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In recent years, there has been a substantial increase of imported Plasmodium vivax incidence in Henan Province. As China is in a pre-elimination phase, the surveillance of imported malaria is essential, but there is no good way to distinguish imported cases from indigenous cases. This paper reports a case of a 39-year-old man who acquired P. vivax while staying in Indonesia for one month in 2013, and relapsed in Henan, China in 2014. This was diagnosed as vivax malaria based on rapid diagnostic test, Giemsa-stained peripheral blood smear and Plasmodium species-specific nested PCR. The genetic sequence for the circumsporozoite protein genes was analysed and the genetic variations were compared with a previously constructed database of Chinese isolates. The results from the circumsporozoite protein (CSP) gene sequence analysis centered on the repeat patterns showed that the imported cases had completely different sequences from any subtypes from Chinese isolates, but well matched with the countries travelled by the patient. The imported vivax cases were able to clearly distinguish from the indigenous vivax cases by detecting the CSP gene and were able to confim its origin by genotyping. [ABSTRACT FROM AUTHOR]

Background: In a conventional P-median model, demanding points are likely assigned to the closest supplying facilities, but this method exhibits evident limitations in real cases. Methods: This paper proposed a modified P-median model in which exact and approximate strategies are used. The first strategy aims to enumerate all of the possible combinations of P facilities, and the second strategy adopts simulated annealing to allocate resources considering capacity constraint and spatial compactness constraint. These strategies allow us to choose optimal locations by applying visual analytics, which is rarely employed in location allocation planning. Results: This model is applied to a case study in Henan Province, China, where three optimal healthcare centers are selected from candidate cities. First, the weighting factor in spatial compactness constraint is visually evaluated to obtain a plausible spatial pattern. Second, three optimal healthcare centers, namely, Zhengzhou, Xinxiang, and Nanyang, are identified in a hybrid transportation network by performing visual analytics. Third, alternative healthcare centers are obtained in a road network and compared with the above solution to understand the impacts of transportation network types. Conclusions: The optimal healthcare centers are visually detected by employing an improved P-median model, which considers both geographic accessibility and service quality. The optimal solutions are obtained in two transportation networks, which suggest high-speed railways and highways play a significant role respectively [ABSTRACT FROM AUTHOR]