Objective To understand the awareness status of malaria control knowledge of primary and secondary school stu-dents in malaria endemic areas of Shandong Province,so as to provide the baseline information for formulating the malaria control strategy. Methods A cross-sectional survey was conducted in 5 TypeⅡmalaria-endemic counties in Shandong Province. A struc-tured questionnaire survey was administrated to students in primary and secondary schools. Results A total of 1 884 students were completed with the questionnaires and all were effective. The total awareness rate of malaria control knowledge was 65.9%, and 54.7% of the students knew the transmission route of malaria and only 31.5% of the students were aware of the preventive methods of malaria. There were significant differences of the awareness scores of malaria control knowledge among different malar-ia endemic areas but there were no significant differences between the awareness rates of male and female students and between two different education levels. Conclusions The awareness of malaria control knowledge of primary and secondary school stu-dents in Shandong Province is poor;therefore,the health education of malaria control knowledge for primary and secondary school students should be strengthened.

Objective To understand the malaria situation of Shandong Province in 2013,so as to provide the evidence for formulating targeted prevention and control strategy and measures. Methods The data of malaria cases of Shandong Province in 2013 were collected from the Information Management System for Infectious Diseases Report and Information Management Sys-tem for Parasitic Diseases Control and Prevention. The data of epidemiological characteristics of malaria situation and the diagno-sis and treatment of malaria cases were analyzed by Microsoft Excell2007. Results There were 131 malaria cases reported in 2013,all of them were imported cases,and 127 cases(96.95%)were imported from African countries. A total of 116 cases (88.55%)were falciparum malaria cases. Totally 97.71%of the cases were male and the average age of malaria cases was 39 years. A total of 61.83%of the cases were peasants and 65.65%of the cases only received junior high school education. The dis-tribution of malaria cases was concentrated in Tai’an City(32 cases),Yantai City(19 cases)and Weihai City(17 cases),total-ly acounting for 53.13%. There was no significant seasonal variation in the reporting time of the cases. The median time from on-set to seeing doctor was four days and the median time from seeing doctor to being diagnosed was one day. Totally 35.88%of the cases were misdiagnosed when the first visit to a doctor. All of the cases were laboratory confirmed and 100%of them received the standard treatment after diagnosis. Conclusions All of the malaria cases were imported cases in Shandong Province in 2013. To control the imported malaria in Shandong Province,it is necessary to further strengthen the multi-sectoral cooperation, health education,malaria screening and professional training.

Objective To understand the malaria epidemic situation and characteristics in Shandong Province in 2014,so as to provide evidences for taking targeted strategies and measures for malaria elimination. Methods The data of malaria epi?demic and malaria cases of Shandong Province in 2014 were collected from Information Management System for Infectious Dis?eases Report and Information Management System for Parasitic Diseases Control and Prevention. The epidemiological character?istics of malaria situation and the diagnosis and treatment of malaria cases were analyzed by Microsoft Excel 2007. Results A total of 150 malaria cases were reported in Shandong Province in 2014,which increased by 14.50% compared with that in 2013 (131 cases). All the cases were imported from other countries except one imported from Yunnan Province in China,and most of the imported cases were from Africa(142 cases,95.30%). All the cases were confirmed in Shandong Provincial Reference Labo?ratory and there were 121 cases(80.67%)infected with Plasmodium falciparum,16 cases(10.67%)infected with P. vivax,9 cases(6.00%)infected with P. ovale and 4 cases(2.67%)infected with P. malariae. The cases were mainly distributed in Tai’ an(40 cases,26.67%),Yantai(17 cases,11.33%),Weihai(13 cases,8.67%),Jining(11 cases,7.33%)and Heze(11 cases,7.33%)cities. Conclusions There have been no local malaria cases reported in Shandong Province in the continuous 3 years. However,the reported number of imported malaria cases shows an increasing trend in the province in recent years,and the species of infected Plasmodium are diverse. Imported malaria from other countries is the key of malaria control in Shandong Province at present.

Objective To understand the capacity of Plasmodium detection and helminth detection and the mastery degree of basic knowledge of parasitic diseases. Methods Three professionals from each city were selected as contestants. The content of the competition contained three parts. The first part included making blood slides and Giemsa staining of Plasmodium,and identifi-cation of species and number with microscopy,the second part included making stool slides with Kato-Katz technique and identifi-cation of common helminth eggs with microscopy,and the third part was basic knowledge of parasitic diseases. Results Totally 51 contestants took part in the competition. The average score of the test of making blood slides was 14.8±3.3,and the passing rate was 82.4%. The average score of the identification of species and number of Plasmodium with microscopy was 19.2 ± 9.3,and the passing rate was 29.4%. The average score of the test of making stool slides was 9.3±0.7,and the passing rate was 100%. The aver-age score of the identification of common helminth eggs with microscopy was 28.0±2.6,and the passing rate was 100%. The aver-age score of basic knowledge of parasitic diseases was 76.3±11.9,and the passing rate was 88.2%. The average score of the test of making blood slides in the female was higher than that in the male(15.7vs.13.5,P<0.05),and the average score of the test of making blood slides in the intermediate title contestants was higher than that in the junior title contestants(16.1vs.14.1,P <0.05). The average score of the basic knowledge of parasitic diseases in the contestants from cities was higher than that in the con-testants from towns(83.2vs.72.6,P<0.05),and the average score of basic knowledge of parasitic diseases in the contestants from high economic level cities was higher than that in the contestants from low economic level cities(82.4vs.71.5,P<0.01). Conclu-sions For professionals in Shandong Province,the capacity of helminth detection was strong and the basic knowledge of parasitic diseases was mastered well,while the capacity of Plasmodium detection was weak.

Objective To explore the association between malaria epidemic situation and some natural and social factors in high?incidence areas of Shandong Province,so as to provide evidences for malaria elimination in these areas. Methods Twenty towns of 10 counties(cities,districts,)in the high incidence areas of malaria in Shandong Province were selected as the study sites,and the residents in the study sites were investigated by questionnaires with one household as a unit,so as to understand the related natural and social factors. In addition,the malaria epidemic data in the study sites from 2006 to 2010 were collected, and the correlation between these factors and the epidemic situation of malaria was analyzed by Spearman rank correlation and multiple stepwise regression. Results The square root of malaria incidence rate(Y)was negatively related to the rate of house?holds using insecticide(X3),and the rate of households using screen doors and windows(X4)(both P<0.05),but was positive?ly related to the rate of housing surrounding water environment and exposure ratio(X6)(both P<0.05). The regression equa?tion established was Y=0.032X5+0.048X6-0.495,R2=0.973. Conclusions Malaria incidence is obviously associated with some natural and social factors. The measures such as clearing the breeding place of mosquito,protecting the exposure popula?tion at nightfall,as well as using door?window screen and repellents correctly,can effectively control malaria.

Objective To understand the infection status of intestinal parasites and related knowledge and behavior factors of the residents in north-west Shandong Province,so as to provide the evidence for taking targeted preventive measures. Meth-ods Eighteen villages were randomly selected as survey spots by the stratified multi-stage sample method. The Kato-Katz tech-nique was used to detect intestinal parasite eggs among the residents and the cellophane tape anus test was used to detect Entero-bius vermicularis eggs among 3-12 years old children. Questionnaires were applied to investigate related knowledge and behavior factors about the intestinal parasite infections in the residents. Results Totally 6 366 residents were detected for intestinal para-sites and the infection rate was 0.28%(18 cases). Totally 895 children were detected for E. vermicularis and the infection rate was 5.70%(51 cases). Totally 2 915 residents were investigated by questionnaires and the awareness rate of knowledge about preventing parasitic diseases was 26.72%. The formation rates of washing hands before meal and after WC,washing fruit and vegetable before eating,never drinking unboiled water were 55.42%,42.87%,43.54%and 83.04%respectively. The aware-ness rate of knowledge about preventing parasitic diseases of 3-12 years old children was 12.24%;and the formation rates of washing hands before meal and after WC were 47.04%and 30.44%respectively. Conclusions The total infection rate of intesti-nal parasites is low but the E. vermicularis infection rate is high among children in north-west Shandong Province. The awareness rate of knowledge about preventing parasitic diseases and the formation rates of healthy behaviors are all low. Therefore ,the tar-geted health education should be taken to increase the awareness rate and guide the residents to develop their healthy behaviors.

Objective To understand the status of intestinal parasitic infections and the related knowledge and behavior in residents of Jiaodong area of Shandong Province,so as to provide the evidence for making an appropriate preventive and control strategy. Methods A total of 18 villages from 6 counties in Jiaodong area were selected as investigation sites according to the stratified sampling method. The feces samples of the permanent residents aged above 3 years were collected and examined by Kato-Katz technique to find the intestinal parasite eggs,and the children under 12 years old were examined by the method of cellophane anal swab to detect the Enterobius vermicularis eggs. In addition,50 households in each survey sites were randomly selected to in-vestigate the basic family situation and the condition of awareness on prevention knowledge and formation of correct behavior of res-idents by using a structured questionnaire. Results Totally 6 163 residents involved in the feces examinations,and the total in-fection rate of intestinal parasites was 6.91%. The infection rates of Trichuris trichiura,Ascaris lumbricoides and hookworm were 6.56%,0.62%and 0.21%,respectively. The infection rate of E. vermicularis in children under 12 years old was 0.51%. The eggs of Clonorchis sinensis and Taenia solium were not found in this survey. The awareness rate of knowledge about preventing parasitic diseases was 49.54%. The formation rates of washing hands before eating,washing hands after using the toilet,never eating raw fruit and vegetable without washing clean,never working in the field with bare feet,and never drinking unboiled water were 97.78%,91.95%,88.81%,92.42%and 86.48%respectively. Conclusions The infection rate of intestinal parasites is low in Ji-aodong area,but there is a significant difference among different counties. The awareness rate of knowledge about preventing para-sitic diseases is low,but the formation rate of healthy behavior is high. In the future,the health education and the strategy of tak- ing medicine among the key population should be enhanced,and the project of reconstructing safe water supply and lavatory should be advanced.

Objective:To understand the knowledge and skills of professional technicians in prevention and control of parasitic diseases in Shandong Province, and to provide a basis for further capacity building.Methods:On October 12 and 13, 2017, five professional technicians from each of 17 prefectures and cities in Shandong Province participated in the "Shandong Province Parasitic Diseases Prevention and Control Job Skills Competition in 2017". This competition included theoretical knowledge examination (written test) and operation skill examination (operation test). The written test included basic knowledge of parasites life history, pathogen, diagnosis, epidemic and prevention; the operation test included blood smear making, Kato-Katz thick smear making, microscopic examination of Plasmodium and Helminth eggs. The competition results of the competitors were statistically analyzed, and the pass rate, correct answer rate and accuracy of microscopic examination were calculated. According to the report of malaria cases from 2010 to 2017, 17 prefectures and cities in Shandong Province were divided into malaria classⅠreport area (≥100 cases) and malaria classⅡreport area (< 100 cases), and the competition results of the two types of areas were compared. Results:A total of 85 competitors in Shandong Province participated in the competition, including 19 males (22.35%) and 66 females (77.65%); the age was (34.67±6.04) years old, the youngest was 25 years old, and the oldest was 51 years old. The scores of written test and operation test were (67.06±12.73) and (59.31±14.23) points, respectively, and the difference between them was statistically significant ( t=4.949, P < 0.01). The pass rate of written test was 74.12% (63/85); the correct answer rates of morphology, life history, pathogenicity, diagnosis, epidemic and prevention were 71.76% (366/510), 71.61% (913/1 275), 67.94% (462/680), 71.18% (847/1 190), 66.91% (455/680) and 65.76% (1 062/1 615), respectively, there was statistically significant difference in the correct answer rates of different knowledge points (χ 2=18.185, P < 0.01). The pass rate of operation test was 55.29% (47/85); among them, the pass rates of blood smear making, Kato-Katz thick smear making, microscopic examination of Plasmodium and Helminth eggs were 98.82% (84/85), 98.82% (84/85), 70.59% (60/85) and 31.76% (27/85), respectively. Four Plasmodium species were examined, and the overall accuracy of microscopic examination was 61.41% (261/425), there was no statistically significant difference in the accuracy of microscopic examination between different Plasmodium species (χ 2=4.791, P > 0.05). Nine common Helminth eggs were examined, and the overall accuracy of microscopic examination was 47.29% (402/850), there was statistically significant difference in the accuracy of microscopic examination between different Helminth eggs (χ 2=180.064, P < 0.01). The scores [(28.27±3.74) and (23.20±3.39) points, n=30] of microscopic examination of Plasmodium and Helminth eggs in the malaria classⅠ report area were higher than those in the malaria classⅡreport area [(22.40±5.81) and (18.25±3.41) points, n=55], and the differences were statistically significant ( t=2.217, 2.860, P < 0.05). Conclusions:For professional technicians, the mastery of theoretical knowledge in prevention and control of parasitic diseases is better than operation skills in Shandong Province. So the training and assessment of prevention and control skills of parasitic diseases should be strengthened in areas with weak abilities.

Objective:To study the population distribution of Pomacea spp. in Shandong Province and the risk of angiostrongyliasis cantonensis in the local population, and to provide a basis for scientific prevention and control of related diseases. Methods:From July to December 2021, Yanzhou District of Jining City, Ningyang County of Taian City, and Dongying District of Dongying City were selected as surveillance sites to investigate the population and distribution range of Pomacea spp., live snail samples were collected for morphological and genetic identification, and Pomacea spp. infected with the larva of Angiostrongylus cantonensis was detected by lung test. At the same time, sentinel hospital case surveillance was carried out in Yanzhou District, Jining City, and questionnaire was used to study the local residents' awareness of angiostrongyliasis cantonensis and their personal health behaviors. Results:A total of 312 live snail samples were collected. After morphological identification, they were all Pomacea spp.. After gene sequencing, two populations of Pomacea canaliculata and Pomacea maculata were found. No positive snails infected with Angiostrongylus cantonensis were found. A total of 126 patients with headache as the main neurological symptom were admitted to the sentinel hospital, but there were no monitoring cases that met the inclusion criteria. Among the survey population, 48.38% (134/277) of the respondents had heard of angiostrongyliasis cantonensis, 44.77% (124/277) knew that eating Margarya melanioides might cause angiostrongyliasis cantonensis, and 83.39% (231/277) had no related unhealthy eating behavior. Conclusion:Pomacea spp. is found and reported for the first time in Shandong Province, and there is a risk of population infection with angiostrongyliasis cantonensis.

Objective:To understand epidemiological characteristics of imported cases of malaria in Shandong province and provide scientific basis for timely adjustment of prevention and control measures.Methods:The incidence data of malaria, case investigation data and case review data by Shandong Provincial Reference Laboratory for Malaria Diagnosis from 2017 to 2018 were collected. Software SPSS 18.0 was used for statistical analysis and software QGIS 2.18 was used for mapping.Results:A total of 442 imported cases of malaria were reported in Shandong from 2017 to 2018, and the main infection source was in Africa (97.96%, 433/442). All the 17 prefectures in Shandong reported imported malaria cases, mainly in Jining (88 cases), Yantai (65 cases), Weihai (46 cases), Qingdao (44 cases) and Dezhou (42 cases), accounting for 64.48% (285/442). The cases were distributed in 77.37%(106/137) of counties of the province. The cases were reported in every month without seasonal characteristics. The median ( M) of time interval between onset and the first medical care seeking was 2 days, and the interquartile range ( IQR) was 3 days. The M of time interval between the first medical care seeking and final diagnosis was 0 day, and the IQR was 3 days. The proportion of medical care seeking on onset day was only 27.83% (123/442). Only 69.68% (308/442) of cases were diagnosed with malaria in the first medical care seeking, and the diagnostic accuracy of medical institutions below the county level was lower than other medical institutions (all P<0.01). Only 51.13% (226/442) of cases were diagnosed with malaria in the first medical care seeking, the differences in the rates among medical institutions at different levels were not significant ( P>0.05). Conclusions:The imported malaria in Shandong was characterized by a large number of cases, multiple infection sources and wide area distribution during 2017-2018. The awareness of timely medical care seeking in the cases was low, meanwhile the awareness and ability of malaria diagnosis and treatment in primary medical institutions were still inadequate. It is necessary to adjust the prevention and control measures accordingly.