the people; to improve the living environment and quality of life; to reduce disease risk factors; to promote the levels of social comprehensive health and public health. Through the launching of governmental policies and cooperation between collectives and individuals, it is possible to achieve the goals of disease prevention and having a better life and health for local people by environmental improvement in the urban and rural, national health education and health promotion, and pest and its transmitted diseases control. Simply to say, the goal of patriotic public health movement is to improve the living environment, to control pests and its transmitted diseases, and to promote health education and conditions in people. It is a health promotion model with Chinese characteristics, it is also the most influential health event in our history and a great innovation in health field in China.

Although coronavirus disease 2019 (COVID-19) remains rampant in many countries, it has recently waned in Sichuan, China. This study examined spatiotemporal variations of the epidemiological characteristics of COVID-19 across its course. Three approaches, i.e. calendar-based, measure-driven and data-driven ones, were applied to all individual cases reported as of 30th November 2020, dividing the COVID-19 pandemic into five periods. A total of 808 people with confirmed diagnosis and 279 asymptomatic cases were reported, the majority of whom were aged 30-49 and <30 years, respectively. The highest risk was seen in Chengdu (capital city), with 411 confirmed and 195 asymptomatic cases. The main sources of infection changed from importation from Hubei Province to importation from other provinces, then local transmission and ultimately importation from foreign countries. The periods highlighted by the three methods presented different epidemic patterns and trends. The calendar-based periods were even with most cases aggregated in the first period, which did not reflect various transmission patterns of COVID-19 due to various sources of infection; the measure-driven and data-driven periods were not consistent with each other, revealing that the effects of implementing prevention measures were reflected on the epidemic trend with a time lag. For example, the decreasing trends of new cases occurred 7, 3 and 4 days later than the firstlevel emergency response, the district-level prevention measures and the second-level emergency response, respectively. This study has advanced our understanding of epidemic course and foreshown all stages of COVID-19 epidemic. Many countries can learn from our findings about what will occur next in their timelines and how to be better prepared.

RNA-sequencing (RNA-seq) is a versatile, high-throughput technology that is being widely employed for screening differentially expressed genes (DEGs) in various diseases. Echinococcosis, a globally distributed zoonosis, has been reported to impose a heavy disease burden in pastoral areas of China. Herein we aimed to explore the molecular mechanisms underlying echinococcosis. In this study, peripheral blood samples were collected from six patients with alveolar echinococcosis (AE), six patients with cystic echinococcosis (CE), and six healthy controls. RNA-Seq (mRNA) was performed to detect gene transcript and expression levels, and DEGs were subjected to bioinformatic analyses. In comparison with healthy controls, 492 DEGs (270 upregulated, 222 downregulated) were found in the AE group and 424 DEGs (170 upregulated, 254 downregulated) were found in the CE group (|log 2 (fold change)| > 1 and P < 0.05). Further, 60 genes were upregulated and 39 were downregulated in both the AE and CE groups. Gene ontology enrichment analysis indicated that DEGs were mainly involved in molecular functions, including extracellular space, extracellular region, organ and system development, and anatomical structure development. Protein–protein interaction (PPI) networks were constructed to depict the complex relationship between DEGs and interacting proteins.

BACKGROUND:The global epidemic of novel coronavirus pneumonia (COVID-19) has resulted in substantial healthcare resource consumption. Since patients' hospital length of stay (LoS) is at stake in the process, an investigation of COVID-19 patients' LoS and its risk factors becomes urgent for a better understanding of regional capabilities to cope with COVID-19 outbreaks.METHODS:First, we obtained retrospective data of confirmed COVID-19 patients in Sichuan province via National Notifiable Diseases Reporting System (NNDRS) and field surveys, including their demographic, epidemiological, clinical characteristics and LoS. Then we estimated the relationship between LoS and the possibly determinant factors, including demographic characteristics of confirmed patients, individual treatment behavior, local medical resources and hospital grade. The Kaplan-Meier method and the Cox Proportional Hazards Model were applied for single factor and multi-factor survival analysis.RESULTS:From January 16, 2020 to March 4, 2020, 538 human cases of COVID-19 infection were laboratory-confirmed, and were hospitalized for treatment, including 271 (50%) patients aged ≥ 45, 285 (53%) males, and 450 patients (84%) with mild symptoms. The median LoS was 19 (interquartile range (IQR): 14-23, range: 3-41) days. Univariate analysis showed that age and clinical grade were strongly related to LoS (P<0.01). Adjusted multivariate analysis showed that the longer LoS was associated with those aged ≥ 45 (Hazard ratio (HR): 0.74, 95% confidence interval (CI): 0.60-0.91), admission to provincial hospital (HR: 0.73, 95% CI: 0.54-0.99), and severe illness (HR: 0.66, 95% CI: 0.48-0.90). By contrast, the shorter LoS was linked with residential areas with more than 5.5 healthcare workers per 1,000 population (HR: 1.32, 95% CI: 1.05-1.65). Neither gender factor nor time interval from illness onset to diagnosis showed significant impact on LoS.CONCLUSIONS:Understanding COVID-19 patients' hospital LoS and its risk factors is critical for governments' efficient allocation of resources in respective regions. In areas with older and more vulnerable population and in want of primary medical resources, early reserving and strengthening of the construction of multi-level medical institutions are strongly suggested to cope with COVID-19 outbreaks.

2019年底,武汉暴发新冠肺炎疫情后,基于对疾病认识的不断深入,国家卫生健康委员会及时出台和更新防控方案指导各地开展疫情防控.从现场调查到证据整合,再到形成国家方案,势必耗费较长时间.四川省基于现场证据,不等国家方案更新,及时调整具体措施,提前实施了密切接触者判定时间前推到感染者发病或检出阳性前3d、无症状感染者与确诊病例同等管理、粪便标本核酸检测结果纳入出院和解除隔离标准、分区分类管控、圈层管控等措施,起到较好防控效果.提示各地方在应对新发传染病时,应谨慎研究,大胆探索"基于国家方案原则、依据现场确切证据、及时调整具体措施"的模式.

国家"十三五"棘球蚴病防治规划确定的基本控制目标是到2020年70%的县人群患病率降低到1%以下及犬感染率降低到5%以下。2019年四川省有83%的县达到目标,超过国家目标任务要求。四川省棘球蚴病防治经过重点调查研究阶段、以卫生部门为主的防控试点阶段、部门协同防控初步阶段和政府主导攻坚达到基本控制阶段等4个阶段。四川省棘球蚴病从流行到基本控制,防治工作取得了显著成效,表明以"控制传染源为主、中间宿主防控与病人查治相结合"的综合防治策略十分有效。四川省的成功得益于"党政齐抓,全员共抓"、部门协作、科学防控及专业队伍的支撑,得益于不断探索新的策略措施,如季节性加强犬的驱虫和控制、定居点灭鼠等,以及创新患者筛查管理、健康教育、宿主监测等。未来要坚持行之有效的策略措施,并根据流行及防控的新情况及时优化策略措施,做到精准防控以进一步控制棘球蚴病的流行。

Schistosomiasis persists in Asian regions despite aggressive elimination measures. To identify factors enabling continued parasite transmission, we performed reduced representation genome sequencing on Schistosoma japonicum miracidia collected across multiple years from transmission hotspots in Sichuan, China. We discovered strong geographic structure, suggesting that local, rather than imported, reservoirs are key sources of persistent infections in the region. At the village level, parasites collected after referral for praziquantel treatment are closely related to local pre-treatment populations. Schistosomes within villages are also highly related, suggesting that only a few parasites from a limited number of hosts drive re-infection. The close familial relationships among miracidia from different human hosts also implicate short transmission routes among humans. At the individual host level, genetic evidence indicates that multiple humans retained infections following referral for treatment. Our findings suggest that end-game schistosomiasis control measures should focus on completely extirpating local parasite reservoirs and confirming successful treatment of infected human hosts.