Species of sandflies and prevalence of Leishmania infections in sandflies in selected areas of northern and northwestern China
This study identified sandfly species and Leishmania infection prevalence across northern and northwestern China, finding Ph. chinensis and Ph. wui as dominant vectors, with Leishmania infantum and L. donovani detected at infection rates of up to 1.00%, highlighting regional vector diversity and the need for targeted surveillance and control strategies.
To investigate the species of sandflies and the prevalence of Leishmania infections in sandflies from selected areas of northern and northwestern China, so as to provide insights into identification of leishmaniasis vectors and assessment of epidemiological trends of leishmaniasis in China. Sandfly samples were collected from Mentougou District of Beijing Municipality, Xiangning County in Linfen City of Shanxi Province, Ejin Banner in Alxa League of Inner Mongolia Autonomous Region, and Payzawat County of Karamay District of Karamay City, Gaochang District of Turpan City in Xinjiang Uygur Autonomous Region from July 2023 to July 2024. Approximately 100 intact female sandfly samples were randomly selected from each site and the species of sandflies was identified according to morphological characteristics and molecular assays. Female sandflies originating from the same habitat were grouped into pools of 10 individuals. Leishmania infection was detected using polymerase chain reaction (PCR) assay targeting the internal transcribed spacer 1 (ITS-1) gene, and the prevalence of Leishmania infection was calculated in sandflies from different sampling sites using the minimum infection rate (MIR) method. In addition, positive amplicons were sequenced and subjected to phylogenetic analysis. A total of 6 155 sandflies were collected from different environments at sampling sites across the six aforementioned regions from July 2023 to July 2024. Phlebotomus chinensis (96.00%) was the dominant sandfly species in Mentougou District, Beijing Municipality, with a small proportion of Ph. sergenti (4.00%), and only Ph. chinensis was found in Xiangning County, Linfen City, Shanxi Province. Ph. wui was the only sandfly species detected in Ejin Banner, Alxa League, Inner Mongolia Autonomous Region, and Payzawat County, Kashgar City, Xinjiang Uygur Autonomous Region, and Ph. caucasicus (97.70%) was the dominant sandfly species in Karamay District, Karamay City, Xinjiang Uygur Autonomous Region, with a small proportion of Ph. wui (2.30%), while Ph. alexandri was the only species in Gaochang District, Turpan City, Xinjiang Uygur Autonomous Region. A total of 40, 60, 34, 18, 18, and 22 pools of sandfly samples were tested from Mentougou District in Beijing Municipality, Xiangning County in Linfen City of Shanxi Province, Ejin Banner in Alxa League of Inner Mongolia Autonomous Region, Payzawat County in Kashgar City, Karamay District in Karamay City, and Gaochang District in Turpan City of Xinjiang Uygur Autonomous Region, respectively. L. infantum was detected in Ph. chinensis samples from Mentougou District in Beijing Municipality, and Xiangning County of Linfen City in Shanxi Province, with MIR of 0.25% to 1.00%, and L. donovani was detected in Ph. wui from Ejin Banner in Alxa League of Inner Mongolia Autonomous Region, and Payzawat County in Kashgar City of Xinjiang Uygur Autonomous Region, with MIR of 0.56% to 0.88%; however, no Leishmania infection was detected in Ph. caucasicus from Karamay District in Karamay City or Ph. alexandri from Gaochang District in Turpan City of Xinjiang Uygur Autonomous Region. Phylogenetic analysis showed that the Leishmania ITS-1 gene sequences obtained from Mentougou District in Beijing Municipality and Xiangning County in Linfen City of Shanxi Province were clustered into the same clade with the reference sequences of L. infantum ITS-1 gene, while the Leishmania ITS-1 gene sequences obtained from Ejin Banner in Alxa League of Inner Mongolia Autonomous Region and Payzawat County in Kashgar City of Xinjiang Uygur Autonomous Region were clustered into the same clade with the reference sequences of L. donovani ITS-1 gene. There are variations in sandfly species in selected areas of northern and northwestern China, and variations in the species of Leishmania infecting sandflies. Improved surveillance of sandfly vectors and targeted control strategies with adaptations to geographical features and leishmaniasis vectors are recommended.
- Research Article
- 10.16250/j.32.1915.2024295
- May 9, 2025
- Zhongguo xue xi chong bing fang zhi za zhi = Chinese journal of schistosomiasis control
To investigate the genetic diversity of sandfly populations in endemic areas of visceral leishmaniasis in China, so as to provide references insights into management of visceral leishmaniasis and the vector sandflies. Sixteen sampling sites were selected from main endemic foci of visceral leishmaniasis in China from June to September 2024, including Shanxi Province, Shaanxi Province, Henan Province, Gansu Province, Sichuan Province, and Xinjiang Uygur Autonomous Region. Sandflies were captured using light traps and manual aspirators from sheep pens, chicken coops, cave dwellings, bovinesheds, and pig pens at each sampling site. A single sandfly sample was washed in phosphate-buffered saline (PBS), and genomic DNA was extracted from sandfly samples. Cytochrome oxidase subunit 1 (COI) gene was amplified using PCR assay with universal primers, and analyzed and retrieved with the nucleotide sequence analysis tool (BLAST) software, and the sequence of COI gene was aligned with the ClustalX 1.83 and MEGA 7.0 software. The base composition and variation site of the COI gene sequence were analyzed using the software MEGA 7.0, and the number of haplotypes, total number of segregating sites, haplotype diversity, nucleotide diversity, and average nucleotide differences were calculated in the COI gene sequence using the software DnaSP 5.10, followed by Tajima's D test for neutrality. Haplotypes were screened using the software DnaSP 5.10, and the haplotype network map of sandfly samples was plotted using the software Network 5.0. MEGA 7.0 software was employed for gene sequence editing and alignment, and calculation of genetic distances among sandfly species sampled from different regions, and a phylogenetic tree was built with a neighbor-joining method. A total of 466 sandflies were captured from 16 sampling sites in China from June to September 2024, and 430 gene sequences were yielded following PCR amplification and sequencing of the COI gene, with 652 to 688 bp in the length of amplification fragments. The captured sandfly samples were characterized as Phlebotomus chinensis, Sergentomyia squamirostris, Se. koloshanensis, Ph. sichuanensis, and Ph. longiductus following the COI gene sequence alignment in BLAST. A total of 251 haplotypes were identified in the 430 gene sequences from sandfly samples (50.5%), and the average haplotype diversity, nucleotide diversity and average number of nucleotide difference were 0.885, 0.257 and 160.761, respectively. The Tajima's D values were -0.92 for sandfly populations from Yangquan City, Shanxi Province and -1.73 for sandfly populations from Sanmenxia City, Henan Province, and were all more than 0 for sandfly populations from other sampling sites. Haplotype analysis identified 50 haplotypes, which were classified into two haplogroups. Heplogroup 1 included 29 haplotypes, which had a high homology, and heplogroup 2 included 21 haplotypes. The average genetic distance was 0.000 to 0.604 among sandfly samples from different sampling sites, and phylogenetic analysis revealed that the five sandfly species were clustered into distinct clades, all with 100% clade confidence. There is a high genetic polymorphism in the COI gene from five sandfly populations in main endemic foci of visceral leishmaniasis in China, and COI gene may serve as a marker gene for analysis of the genetic structure of sandfly populations.
- Research Article
29
- 10.1007/s40333-020-0073-y
- Sep 1, 2020
- Journal of Arid Land
Can climate change influence agricultural GTFP in arid and semi-arid regions of Northwest China?
- Research Article
11
- 10.1016/j.compag.2020.105846
- Nov 21, 2020
- Computers and Electronics in Agriculture
Spatial–temporal analysis of the comparative advantages of dairy farming: Taking 18 provinces or municipalities in China as an example
- Research Article
229
- 10.1017/s0031182003004153
- Oct 1, 2003
- Parasitology
Human alveolar echinococcosis (AE), caused by the metacestode of the fox tapeworm Echinococcus multilocularis, is the most pathogenic zoonosis in temperate and arctic regions of the northern hemisphere. Prospective collection of human cases in some areas and mass screenings using ultrasound imaging and confirmation with serological techniques have markedly improved our knowledge of the epidemiology of the disease in humans during the past two decades. Transmission occurs when eggs of the tapeworm, excreted by the final hosts (usually foxes but also dogs, wolves and cats), are ingested accidentally by humans or during normal feeding by a variety of rodents and small lagomorphs. However, the species of host animals differ according to regional changes in mammalian fauna. This review mostly focuses on epidemiology of alveolar echinococcosis in those parts of the world where new and more accurate epidemiological data are now available, i.e. China and Europe, as well as on new epidemiological trends that can be suspected from recent case reports and/or from recent changes in animal epidemiology of E. multilocularis infection. The People's Republic of China (PRC) is a newly recognized focus on AE in Asia. Human AE cases were firstly recognized in Xinjiang Uygur Autonomous Region and Qinghai Provinces at the end of 1950s and infected animals were first reported from Ningxia in central China and northeast of Inner Mongolia in the 1980s. E. multilocularis (and human cases of AE) appears to occur in three areas: (1) Northeastern China (northeast focus): including Inner Mongolia Autonomous region and Heliongjiang Province (2) Central China (central focus): including Gansu Province, Ningxia Hui Autonomous Region, Sichuan Province, Qinghai Province and Tibet Autonomous Region and (3) Northwestern China: including Xinjiang Uygur Autonomous Region, bordered with Mongolia, Russia, Kazakhstan and Kyrgyzstan. The highest prevalence of the disease, up to 15 per cent of the population in some villages, is reached in China. In Europe, data from the European Echinococcosis Registry (EurEchinoReg: 1982-2000) show 53 autochthonous cases of AE in Austria, 3 in Belgium, 235 in France, 126 in Germany, 1 in Greece, and 112 in Switzerland, and 15 'imported' cases, especially from central Asia; 14 cases were collected in Poland, a country not previously considered endemic for AE. Improved diagnostic technology, as well as a real increase in the infection rate and an extension to new areas, can explain that more than 500 cases have been reported for these 2 decades while less than 900 cases were published for the previous 7 decades. New epidemiological trends are related to an unprecedented increase in the fox population in Europe, to the unexpected development of urban foxes in Japan and in Europe, and to changes in the environmental situation in many countries worldwide due to climatic or anthropic factors which might influence the host-predator relationship in the animal reservoir and/or the behavioural characteristics of the populations in the endemic areas.
- Research Article
- 10.11922/11-6035.ncdc.2025.0009.zh
- Jul 1, 2025
- China Scientific Data
<p indent="0mm">Under the backdrop of global climate change and carbon neutrality targets, accurately assessing carbon stock changes in arid and semi-arid ecosystems is crucial for national carbon budget estimations. This dataset was developed using the Arid Ecosystem Model (AEM) to simulate carbon storage in northern China and the Yellow River Basin with a spatial resolution of <sc>10 km×10 km.</sc> The study area includes northern China and the Yellow River Basin, namely Xinjiang Uygur Autonomous Region, Tibet Autonomous Region, Qinghai Province, Gansu Province, Inner Mongolia Autonomous Region, Ningxia Hui Autonomous Region, Liaoning Province, Heilongjiang Province, Jilin Province, Hebei Province, Shaanxi Province, Shanxi Province, Sichuan Province, Henan Province, Shandong Province and Beijing. The dataset includes total carbon storage, as well as the vegetation carbon pool, soil carbon pool, and litter carbon pool. The dataset was developed by integrating multi-source climate and vegetation data to drive the model, and further validated through cross-verification with field observations and uncertainty analysis to ensure its scientific robustness and reliability. This study aims to support the analysis of climate change and rising atmospheric CO<sub>2</sub> impacts on carbon storage in the arid and semi-arid regions of northern China and the Yellow River Basin. It provides a scientific foundation for understanding regional carbon cycles and for formulating ecological protection and carbon management strategies. Furthermore, the dataset serves as an important baseline resource for regional ecosystem carbon storage assessments and ecosystem quality assessments. The publication of this dataset provides a scientific foundation for understanding the carbon cycle in northern China and the Yellow River Basin. And it supports the formulation of ecological conservation strategies, contributes to national carbon budget estimations and informs the formulation of sustainable agricultural policies.
- Research Article
1
- 10.3760/cma.j.cn112338-20230327-00183
- Sep 10, 2023
- Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi
Objective: To analyze the mortality trend of hypertension in Xinjiang Uygur Autonomous Region, Qinghai Province, Shaanxi Province, Gansu Province, Ningxia Hui Autonomous Region and Inner Mongolia Autonomous Region (6 provinces) in northwestern China, from 2013 to 2021, and evaluate the influence of hypertension on people's life expectancy. Methods: Based on national death surveillance data and demographic data in the 6 provinces from 2013 to 2021, the mortality rate, standardized mortality rate, life expectancy, cause eliminated life expectancy (CELE), potential gains in life expectancy (PGLEs) and life loss rate of hypertension were calculated. Software Joinpoint was used to analyze the mortality trends and calculate average annual percentage change (AAPC) and annual percentage change (APC) in hypertension deaths. Results: From 2013 to 2021, the overall standardized mortality rate of hypertension in the 6 provinces showed a downward trend (AAPC=-1.82%, P=0.050). The mortality rate in rural area was always higher than that in urban area, and showed an increasing trend after 2016 (APC=4.74%, P=0.003), and the mortality rate in men was always higher than that in women. The incidence trend of deaths of different types of hypertension were different, and the deaths caused by hypertensive heart disease accounted for the highest proportion (72.69%). In 2021, the life expectancy of the population in the 6 provinces increased by 1.01 years, the CELE increased by 0.93 years, the PGLEs decreased by 0.08 years, and the life loss rate decreased by 0.11% compared with 2013. Conclusions: The overall standardized mortality rate of hypertension showed a decreasing trend in the 6 northwestern provinces from 2013 to 2021, but it showed an increasing trend in rural area after 2016. Prevention of hypertension should be further strengthened in rural area, men and elderly population.
- Supplementary Content
39
- 10.1186/s40249-016-0107-z
- Feb 23, 2016
- Infectious Diseases of Poverty
After the existence of phlebotomine sand flies was first reported in China in 1910, the distribution of different species and their role in the transmission of visceral leishmaniasis (VL) have been extensively studied. Up until 2008, four species have been verified as vectors of VL, namely, Phlebotomus chinensis (Ph. sichuanensis), Ph. longiductus (Ph. chinensis longiductus), Ph. wui (Ph. major wui), and Ph. alexandri.The sand fly species vary greatly depending on the natural environments in the different geographic areas where they are endemic. Ph. chinensis is euryecious and adaptable to different ecologies, and is thus distributed widely in the plain, mountainous, and Loess Plateau regions north of the Yangtze River. Ph. longiductus is mainly distributed in ancient oasis areas south of Mt. Tianshan in the Xinjiang Uygur autonomous region. Ph. wui is the predominant species in deserts with Populus diversifolia and Tamarix vegetation in Xinjiang and the western part of the Inner Mongolia autonomous region. Finally, Ph. alexandri is steroecious and found only in stony desert areas, such as at the foot of the mountains in Xinjiang and the western Hexi Corridor, in Gansu province. This review summarized the relationship between the geographic distribution pattern of the four sand fly species and their geographical landscape in order to foster research on disease distribution and sand fly control planning. Furthermore, some problems that remained to be solved about vectors of VL in China were discussed.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-016-0107-z) contains supplementary material, which is available to authorized users.
- Research Article
5
- 10.1016/j.apgeochem.2016.06.008
- Jun 23, 2016
- Applied Geochemistry
Comparative study on the hydrogeochemical environment at the major drinking water based arsenism areas
- Research Article
- 10.3760/cma.j.issn.1674-2907.2019.27.005
- Sep 26, 2019
- Chinese Journal of Modern Nursing
Objective To understand the self-management status among elderly chronic heart failure (CHF) patients and to compare the regional differences of self-management. Methods By random cluster sampling, we investigated 6 124 elderly CHF patients from 102 hospitals in five regions, East China (Jiangxi Province, Shanghai Municipality, Zhejiang Province) , West China (Qinghai Province, Xinjiang Uygur Autonomous Region, Shaanxi Province, Gansu Province, Ningxia Hui Autonomous Region, Yunnan Province) , South China (Hainan Province, Guangxi Zhuang Autonomous Region) , North China (Heilongjiang Province, Inner Mongolia Autonomous Region) , Central China (Henan Province, Hubei Province, Hunan Province) . The investigation result statistics were carried out and regional differences were compared. Results The self-management of elderly CHF patients had a low to medium level with 61.25% (49/80) <80% for the scoring rate. The scores of East China and Central China were higher and the score of West China was low; the regional differences were statistical (H=59.07, P<0.01) . The score of diet management was highest with 66.67% for the scoring rate (8/12) ; East China had the highest score, and West China had the lowest score; the regional differences were statistical (H=92.49, P<0.01) . The scoring rate of medication management was 65.00% (13/20) with the highest in East China and low in North China and West China; the regional differences were statistical (H=351.10, P<0.01) . Mental/social adjustment management was poor with 60.00% (12/20) for the scoring rate; the scores of Ease China were higher than those of North and West China; the regional differences were statistical (H=8.84, P<0.01) . Symptom management was the worst with 57.14% (16/28) for the scoring rate; the scores of East and Central China were high; the regional differences were also statistical (H=17.62, P<0.01) . Conclusions Self-management of elderly CHF patients needs to be improved. Systematic and targeted health education for different regions should be carried out to improve patients' self-management and to reduce the disease burden. Key words: Heart failure; Aged; Multicenter study; Self-management
- Research Article
18
- 10.46234/ccdcw2025.020
- Jan 1, 2025
- China CDC weekly
The number of reported cases of human brucellosis significantly increased from 45,046 (3.25/100,000) in 2019 to 70,439 (4.99/100,000) in 2023. Human brucellosis continued to spread and expand of in northern China, with the most cases reported in the Inner Mongolia Autonomous Region (n=87,961), Xinjiang Uygur Autonomous Region (n=27,845) and Shanxi Province (n=21,932). In southern China, reported cases increased substantially from 2,036 in 2019 to 5,128 in 2023. Joinpoint regression analysis revealed an upward trend in incidence rate across 29 provincial-level administrative divisions (PLADs), with an annual percent change (APC) of 12.86, (P<0.05), with particularly rapid increases observed in most southern PLADs. Spatiotemporal analysis identified high-risk clusters concentrated in the northwestern and northeastern regions. With the continued worsening of human brucellosis over the past five years, implementing strict controls on the movement of infected animals is urgeent.
- Research Article
34
- 10.1023/a:1016079216654
- Sep 1, 2002
- Environmental Geochemistry and Health
In China, endemic arseniasis attributable to the geological-geochemistry environment is mainly found in the plain of the Great Bend of the Yellow River and the Hu-Bao plain in the Inner Mongolia Autonomous Region, in the Datong basin of Shanxi Province, the floodplain of the northern side of the Tian Mountain of Xinjiang Uygur Autonomous Region, and in the southwest coastal plain of Taiwan. These areas share many similar characteristics including widespread occurrences, a large population being affected, and the magnitude of risk involved. The population living in these areas is estimated to be around 5.5 × 105, of which of 2.5 × 105 are resident in Inner Mongolia. Based on our systematic research and comparison of various areas, we found the different types of arseniasis are often associated with different regions. The neural arseniasis is distributed in Xinjiang Uygur Autonomous Region and Shanxi Province, caused by inorganic arsenic in drinking water while the cycling-obstacle arseniasis is mainly found in Inner Mongolia and Taiwan, associated with organic arsenic in water. The distribution of arsenic affected villages in Inner Mongolia exhibits orientation and focus on low-lying land in the subsiding centre of the Great Bend basin, which was enriched with humus in the lake and limnetic deposits. Much CH4 gas can be detected in the water of shallow and deep wells in these villages. Some of the wells with higher concentrations of CH4 can even be ignited. This is a typical reductive geochemical environment. We tested the total amount of arsenic (ΣAs), As3+, and methyl arsenate in all types of water sources. It is found that the number of arseniasis cases is not clearly related to the total amount of arsenic (ΣAs) in the water. However, it is related to the ratio of As3+ plus methyl arsenic to the total amount of arsenic (ΣAs). The higher the ratio, the higher the number of people affected and the more serious the illness. The statistical results also indicate that good drinking water accounts for 60% of the drinking water source while the arsenic contaminated water makes up about 25% of the drinking water in the study area. This research reveals that the local geochemical environment is responsible for the spreading of the endemic arseniasis in the area and thus suggests a new direction of how to prevent such disease.
- Research Article
55
- 10.3389/fcimb.2018.00283
- Aug 30, 2018
- Frontiers in Cellular and Infection Microbiology
Anaplasma capra is an emerging pathogen, which can infect ruminants and humans. This study was conducted to determine the occurrence of A. capra in the blood samples of sheep and goats in China. Using nested polymerase chain reaction (nested-PCR) targeting the gltA gene and conventional PCR targeting the heat shock protein (groEL) gene and the major surface protein4 gene (msp4), A. capra was detected in 129 (8.9%) of 1453 sheep and goat blood samples. The positive rate was higher in goats (9.4%, 89/943) than in sheep (7.8%, 40/510) (χ2 = 1.04, p > 0.05, df = 1). For sheep, A. capra was found in 17 sites from 2 provinces. The prevalence was 28.6% in sheep from Liaoning province, which was higher than in Henan Province (7.3%). For goats, A. capra was detected in 35 sites from 7 provinces. The prevalence varied from 0 to 19.4% in the goat sites examined. The prevalence rates were 19.4, 19.3, 10, 8.8, 6.8, 1.8, and 0% in goats from Guizhou province, Henan Province, Inner Mongolia Autonomous Region, Shanxi Province, Xinjiang Uygur Autonomous Region, Yunnan province, and Gansu province, respectively. Based on the analysis of the A. capra citrate synthase gene (gltA), two variants were identified. Variant I showed a high sequence similarity to the A. capra, which were previously reported in sheep, goats, Ixodes persulcatus, Haemaphysalis longicornis, Haemaphysalis qinghaiensis, and humans. Variant II was only found in Luoyang, Anyang, and Sanmengxia, of Henan province. To our knowledge, this is the first detection of this variant of A. capra in sheep and goat blood in China. Phylogenetic analysis based on groEL and msp4 genes showed that the Anaplasma sp. sequences clustered independently from A. capra and other Anaplasma species with high bootstrap values. We found A. capra DNA in sheep and goats in China, providing evidence that sheep and goats can be infected by A. capra. We also found that this zoonotic pathogen is widely distributed in China. This study provides information for assessing the public health risks for human anaplasmosis.
- Research Article
278
- 10.1016/0040-1951(90)90008-v
- Sep 1, 1990
- Tectonophysics
New paleomagnetic results from northern China: collision and suturing with Siberia and Kazakhstan
- Research Article
6
- 10.3390/molecules29215142
- Oct 30, 2024
- Molecules (Basel, Switzerland)
Cow milk is rich in proteins, fats, carbohydrates, and minerals; however, its precise nutrient content varies based on various factors. In the current study, we evaluated the differences in the fatty acid and protein contents of milk and the factors associated with these differences. To achieve this, samples were collected from seven types of cows in different regions. These included samples from three dairy breeds: Chinese Holstein milk from Beijing, China (BH), Chinese Holstein milk (HH) and Jersey milk (JS) from Hebei province, China; and four dairy/meat breeds: Sanhe milk (SH) from Inner Mongolia Autonomous Region, China, Xinjiang brown milk (XH) and Simmental milk (SI) from Xinjiang Uygur Autonomous Region, China, and Shu Xuanhua milk (SX) from Sichuan province, China. Breed significantly affects total fat, fatty acid, and protein contents. Additionally, geographic region significantly affects the contents of different fatty acids, α-lactalbumin, and lactoferrin. JS has the highest total fat and casein contents. XH samples contain significantly higher unsaturated fatty acid content than BH samples and do not differ significantly from JS. Additionally, the low β-lactoglobulin and high lactoferrin contents in XH samples may be favorable for the growth and development of infants. Our results may inform the development of dairy products from different cow breeds and advance the process of accurate breed identification.
- Book Chapter
15
- 10.1007/978-981-13-2529-8_4
- Jan 1, 2019
Arsenicosis, also described as blackfoot disease, was first reported in the 1950s in Taiwan, China. In the mainland of China, endemic arsenic poisoning induced by consumption of arsenic-contaminated drinking water was first reported in 1983 in Kuitun City, Xinjiang Uygur Autonomous Region. The distribution of endemic arsenicosis has also been confirmed in Inner Mongolia Autonomous Region, Shanxi, Jilin, Ningxia, Qinghai, Anhui, Gansu, Hubei, Yunnan, and Shaanxi provinces. According to the recent research by Eawag, Swiss Federal Institute of Aquatic Science and Technology, there are estimated 19.6 million people who are at risk of being affected by arsenic-contaminated groundwater. In addition, another type of endemic arsenic poisoning is found due to burning coal containing high levels of arsenic. Consumption of arsenic-contaminated food (mainly corns and chili peppers) dried by burning coal with high concentration of arsenic and inhalation of arsenic-contaminated air are the main exposure routes of this kind of arsenicosis.