Vol. 3 No. 35 Aug 27, 2021 PARASITIC DISEASES ISSUE Preplanned Studies Assessment on the Diagnostic Capacity for Parasitic Diseases of Health Facilities — China, 2019 731 Modelling the Ecological Suitability of the Chagas Disease Vector Triatoma rubrofasciata — China 736 Surveillance of Malaria Vectors — 18 Sites, 12 PLADs, China, 2018–2020 741 Commentary Diversity, Geography, and Host Range of Emerging Mosquito-Associated Viruses — China, 2010–2020 746 China CDC Weekly Editorial Board Editor-in-Chief George F. Gao Deputy Editor-in-Chief Liming Li Gabriel M Leung Zijian Feng Executive Editor Feng Tan Members of the Editorial Board Xiangsheng Chen Xiaoyou Chen Zhuo Chen (USA) Xianbin Cong Gangqiang Ding Xiaoping Dong Mengjie Han Guangxue He Xi Jin Biao Kan Haidong Kan Qun Li Tao Li Zhongjie Li Min Liu Qiyong Liu Jinxing Lu Huiming Luo Huilai Ma Jiaqi Ma Jun Ma Ron Moolenaar (USA) Daxin Ni Lance Rodewald (USA) RJ Simonds (USA) Ruitai Shao Yiming Shao Xiaoming Shi Yuelong Shu Xu Su Chengye Sun Dianjun Sun Hongqiang Sun Quanfu Sun Xin Sun Jinling Tang Kanglin Wan Huaqing Wang Linhong Wang Guizhen Wu Jing Wu Weiping Wu Xifeng Wu (USA) Yongning Wu Zunyou Wu Lin Xiao Fujie Xu (USA) Wenbo Xu Hong Yan Hongyan Yao Zundong Yin Hongjie Yu Shicheng Yu Xuejie Yu (USA) Jianzhong Zhang Liubo Zhang Rong Zhang Tiemei Zhang Wenhua Zhao Yanlin Zhao Xiaoying Zheng Zhijie Zheng (USA) Maigeng Zhou Xiaonong Zhou Advisory Board Director of the Advisory Board Jiang Lu Vice-Director of the Advisory Board Yu Wang Jianjun Liu Jun Yan Members of the Advisory Board Chen Fu Gauden Galea (Malta) Dongfeng Gu Qing Gu Yan Guo Ailan Li Jiafa Liu Peilong Liu Yuanli Liu Roberta Ness (USA) Guang Ning Minghui Ren Chen Wang Hua Wang Kean Wang Xiaoqi Wang Zijun Wang Fan Wu Xianping Wu Jingjing Xi Jianguo Xu Jun Yan Gonghuan Yang Tilahun Yilma (USA) Guang Zeng Xiaopeng Zeng Yonghui Zhang Editorial Office Directing Editor Feng Tan Managing Editors Lijie Zhang Yu Chen Peter Hao (USA) Senior Scientific Editors Ning Wang Ruotao Wang Shicheng Yu Qian Zhu Scientific Editors Weihong Chen Xudong Li Nankun Liu Lu Ran Xi Xu Qing Yue Xiaoguang Zhang Ying Zhang Cover Photo: China CDC staff collecting Snail Pomacea canaliculata in the field, July 9, 2021, Qiongzhong County, Hainan Province (Photographer: Yun-jia Tian from National Institute of Parasitic Diseases, China CDC） China CDC Weekly Preplanned Studies Assessment on the Diagnostic Capacity for Parasitic Diseases of Health Facilities — China, 2019 Qiang Wang1; Jing Xu1; Yuwan Hao1; Tian Tian1; Zelin Zhu1; Xueqiang Zhang1; Liying Wang1; Shaohong Chen1; Jiaxu Chen1; Ning Xiao1; Shizhu Li1,# diagnosing parasitic diseases, further capacity building Summary for diagnosis, especially parasitological methods, What is already known about this topic? should be strengthened to avoid misdiagnosis of Morbidity and prevalence of several major parasitic patients and provide accurate data for policymaking. diseases have been declining in China. To reduce the In August 2019, a national competition for parasitic disease burden of parasitic diseases and protect public diseases was held by the NHC in Changchun City of health security, conducting accurate diagnoses Jilin Province. A total of 32 teams with 128 following timely treatment is important. technicians attended the competition. Each team was What is added by this report? composed of four professional staff members, with at In the national competition held in 2019, the overall least one being from hospitals and two from agencies accuracy rates of participants for theoretical knowledge below the provincial level. All participants were aged and slides interpretation for parasitic diseases were less than or equal to 45 years old. The competition 80.44% and 66.87%, respectively. Significant consisted of 2 parts: 1) theoretical knowledge on the differences in the accuracy rates of detecting life cycle of common parasites, their etiology and schistosomiasis or malaria existed between endemic diagnosis, and control and prevention strategies of areas and non-endemic areas, respectively. several parasitic diseases were evaluated through a What are the implications for public health paper test composed of 50 questions featured as single- practice? choice, multiple-choice, and true or false categories; The study results will help policymakers and health and 2) the technical skills for interpretation of blood managers to identify the gaps in parasitic diseases, help smear slides and Kato-Katz thick smear slides were to strengthen diagnostic capacity, and improve quality examined. All slides and the reference answers were prepared by the National Institute of Parasitic Disease of control programs. (NIPD) of China CDC. China used to be overloaded by the heavy burden All assessment activities were conducted in parallel in single blind manner. The original results of each caused by parasitic diseases. However, through several participant were entered into a computer by Microsoft decades of effort, the number of cases and the Excel (version 2013, Microsoft Corp, Redmond, USA) prevalence of parasitic diseases had declined and descriptive statistics was conducted by SPSS dramatically nationwide (1–3). However, misdiagnosis software (version 20, IBM Corp, Armonk, USA) to of parasitic diseases was reported from occasionally, describe the general information of participants. The especially for imported cases or asymptomatic cases accuracy rate was calculated as the number of questions with light infections. To understand the gap in answered accurately divided by the total number of diagnostic capacity that exists for parasitic diseases, a questions, or the accumulated number of parasite nationwide competition was conducted in August species in slides interpreted accurately divided by the 2019 by the National Health Commission (NHC) total number of referenced parasite species provided by through a paper test and interpretation of slides NIPD. Chi-squared statistics were used to compare the containing parasite worms or eggs. Generally, values between or among subgroups. The level of technicians grasped the knowledge of parasitic disease statistical significance was defined as P<0.05. well but their practical skills for slides interpretation In total, 128 participants from 30 provincial-level were not satisfactory with an overall accuracy rate of administrative divisions (PLADs), Xinjiang Production 66.87%. As parasitological methods relying on and Construction Corps, and Chinese General interpreting slides were still the gold standard for Administration of Customs attended the competition. Chinese Center for Disease Control and Prevention CCDC Weekly / Vol. 3 / No. 35 731 China CDC Weekly Overall, 28.9% (37/128) of participants were male and 84.38% (1,080/1,280), 83.98% (1,075/1,280), 71.1% (91/128) were female. All participants were 76.72% (982 /1,280), 81.75% (1,465/1,792), and aged with a mean value of 32.43±4.95 years old. The 71.09% (546/768), respectively, showing significant majority of participants (96.1%, 123/128) were junior difference (χ2=78.673, P<0.05). staff with primary or middle level professional titles, For the interpretation of slides, the accuracy rate for while the rest were senior staff. Among of them, 82 thick smear slides and blood smear slides was 67.19% participants were working at agencies of public health (2,097/3,121) and 65.31% (418/640), respectively, while 46 participants were from hospitals. with the overall accuracy rate being 66.87% In the theoretical knowledge assessment, the (2,515/3,761) (Table 2). Individually, the accuracy accuracy rate was 80.44% (5,148/6,400) for all rate for the interpretation of thick smear slides ranged participants but varied from 38.00% (19/50) to from 10% (3/30) to 96.55% (28/29); 22 participants 98.00% (49/50). Chi-square analysis showed that the had a 100% accuracy rate, but 4 participants provided females had higher accuracy rates than the males all wrong answers for blood smear slides interpretation. (χ2=14.139, P<0.01) while the accuracy rate in The average accuracy rates did not differ significantly participants from public health agencies was higher among agencies (χ2=5.494, χ2=0.073, P>0.05), but than that from hospitals (χ2=8.374, P<0.01). females, younger professional staff, and senior staff had Significant differences were also detected when higher accuracy rates (P<0.05). analyzing accuracy rates by strata of professional titles In analyzing the accuracy rates by helminth species, and agencies (χ2=8.571, χ2=24.023, P<0.05). But the highest accuracy was 87.50% (420/480) for the no difference in accuracy rate was found among detection of Clonorchis sinensi, followed by 83.73% different age groups (χ2=2.442, P>0.05) (Table 1). (669/799) for Ascarias spp. The lowest accuracy rate For the knowledge points, the accuracy rates was 25.89% (124/479) for detection of Schistosoma regarding to diagnosis, detection technology, the life japonicum (Table 3). Significant differences in accuracy cycle of parasites, and control and prevention of rates were detected among helminth species parasitic diseases were 84.90% (1,304/1,536), 84.01% identification (χ2=593.544, P<0.05). For (1,398/1,664), 83.52% (1,176/1,408), and 70.87% identification of plasmodium species, the accuracy rate (1,270/1,792), respectively, presenting significant for detecting Plasmodium malariae, P. falciparum, P. differences (χ2=145.682, P<0.05). In addition, the vivax, and negative slides were 57.50% (23/40), accuracy rates of answers to questions related to the 60.47% (179/296), 69.64% (117/168), and 72.79% diagnosis of schistosomiasis, malaria, echinococcosis, (99/136), respectively, presenting significant other parasitic disease, and comprehensive issues were differences (χ2=8.888, P<0.05). The accuracy rate of TABLE 1. The accuracy rates of 128 participants for knowledge test related to parasitic diseases in China, 2019. No. No.