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Hand, foot, and mouth disease (HFMD) is a global infectious disease resulting in millions of cases and even hundreds of deaths. Although a newly developed formalin-inactivated EV71 (FI-EV71) vaccine is effective against EV71, which is a major pathogen for HFMD, no vaccine against HFMD itself has yet been developed. Therefore, establishing a sensitive and accurate early warning system for HFMD is important. The early warning model for HFMD in the China Infectious Disease Automated-alert and Response System combines control chart and spatial statistics models to detect spatiotemporal abnormal aggregations of morbidity. However, that type of early warning for HFMD just involves retrospective analysis. In this study, we apply a Bayesian belief network (BBN) to estimate the increased risk of death and severe HFMD in the next month based on pathogen detection and environmental factors. Hunan province, one of the regions with the highest prevalence of HFMD in China, was selected as the study area. The results showed that compared with the traditional early warning model for HFMD, the proposed method can achieve a very high performance evaluation (the average AUC tests were more than 0.92). The model is also simple and easy to operate. Once the structure of the BBN is established, the increased risk of death and severe HFMD in the next month can be estimated based on any one node in the BBN. [ABSTRACT FROM AUTHOR]

Objective To evaluate the safety and efficacy of combining artemether (AM) and praziquantel (PZQ) in different regimens for treating acute schistosomiasis japonica. Methods We undertook a randomized, double-blind, placebo-controlled trial within four specialized schistosomiasis hospitals in the Dongting Lake region, Hunan province, China, between May 2003 and December 2005. Study participants were randomized into one of four treatment regimes: group A received 60 mg/kg PZQ + 6 mg/kg AM; group B received 60 mg/kg PZQ + AM placebo; group C received 120 mg/kg PZQ + 6 mg/kg AM; and group D received 120 mg/kg PZQ + AM placebo. All participants were followed up over a 45-day period. The primary endpoint of the trial was human infection status (determined by positive stool examination). Secondary endpoints involved clinical observations and blood biochemistry, including monitoring haemoglobin and alanine aminotransferase levels over time. Findings Treatment efficacies of the four different treatment regimens were 98.0%, 96.4%, 97.7% and 95.7% for group A, B, C, and D respectively (P > 0.05). The group B had a greater treatment efficacy (96.4%) than the group D (95.7%) (P > 0.05). Group A treatment was better for clearance of fever (P < 0.05) and resulted in a shorter hospitalization time (P < 0.05). Conclusion This is the first report of a randomized, double-blind, placebo-controlled trial for evaluating combined chemotherapy with AM and two different dosages (60 mg/kg and 120 mg/kg) of PZQ in the treatment of acute schistosomiasis japonica in China. The combination of AM and PZQ chemotherapy did not improve treatment efficacy compared with PZQ alone. PZQ given as a dosage of 60 mg/kg (1 day, 3 × 20 mg/kg doses at 4-5 hour intervals) may be as effective as a dosage of 120 mg/kg (6 days, 20 mg/kg for each day split into 3 doses at 4-5 hour intervals). [ABSTRACT FROM AUTHOR]