Scrub typhus is a life-threatening disease caused by Orientia tsutsugamushi, and specific antimicrobial medicine is available. Early and accurate diagnosis is essential for reducing the risk of severe complications and death. In this study, we aimed to evaluate the case diagnosis situation among medical care institutions and geographical regions in China, and the results will benefit both clinical practice and the disease surveillance system. We extracted individual scrub typhus case data 2006–2016 from a national disease surveillance system in China. The diagnosis category and interval time from illness onset to diagnosis were compared among three levels of medical care institutions and provinces. The descriptive analysis method was performed in our study. During the 11-year study period, 93 481 scrub typhus cases, including 57 deaths, were recorded in the nationwide surveillance system. The overall proportion of laboratory-confirmed cases was only 4.7%, and this proportion varied greatly among primary medical centres (2.8%), county level hospitals (4.2%), and city level hospitals (6.3%). Notably, the proportion of laboratory-confirmed cases has consistently decreased from 16.3% in 2006 to 2.6% in 2016, and the same decreasing trend was found among all three levels of medical care institutions. The interval from illness onset to case diagnosis (Tdiag) for all cases was 5 days (interquartile range [IQR]: 2–9 days) and decreased from 7 days (IQR: 3–11 days) in 2006 to 5 days (IQR: 2–8 days) in 2016. The risk of death for patients with a Tdiag of > 7 days was 2.2 times higher (OR = 2.21, 95% CI: 1.05–5.21) than that of patients with a Tdiag of < 2 days. The interval time from illness onset to diagnosis for scrub typhus cases decreased greatly in China; however, the diagnosis rate of cases with laboratory-confirmed results must be increased among all levels of medical care institutions to reduce both the risk of death and the misuse of antibiotics associated with scrub typhus.

Helminthiases have placed a huge burden of disease on the population in China. However, widespread control activities have led to significant achievements. As health education has been widely disseminated and plays an important role in the control and elimination of these diseases, we collected health education products aimed at controlling and preventing helminthiases in China. We analyzed their characteristics and assessed their quality. Firstly, health education products aimed at controlling and preventing helminthiases were collected from a diverse range of organizations. Secondly, the expert brainstorming and Delphi methods were applied to establish an evaluation system, which was then used to assess the collected products systematically. Those deemed excellent were awarded. Characteristics – including type, source, targeted disease(s), targeted population, and languages – of the collected products and the awarded products were presented here. In total, 96 health education products on helminthiases were collected from 53 organizations. Most products belonged to either the graphic design (47) or daily-use (24) category. Seventy were collected from Centers for Disease Control and Prevention and 20 from institutes or control stations of parasitic diseases, primarily at the provincial and county levels. Regarding disease targets of the products, 67 focused on a single helminthiasis, 25 on multiple helminthiases, and the remaining four on non-specific diseases. Of the 67 single helminthiasis-focused products, most targeted schistosomiasis (37), followed by echinococcosis (16). The majority of products (79) targeted the general population, while 11 targeted students specifically. Regarding languages, 86 products were only in Chinese, while the other ten were in both Chinese and the minority languages of China. Out of these ten products, one targeted schistosomiasis and the other nine targeted echinococcosis. Thirty-four products were awarded. The characteristics of the awarded products were similar to those of the collected products. A diverse range of health education products have been designed and applied for the prevention and control of helminthiases in China. Many products have good features such as specifying the targeted diseases and populations. However, there are significant gaps in terms of both the quantity and quality of products pertaining to some of the diseases. Experiences from the awarded products could be drawn upon to design more products aimed at a range of different helminthiases.

(1) Background: Enterobius vermicularis infection causes a significant health burden in children. The infection occurs throughout the country and remains a serious public concern in China. Therefore, it is necessary to know the situation of E. vermicularis infection, to provide a scientific basis for the disease control and the optimum conditions for children’s growth. (2) Methods: Descriptive epidemiological analysis was implemented to demonstrate the status and changing trend of E. vermicularis infection from 2016 to 2020, while the spatial distribution characteristics and spatial-temporal clustering were illuminated by spatial autocorrelation analysis and spatio-temporal scanning analysis. (3) Results: The infection of E. vermicularis showed a fluctuating downward trend with a decline of 32.00% in 2020 compared to that in 2016 and was concentrated in central and southern China. There was no significant difference in infection rate between boys and girls, while the high infection rate was presented in 4-, 5- and 6- year-old children. The hotspots and spatial clustering areas were mainly concentrated in southern China. (4) Conclusions: From 2016 to 2020, the infection rate of E. vermicularis in children aged 3 to 9 years in China demonstrated a declining trend, and its distribution showed spatial clustering, mainly in southern China. Therefore, it is necessary to strengthen surveillance and implement control measures in combination with health education and environmental improvement.

Background: Clonorchiasis is caused by the ingestion of raw freshwater fish containing infective metacercariae of Clonorchis sinensis . This study aimed to fully evaluate disease burden in terms of disability-adjusted life years (DALYs) for clonorchiasis in China. Methods: Following our previous study which established the fine-scale prevalence distribution of C. sinensis infection in China, we further adopted Bayesian geostatistical models to estimate the infection intensity in terms of eggs per gram of feces (EPG) in infected individuals based on the national surveillance data of clonorchiasis between 2016 and 2021. Disability weight was then captured through its quantitative association with EPG, and used to estimate years of life living with a disability (YLDs). Incidence of cholangiocarcinoma attributed to C. sinensis infection was employed to calculate years of life lost (YLLs). DALYs was then estimated at 5 × 5 km ² resolution, and aggregated by areas and populations. Results: In 2020, 431,009 [95% Bayesian credible interval (BCI): 370,427 to 500,553] DALYs were exerted due to clonorchiasis in China, of which 372,918 (95% BCI: 318,775–435,727) was due to YLDs and 57,998 (95% BCI: 50,816–66,069) due to YLLs. The DALYs, YLDs and YLLs per 1000 were 0.31 (95% BCI: 0.26–0.35), 0.26 (95% BCI: 0.23–0.31), and 0.04 (95% BCI: 0.04–0.05), respectively. The DALYs predominantly distributed in southern areas including Guangxi (201,029, 95% BCI: 157,589–248,287) and Guangdong (161,958, 95% BCI: 128,326–211,358). The DALYs was over doubled in male (302,678, 95% BCI: 262,028–348,300) than in female (127,970, 95% BCI: 106,834–151,699), and high in middle aged population. Conclusions: Clonorchiasis causes significant disease burden in China especially in southern areas including Guangxi and Guangdong. Urgent control is needed for clonorchiasis in the endemic areas with high burden, and adult males need to be prioritized. Graphical