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Guillot C, Bouchard C, Aenishaenslin C, Berthiaume P, Milord F, Leighton PA. Criteria for selecting sentinel unit locations in a surveillance system for vector-borne disease: A decision tool. Front Public Health 2022; 10:1003949. [PMID: 36438246 PMCID: PMC9686450 DOI: 10.3389/fpubh.2022.1003949] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/10/2022] [Indexed: 11/11/2022] Open
Abstract
Objectives With vector-borne diseases emerging across the globe, precipitated by climate change and other anthropogenic changes, it is critical for public health authorities to have well-designed surveillance strategies in place. Sentinel surveillance has been proposed as a cost-effective approach to surveillance in this context. However, spatial design of sentinel surveillance system has important impacts on surveillance outcomes, and careful selection of sentinel unit locations is therefore an essential component of planning. Methods A review of the available literature, based on the realist approach, was used to identify key decision issues for sentinel surveillance planning. Outcomes of the review were used to develop a decision tool, which was subsequently validated by experts in the field. Results The resulting decision tool provides a list of criteria which can be used to select sentinel unit locations. We illustrate its application using the case example of designing a national sentinel surveillance system for Lyme disease in Canada. Conclusions The decision tool provides researchers and public health authorities with a systematic, evidence-based approach for planning the spatial design of sentinel surveillance systems, taking into account the aims of the surveillance system and disease and/or context-specific considerations.
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Affiliation(s)
- Camille Guillot
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada,Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada,Centre de recherche en santé publique de l'Université de Montréal et du CIUSSS du Centre-Sud-de-l'île-de-Montréal (CReSP), Montréal, QC, Canada,*Correspondence: Camille Guillot
| | - Catherine Bouchard
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada,Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, St. Hyacinthe, QC, Canada
| | - Cécile Aenishaenslin
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Philippe Berthiaume
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada,Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, St. Hyacinthe, QC, Canada
| | - François Milord
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Patrick A. Leighton
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada,Centre de recherche en santé publique de l'Université de Montréal et du CIUSSS du Centre-Sud-de-l'île-de-Montréal (CReSP), Montréal, QC, Canada
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Hu Y, Bergquist R, Chen Y, Ke Y, Dai J, He Z, Zhang Z. Dynamic evolution of schistosomiasis distribution under different control strategies: Results from surveillance covering 1991-2014 in Guichi, China. PLoS Negl Trop Dis 2021; 15:e0008976. [PMID: 33406136 PMCID: PMC7787434 DOI: 10.1371/journal.pntd.0008976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 11/11/2020] [Indexed: 12/03/2022] Open
Abstract
Background Since the founding of the China, the Chinese government, depending on the changing epidemiological situations over time, adopted different strategies to continue the progress towards elimination of schistosomiasis in the country. Although the changing pattern of schistosomiasis distribution in both time and space is well known and has been confirmed by numerous studies, the problem of how these patterns evolve under different control strategies is far from being understood. The purpose of this study is, therefore, to investigate the spatio-temporal change of the distribution of schistosomiasis with special reference to how these patterns evolve under different control strategies. Methodology / Principal findings Parasitological data at the village level were obtained through access to repeated cross-sectional surveys carried out during 1991–2014 in Guichi, a rural district along the Yangtze River in Anhui Province, China. A hierarchical dynamic spatio-temporal model was used to evaluate the evolving pattern of schistosomiasis prevalence, which accounted for mechanism of dynamics of the disease. Descriptive analysis indicates that schistosomiasis prevalence displayed fluctuating high-risk foci during implementation of the chemotherapy-based strategy (1991–2005), while it took on a homogenous pattern of decreasing magnitude in the following period when the integrated strategy was implemented (2006–2014). The dynamic model analysis showed that regularly global propagation of the disease was not present after the effect of proximity to river was taken into account but local pattern transition existed. Maps of predicted prevalence shows that relatively high prevalence (>4%) occasionally occurred before 2006 and prevalence presents a homogenous and decreasing trend over the study area afterwards. Conclusions Proximity to river is still an important determinant for schistosomiasis infection regardless of different types of implemented prevention and control strategies. Between the transition from the chemotherapy-based strategy to the integrated one, we noticed a decreased prevalence. However, schistosomiasis would remain an endemic challenge in these study areas. Further prevention and control countermeasures are warranted. Schistosomiasis japonica is one of the most serious parasitic diseases in China. The Chinese government has launched three different rounds of national schistosomiasis control programs since 1950s. The latest two are the World Bank Loan Project (WBLP) that ushered in chemotherapy as the main control approach, active from 1992 to 2001, and the integrated control strategy that took its place in 2005. In this study, we investigated changes in the dynamics of schistosomiasis transmission over space and time under these different control strategies. Based on spatio-temporal analyses of the schistosomiasis prevalence data at the village level during 1991–2014 in Guichi, Anhui Province, we built a dynamic model to evaluate the evolving pattern of prevalence. We found that the schistosomiasis prevalence generally showed a north-western shift over the study area during 1991–2005, while there was no such trend during 2006–2014. This global shifting trend disappeared after the effect of proximity to river was taken into account, but local change still existed which was possibly due to the transition between the two latest national control strategies. We conclude that proximity to River is still an important determinant for schistosomiasis prevalence and that although the integrated control strategy is more effective than the WBPL in reducing schistosomiasis prevalence, the disease would remain endemic for the long term without further improvements of the control program.
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Affiliation(s)
- Yi Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
- Laboratory for Spatial Analysis and Modeling, School of Public Health, Fudan University, Shanghai, China
| | | | - Yue Chen
- School of Epidemiology, Pubic Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Yongwen Ke
- Schistosomiasis Station of Prevention and Control in Guichi Distirct, Anhui Province, China
| | - Jianjun Dai
- Schistosomiasis Station of Prevention and Control in Guichi Distirct, Anhui Province, China
| | - Zonggui He
- Schistosomiasis Station of Prevention and Control in Guichi Distirct, Anhui Province, China
| | - Zhijie Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
- Laboratory for Spatial Analysis and Modeling, School of Public Health, Fudan University, Shanghai, China
- * E-mail:
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Abe EM, Tambo E, Xue J, Xu J, Ekpo UF, Rollinson D, Yang K, Li SZ, Zhou XN. Approaches in scaling up schistosomiasis intervention towards transmission elimination in Africa: Leveraging from the Chinese experience and lessons. Acta Trop 2020; 208:105379. [PMID: 32006521 DOI: 10.1016/j.actatropica.2020.105379] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 01/29/2020] [Accepted: 01/29/2020] [Indexed: 12/20/2022]
Abstract
Schistosoma japonicum, differs from the African species including S. mansoni and S. haematobium, is a zoonotic parasite as it infects both human and animals including domestic ruminant animals such as cattle and animals from the wild. Considering China's success story in the elimination of schistosomiasis, the China-Africa collaboration on schistosomaisis elimination in Africa is an important cooperative health development initiative. This review examines the importance of China-Africa collaboration on schistosomiasis elimination using effective surveillance-response intervention strategy as the platform to effectively drive the elimination of schistosomiasis in Africa. Three conclusions were made after reviewing the similarity and differences in schistososmiasis control programmes between China and African continent as follows: (i) Politically, China's lessons is that leveraging on the integrated control strategies and the recognition that schistosomiasis is a public health problem which prompted the interest of government in China. It is necessary for African leaders and governments to recognize schistosomiasis as a public health challenge that must be given serious attention in terms of funding and setting up frameworks to complement control efforts. (ii) Technically, efficient monitoring and surveillance system mechanism will facilitate contextual and effective management of schistosomiasis elimination across different environment, and African programme managers should embrace the use of appropriate diagnostic tools to guide treatment strategies at different thresholds of schistosomiasis control. (iii) Strategically, effective control of snail intermediate hosts and precision mapping of snail distribution should be prioritized for successful schistosomiasis elimination in Africa.
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Affiliation(s)
- Eniola M Abe
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China.
| | - E Tambo
- Département de Biochimie et Science Pharmaceutiques, Université des Montagnes, Bagangté, République du Cameroon.
| | - Jingbo Xue
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China.
| | - Jing Xu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China.
| | - Uwem F Ekpo
- Department of Pure and Applied Zoology, Federal University of Agriculture, Alabata Road, Abeokuta, 110001, Nigeria.
| | - David Rollinson
- The Natural History Museum, Cromwell Road, London SW7 5BD, United Kingdom.
| | - Kun Yang
- Jiangsu Institute of Parasitic Diseases, Wuxi, China.
| | - Shi-Zhu Li
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China.
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China.
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Xu J, Li SZ, Zhang LJ, Bergquist R, Dang H, Wang Q, Lv S, Wang TP, Lin DD, Liu JB, Ren GH, Yang K, Liu Y, Dong Y, Zhang SQ, Zhou XN. Surveillance-based evidence: elimination of schistosomiasis as a public health problem in the Peoples' Republic of China. Infect Dis Poverty 2020; 9:63. [PMID: 32505216 PMCID: PMC7275476 DOI: 10.1186/s40249-020-00676-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 05/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A steady progress on schistosomiasis control in the Peoples' Republic of China (P.R. China) was achieved and broadened into the twelve-year medium and long term national plan (MLNP) which marled the implementation of an integrated control strategy across all endemic areas in P.R. China in 2004. To understand the endemic trends of schistosomiasis to assess the effectiveness of an integrated strategy, we conducted an analysis of schistosomiasis surveillance data spanned from 2005 to 2015. METHODS The schistosomiasis sentinel surveillance data from sentinel sites were collected and analyzed from 2005 to 2015. In these sentinel sites, residents aged 6 years or above were screened annually by indirect hemagglutination assay (IHA), while only antibody positives were followed by stool examination either Kato-katz method (KK) and/or hatching technique (HT). Domestic animals raised in sentinel sites were examined by HT for confirming the infection of schistosomes. Snail investigation was conducted each year through systematic sampling method combined with environmental sampling method. The snails collected from field were tested by microscopic dissection method. The infection rates of schistosomes in residents, domestic animals and snails, as well as the indicators reflecting the snails' distribution were calculated and analyzed. ANOVA analysis was used to examine the changes of the number of eggs per gram feces in population and Chi-square test was used to examine any change in proportions among groups. RESULTS A total of 148 902 residents from sentinel sites attended this study and 631 676 blood samples were examined by IHA test during the 11 covered years. The annual average antibody positive rates presented a significant decrease trends, from 17.48% (95% CI: 17.20-17.75%) in 2005 to 5.93% (95% CI: 5.71-6.15%) (χ2 = 8890.47, P < 0.001) in 2015. During 2005-2015, the average infection rate of schistosomes in residents declined from 2.07% (95% CI: 1.96-2.17%) to 0.13% (95% CI: 0.09-0.16%), accompanied by significant decrease of infection intensity in population. In 2015, the stool positives were only found in farmers, fishermen and boatmen with infection rate of 0.16% (95% CI: 0.11-0.20%), 0.17% (95% CI: 0-0.50%) respectively. The infection rate of schistosomes in domestic animals dropped from 9.42% (538/5711, 95% CI: 8.66-10.18%) to 0.08% (2/2360, 95% CI: 0-0.20%) from 2005 to 2015. Infections were found in eight species of domestic animals at the beginning of surveillance while only two cattle were infected in 2015. Totally 98 ha of new snail habitats were found, while 94.90% (93/98) distributed in lake and marshland regions. The percentage of frames with snails decreased from 16.96% (56 884/33 5391, 95% CI: 16.83-17.09%) in 2005 to 4.28% (18 121/423 755, 95% CI: 4.22-4.34%) in 2014, with a slightly increase in 2015. Meanwhile, the infection rate of schistosomes in snails was decreased from 0.26% (663/256 531, 95% CI: 0.24-0.28%) to zero during 2005-2015. CONCLUSIONS The infection rate of schistosomes declined significantly, providing evidence that the goal of the MLNP was achieved. Elimination of schistosomiasis as a public health problem defined as WHO was also reached in P.R. China nationwide. Surveillance-response system should be improved and strengthened to realize the final goal of schistosomiasis elimination.
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Affiliation(s)
- Jing Xu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre for Tropical Diseases, Chinese Center for Tropical Disease Research, Shanghai, 200025 People’s Republic of China
| | - Shi-Zhu Li
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre for Tropical Diseases, Chinese Center for Tropical Disease Research, Shanghai, 200025 People’s Republic of China
| | - Li-Juan Zhang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre for Tropical Diseases, Chinese Center for Tropical Disease Research, Shanghai, 200025 People’s Republic of China
| | | | - Hui Dang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre for Tropical Diseases, Chinese Center for Tropical Disease Research, Shanghai, 200025 People’s Republic of China
| | - Qiang Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre for Tropical Diseases, Chinese Center for Tropical Disease Research, Shanghai, 200025 People’s Republic of China
| | - Shan Lv
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre for Tropical Diseases, Chinese Center for Tropical Disease Research, Shanghai, 200025 People’s Republic of China
| | - Tian-Ping Wang
- Anhui Provincial Institute of Schistosomiasis Control, Hefei, Anhui Province 230061 People’s Republic of China
| | - Dan-Dan Lin
- Jiangxi Provincial Institute of Parasitic Disease, Nanchang, Jiangxi Province 330006 People’s Republic of China
| | - Jian-Bing Liu
- Hubei Provincial Institute of Schistosomiasis Control, Hubei Center for Disease Control, Wuhan, Hubei Province 430079 People’s Republic of China
| | - Guang-Hui Ren
- Hunan Provincial Institute of Schistosomiasis Control, Yueyang, Hunan Province 414000 People’s Republic of China
| | - Kun Yang
- Jiangsu Provincial Institute of Schistosomiasis Control, Wuxi, Jiangsu Province 214064 People’s Republic of China
| | - Yang Liu
- Sichuan Center for Disease Control, Chengdu, Sichuan Province 610041 People’s Republic of China
| | - Yi Dong
- Yunnan Provincial Institute of Endemic Diseases Control and Prevention, Dali, Yunnan Province 671000 People’s Republic of China
| | - Shi-Qing Zhang
- Anhui Provincial Institute of Schistosomiasis Control, Hefei, Anhui Province 230061 People’s Republic of China
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre for Tropical Diseases, Chinese Center for Tropical Disease Research, Shanghai, 200025 People’s Republic of China
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Guan Z, Dai SM, Zhou J, Ren XB, Qin ZQ, Li YL, Lv S, Li SZ, Zhou XN, Xu J. Assessment of knowledge, attitude and practices and the analysis of risk factors regarding schistosomiasis among fishermen and boatmen in the Dongting Lake Basin, the People's Republic of China. Parasit Vectors 2020; 13:273. [PMID: 32487266 PMCID: PMC7268453 DOI: 10.1186/s13071-020-04157-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 05/28/2020] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Fishermen and boatmen are a population at-risk for contracting schistosomiasis due to their high frequency of water contact in endemic areas of schistosomiasis in the People's Republic of China (P. R. China). To develop specific interventions towards this population, the present study was designed to assess the knowledge, attitudes and practices (KAPs) towards schistosomiasis of fishermen and boatmen, and to identify the risk factors associated with schistosome infection using a molecular technique in a selected area of Hunan Province in P. R. China. METHODS A cross sectional survey was conducted in the Dongting Lake Basin of Yueyang County, Hunan Province. A total of 601 fishermen and boatmen were interviewed between October and November 2017. Information regarding sociodemographic details and KAPs towards schistosomiasis were collected using a standardized questionnaire. Fecal samples of participants were collected and tested by polymerase chain reaction (PCR). Logistic regression analysis was conducted to explore the risk factors related to the positive results of PCR. RESULTS Of the 601 respondents, over 90% knew schistosomiasis and how the disease was contracted, the intermediate host of schistosomes and preventive methods. The majority of respondents had a positive attitude towards schistosomiasis prevention. However, only 6.66% (40/601) of respondents had installed a latrine on their boats, while 32.61% (196/601) of respondents defecated in the public toilets on shore. In addition, only 4.99% (30/601) respondents protected themselves while exposed to freshwater. The prevalence of schistosomiasis, as determined by PCR, among fishermen and boatmen in Yueyang County was 13.81% (83/601). Age, years of performing the current job, number of times receiving treatment, and whether they were treated in past three years were the main influencing factors of PCR results among this population. CONCLUSIONS Fishermen and boatmen are still at high risk of infection in P. R. China and gaps exist in KAPs towards schistosomiasis in this population group. Chemotherapy, and health education encouraging behavior change in combination with other integrated approaches to decrease the transmission risk in environments should be improved.
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Affiliation(s)
- Zhou Guan
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People’s Republic of China
- Key Laboratory of Parasite and Vector Biology, National Health Commission, Shanghai, People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, Shanghai, People’s Republic of China
- Chinese Center for Tropical Diseases Research, Shanghai, People’s Republic of China
| | - Si-Min Dai
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People’s Republic of China
- Key Laboratory of Parasite and Vector Biology, National Health Commission, Shanghai, People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, Shanghai, People’s Republic of China
- Chinese Center for Tropical Diseases Research, Shanghai, People’s Republic of China
| | - Jie Zhou
- Hunan Institute of Schistosomiasis Control, Yueyang, People’s Republic of China
| | - Xiao-Bing Ren
- Yueyang County Office for Preventive and Control on Schistosomiasis, Yueyang, People’s Republic of China
| | - Zhi-Qiang Qin
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People’s Republic of China
- Key Laboratory of Parasite and Vector Biology, National Health Commission, Shanghai, People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, Shanghai, People’s Republic of China
- Chinese Center for Tropical Diseases Research, Shanghai, People’s Republic of China
| | - Yin-Long Li
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People’s Republic of China
- Key Laboratory of Parasite and Vector Biology, National Health Commission, Shanghai, People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, Shanghai, People’s Republic of China
- Chinese Center for Tropical Diseases Research, Shanghai, People’s Republic of China
| | - Shan Lv
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People’s Republic of China
- Key Laboratory of Parasite and Vector Biology, National Health Commission, Shanghai, People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, Shanghai, People’s Republic of China
- Chinese Center for Tropical Diseases Research, Shanghai, People’s Republic of China
| | - Shi-Zhu Li
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People’s Republic of China
- Key Laboratory of Parasite and Vector Biology, National Health Commission, Shanghai, People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, Shanghai, People’s Republic of China
- Chinese Center for Tropical Diseases Research, Shanghai, People’s Republic of China
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People’s Republic of China
- Key Laboratory of Parasite and Vector Biology, National Health Commission, Shanghai, People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, Shanghai, People’s Republic of China
- Chinese Center for Tropical Diseases Research, Shanghai, People’s Republic of China
| | - Jing Xu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People’s Republic of China
- Key Laboratory of Parasite and Vector Biology, National Health Commission, Shanghai, People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, Shanghai, People’s Republic of China
- Chinese Center for Tropical Diseases Research, Shanghai, People’s Republic of China
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Saelens G, Gabriël S. Currently Available Monitoring and Surveillance Systems for Taenia spp., Echinococcus spp., Schistosoma spp., and Soil-Transmitted Helminths at the Control/Elimination Stage: A Systematic Review. Pathogens 2020; 9:E47. [PMID: 31935916 PMCID: PMC7168685 DOI: 10.3390/pathogens9010047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 01/02/2020] [Accepted: 01/02/2020] [Indexed: 12/13/2022] Open
Abstract
An increasing global focus on neglected tropical diseases (NTDs) has resulted in the set up of numerous control and elimination activities worldwide. This is partly true for Taenia solium taeniasis/cysticercosis, the most important foodborne parasitic infection. Despite substantial progress, adequate monitoring and surveillance (M&S) are required to sustain a status of control/elimination. This is often lacking, especially for T. solium. Therefore, the objective was to conduct a systematic literature review of the currently available M&S systems at the control/elimination stage of the four top-ranked helminth NTDs. Specifically, Taenia spp., Echinococcus spp., Schistosoma spp., and soil-transmitted helminths (STHs) were considered to determine if there are any similarities between their M&S systems and whether certain approaches can be adopted from each other. The systematic review demonstrated that rigorous M&S systems have been designed for the control/elimination stage of both STHs and schistosomiasis, particularly in China. On the other hand, a concept of M&S for Taenia spp. and Echinococcus spp. has not been fully developed yet, due to a lack of epidemiological data and the fact that many endemic countries are far away from reaching control/elimination. Moreover, accurate diagnostic tools for all four diseases are still imperfect, which complicates proper M&S. Finally, there is an urgent need to develop and harmonize/standardize M&S activities in order to reliably determine and compare the epidemiological situation worldwide.
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Affiliation(s)
- Ganna Saelens
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke B-9820, Belgium
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Wu X, Ren J, Gao Z, Xu Y, Xie H, Li T, Cheng Y, Hu F, Liu H, Gong Z, Liang J, Shen J, Liu Z, Wu F, Sun X, Niu Z, Ning A. Plasma D-dimer Can Effectively Predict the Prospective Occurrence of Ascites in Advanced Schistosomiasis Japonica Patients. THE KOREAN JOURNAL OF PARASITOLOGY 2017; 55:167-174. [PMID: 28506039 PMCID: PMC5450959 DOI: 10.3347/kjp.2017.55.2.167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 02/13/2017] [Accepted: 02/14/2017] [Indexed: 12/29/2022]
Abstract
China still has more than 30,000 patients of advanced schistosomiasis while new cases being reported consistently. D-dimer is a fibrin degradation product. As ascites being the dominating symptom in advanced schistosomiasis, the present study aimed to explore a prediction model of ascites with D-dimer and other clinical easy-achievable indicators. A case-control study nested in a prospective cohort was conducted in schistosomiasis-endemic area of southern China. A total of 291 patients of advanced schistosomiasis were first investigated in 2013 and further followed in 2014. Information on clinical history, physical examination, and abdominal ultrasonography, including the symptom of ascites was repeatedly collected. Result showed 44 patients having ascites. Most of the patients’ ascites were confined in the kidney area with median area of 20 mm2. The level of plasma D-dimer and pertinent liver function indicators were measured at the initial investigation in 2013. Compared with those without ascites, cases with ascites had significantly higher levels of D-dimer (0.71±2.44 μg/L vs 0.48±2.12 μg/L, P=0.005), as well ALB (44.5 vs 46.2, g/L) and Type IV collagen (50.04 vs 44.50 μg/L). Receiver operating characteristic curve analyses indicated a moderate predictive value of D-dimer by its own area under curve (AUC) of 0.64 (95% CI: 0.54–0.73) and the cutoff value as 0.81 μg/L. Dichotomized by the cutoff level, D-dimer along with other categorical variables generated a prediction model with AUC of 0.76 (95% CI: 0.68–0.89). Risks of patients with specific characteristics in the prediction model were summarized. Our study suggests that the plasma D-dimer level is a reliable predictor for incident ascites in advanced schistosomiasis japonica patients.
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Affiliation(s)
- Xiaoying Wu
- School of Public Health, Fudan University, Shanghai, China
| | - Jianwei Ren
- Health Department of Guard Bureau of General Office of the Communist Party of China, Beijing, P. R. China
| | - Zulu Gao
- Jiangxi Provincial Institute of Parasitic Diseases, Nanchang, P. R. China
| | - Yun Xu
- Jiangxi Provincial Institute of Parasitic Diseases, Nanchang, P. R. China
| | - Huiqun Xie
- Jiangxi Provincial Institute of Parasitic Diseases, Nanchang, P. R. China
| | - Tingfang Li
- Schistosomiasis Control Station of Yugan County, Shangrao, P. R. China
| | - Yanhua Cheng
- Jiangxi Provincial Institute of Parasitic Diseases, Nanchang, P. R. China
| | - Fei Hu
- Jiangxi Provincial Institute of Parasitic Diseases, Nanchang, P. R. China
| | - Hongyun Liu
- Jiangxi Provincial Institute of Parasitic Diseases, Nanchang, P. R. China
| | - Zhihong Gong
- Jiangxi Provincial Institute of Parasitic Diseases, Nanchang, P. R. China
| | - Jinyi Liang
- Key Laboratory of Tropical Diseases and Control of the Ministry of Education, Guangzhou, P. R. China.,Department of Parasitology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, P. R. China
| | - Jia Shen
- Key Laboratory of Tropical Diseases and Control of the Ministry of Education, Guangzhou, P. R. China.,Department of Parasitology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, P. R. China
| | - Zhen Liu
- Key Laboratory of Tropical Diseases and Control of the Ministry of Education, Guangzhou, P. R. China.,Department of Parasitology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, P. R. China
| | - Feng Wu
- Key Laboratory of Tropical Diseases and Control of the Ministry of Education, Guangzhou, P. R. China.,Department of Parasitology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, P. R. China
| | - Xi Sun
- Key Laboratory of Tropical Diseases and Control of the Ministry of Education, Guangzhou, P. R. China.,Department of Parasitology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, P. R. China
| | - Zhongzheng Niu
- School of Community and Global Health, Claremont Graduate University, Claremont, California, USA
| | - An Ning
- Jiangxi Provincial Institute of Parasitic Diseases, Nanchang, P. R. China
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Hu Y, Li S, Xia C, Chen Y, Lynn H, Zhang T, Xiong C, Chen G, He Z, Zhang Z. Assessment of the national schistosomiasis control program in a typical region along the Yangtze River, China. Int J Parasitol 2016; 47:21-29. [PMID: 27866904 DOI: 10.1016/j.ijpara.2016.09.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 09/13/2016] [Accepted: 09/22/2016] [Indexed: 11/19/2022]
Abstract
Schistosomiasis remains a major public health problem in eastern China, particularly along the Yangtze River Basin. The latest national schistosomiasis control program (NSCP) was implemented in 2005 with the main goal of reducing the rate of infection to less than 5% by 2008 and 1% by 2015. To assess the progress, we applied a Bayesian spatio-temporal model to describe dynamics of schistosomiasis in Guichi, Anhui Province, China, using annual parasitological and environmental data collected within 41 sample villages for the period 2005-2011. Predictive maps of schistosomiasis showed that the disease prevalence remains constant and low. Results of uncertainty analysis, in the form of probability contour maps (PCMs), indicated that the first goal of "infection rate less than 5% by 2008" was fully achieved in the study area. More longitudinal data for schistosomiasis are needed for the assessment of the second goal of "infection rate less than 1% by 2015". Compared with the traditional way of mapping uncertainty (e.g., variance or mean-square error), our PCMs provide more realistic information for schistosomiasis control.
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Affiliation(s)
- Yi Hu
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China; Laboratory for Spatial Analysis and Modeling, School of Public Health, Fudan University, Shanghai, China; Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai, China
| | - Si Li
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China; Laboratory for Spatial Analysis and Modeling, School of Public Health, Fudan University, Shanghai, China; Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai, China
| | - Congcong Xia
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China; Laboratory for Spatial Analysis and Modeling, School of Public Health, Fudan University, Shanghai, China; Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai, China
| | - Yue Chen
- School of Epidemiology, Pubic Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, Ontario, Canada
| | - Henry Lynn
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China; Laboratory for Spatial Analysis and Modeling, School of Public Health, Fudan University, Shanghai, China; Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai, China
| | - Tiejun Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China; Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai, China
| | - Chenglong Xiong
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China; Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai, China
| | - Gengxin Chen
- Schistosomiasis Station of Prevention and Control in Guichi Distirct, Anhui Province, China
| | - Zonggui He
- Schistosomiasis Station of Prevention and Control in Guichi Distirct, Anhui Province, China
| | - Zhijie Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China; Laboratory for Spatial Analysis and Modeling, School of Public Health, Fudan University, Shanghai, China; Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai, China.
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9
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Multi-host model and threshold of intermediate host Oncomelania snail density for eliminating schistosomiasis transmission in China. Sci Rep 2016; 6:31089. [PMID: 27535177 PMCID: PMC4989165 DOI: 10.1038/srep31089] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 07/13/2016] [Indexed: 11/24/2022] Open
Abstract
Schistosomiasis remains a serious public health issue in many tropical countries, with more than 700 million people at risk of infection. In China, a national integrated control strategy, aiming at blocking its transmission, has been carried out throughout endemic areas since 2005. A longitudinal study was conducted to determine the effects of different intervention measures on the transmission dynamics of S. japonicum in three study areas and the data were analyzed using a multi-host model. The multi-host model was also used to estimate the threshold of Oncomelania snail density for interrupting schistosomiasis transmission based on the longitudinal data as well as data from the national surveillance system for schistosomiasis. The data showed a continuous decline in the risk of human infection and the multi-host model fit the data well. The 25th, 50th and 75th percentiles, and the mean of estimated thresholds of Oncomelania snail density below which the schistosomiasis transmission cannot be sustained were 0.006, 0.009, 0.028 and 0.020 snails/0.11 m2, respectively. The study results could help develop specific strategies of schistosomiasis control and elimination tailored to the local situation for each endemic area.
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Xu J, Bergquist R, Qian YJ, Wang Q, Yu Q, Peeling R, Croft S, Guo JG, Zhou XN. China-Africa and China-Asia Collaboration on Schistosomiasis Control: A SWOT Analysis. ADVANCES IN PARASITOLOGY 2016; 92:435-66. [PMID: 27137455 DOI: 10.1016/bs.apar.2016.02.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Schistosomiasis, a disease caused by a trematode, parasitic worm, is a worldwide public health problem. In spite of great progress with regard to morbidity control, even elimination of this infection in recent decades, there are still challenges to overcome in sub-Saharan Africa and endemic areas in Southeast Asia. Regarded as one of the most successful countries with respect to schistosomiasis control, The People's Republic of China has accumulated considerable experience and learnt important lessons in various local settings that could benefit schistosomiasis control in other endemic countries. Based on an analysis of conceived strengths, weaknesses, opportunities and threats (SWOT) of potential collaborative activities with regard to schistosomiasis in Africa and Asia, this article addresses the importance of collaborative efforts and explores the priorities that would be expected to facilitate the transfer of Chinese experience to low- and middle-income countries in Africa and Asia.
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Affiliation(s)
- J Xu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, The People's Republic of China; Key Laboratory of Parasite & Vector Biology, Ministry of Public Health, Shanghai, The People's Republic of China; WHO Collaborating Center for Tropical Diseases, Shanghai, The People's Republic of China
| | - R Bergquist
- Geospatial Health, University of Naples Federico II, Naples, Italy
| | - Y-J Qian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, The People's Republic of China; Key Laboratory of Parasite & Vector Biology, Ministry of Public Health, Shanghai, The People's Republic of China; WHO Collaborating Center for Tropical Diseases, Shanghai, The People's Republic of China
| | - Q Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, The People's Republic of China; Key Laboratory of Parasite & Vector Biology, Ministry of Public Health, Shanghai, The People's Republic of China; WHO Collaborating Center for Tropical Diseases, Shanghai, The People's Republic of China
| | - Q Yu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, The People's Republic of China; Key Laboratory of Parasite & Vector Biology, Ministry of Public Health, Shanghai, The People's Republic of China; WHO Collaborating Center for Tropical Diseases, Shanghai, The People's Republic of China
| | - R Peeling
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - S Croft
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - J-G Guo
- World Health Organization, Geneva, Switzerland
| | - X-N Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, The People's Republic of China; Key Laboratory of Parasite & Vector Biology, Ministry of Public Health, Shanghai, The People's Republic of China; WHO Collaborating Center for Tropical Diseases, Shanghai, The People's Republic of China
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11
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Xu J, Yu Q, Tchuenté LAT, Bergquist R, Sacko M, Utzinger J, Lin DD, Yang K, Zhang LJ, Wang Q, Li SZ, Guo JG, Zhou XN. Enhancing collaboration between China and African countries for schistosomiasis control. THE LANCET. INFECTIOUS DISEASES 2016; 16:376-83. [PMID: 26851829 DOI: 10.1016/s1473-3099(15)00360-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 09/19/2015] [Accepted: 09/30/2015] [Indexed: 11/25/2022]
Abstract
Schistosomiasis remains an important public health issue, with a large number of cases reported across sub-Saharan Africa, and parts of Asia and Latin America. China was once highly endemic, but has made substantial progress and is moving towards elimination of schistosomiasis. Meanwhile, despite long-term, repeated, school-based chemotherapy in many African countries, more than 90% of all schistosomiasis cases are concentrated in Africa, and hence, this continent constitutes the key challenge for schistosomiasis control. Opportunities and issues for international collaboration in the fight against schistosomiasis are outlined with a focus on China's experiences, including the role of public health authorities and intersectoral collaboration, use of new and effective snail control approaches and diagnostic tools adapted to the specific stage of control, as well as the strengthening of risk mapping and surveillance-response mechanisms. Training courses targeting African governmental officials and professionals, coupled with field visits of African scientists and control programme managers to China, and vice versa, are considered important for improved schistosomiasis control and elimination. The crucial question remains whether the Chinese experience can be translated and applied in African countries to improve the effectiveness of health interventions and scale-up.
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Affiliation(s)
- Jing Xu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Center for Tropical Diseases, Shanghai, China
| | - Qing Yu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Center for Tropical Diseases, Shanghai, China
| | | | | | - Moussa Sacko
- National Institute for Research in Public Health, Ministry of Health, Bamako, Mali
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Dan-Dan Lin
- Jiangxi Provincial Institute of Parasitic Disease, Nanchang, China
| | - Kun Yang
- Jiangsu Provincial Institute of Schistosomiasis Control, Wuxi, China
| | - Li-Juan Zhang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Center for Tropical Diseases, Shanghai, China
| | - Qiang Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Center for Tropical Diseases, Shanghai, China
| | - Shi-Zhu Li
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Center for Tropical Diseases, Shanghai, China
| | - Jia-Gang Guo
- Department of Control of Neglected Tropical Diseases, WHO, Geneva, Switzerland
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Center for Tropical Diseases, Shanghai, China.
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Zhang LJ, Li SZ, Wen LY, Lin DD, Abe E, Zhu R, Du Y, Lv S, Xu J, Webster B, Rollinson D, Zhou XN. The Establishment and Function of Schistosomiasis Surveillance System Towards Elimination in The People's Republic of China. ADVANCES IN PARASITOLOGY 2016; 92:117-41. [PMID: 27137445 DOI: 10.1016/bs.apar.2016.03.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Schistosoma japonicum is the main schistosome species in The People's Republic of China, causing intestinal schistosomiasis, a debilitating disease of public health importance. The People's Republic of China used to be heavily endemic with schistosomiasis, but great progress has been made through the vigorous efforts of the national control programmes in the last six decades. Presently, efforts are geared towards eliminating schistosomiasis from The People's Republic of China by the end of 2025 through effective schistosomiasis surveillance, an important component in the drive towards schistosomiasis elimination. Therefore, this article explicitly outlines the development and progress made in schistosomiasis surveillance since 1990 with a special focus on the new surveillance system in use. Although the surveillance system has steadily improved over the years, it is faced with many challenges. Hence, more efforts are needed to establish an effective and sensitive evaluation system for the national schistosomiasis elimination programme in The People's Republic of China.
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Wang SR, Zhu YJ, Ge QP, Yang MJ, Huang JL, Huang WQ, Zhuge HX, Lu DB. Effect of photoperiod change on chronobiology of cercarial emergence of Schistosoma japonicum derived from hilly and marshy regions of China. Exp Parasitol 2015; 159:227-32. [DOI: 10.1016/j.exppara.2015.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 08/06/2015] [Accepted: 10/13/2015] [Indexed: 10/22/2022]
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14
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Delayed response of snails' vertical distribution on the bottomland to the changing water level at the downstream area of the Three Gorges project. ECOL INFORM 2015. [DOI: 10.1016/j.ecoinf.2015.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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15
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Identifying Spatial Clusters of Schistosomiasis in Anhui Province of China: A Study from the Perspective of Application. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:11756-69. [PMID: 26393632 PMCID: PMC4586705 DOI: 10.3390/ijerph120911756] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 09/10/2015] [Accepted: 09/10/2015] [Indexed: 12/02/2022]
Abstract
With the strategy shifting from morbidity control to transmission interruption, the burden of schistosomiasis in China has been declining over the past decade. However, further controls of the epidemic in the lake and marshland regions remain a challenge. Prevalence data at county level were obtained from the provincial surveillance system in Anhui during 1997–2010. Spatial autocorrelation analysis and spatial scan statistics were combined to assess the spatial pattern of schistosomiasis. The spatial-temporal cluster analysis based on retrospective space-time scan statistics was further used to detect risk clusters. The Global Moran’s I coefficients were mostly statistically significant during 1997–2004 but not significant during 2005–2010. The clusters detected by two spatial cluster methods occurred in Nanling, Tongling, Qingyang and Wuhu during 1997–2004, and Guichi and Wuhu from 2005 to 2010, respectively. Spatial-temporal cluster analysis revealed 2 main clusters, namely Nanling (1999–2002) and Guichi (2005–2008). The clustering regions were significantly narrowed while the spatial extent became scattered during the study period. The high-risk areas shifted from the low reaches of the Yangtze River to the upper stream, suggesting the focus of schistosomiasis control should be shifted accordingly and priority should be given to the snail habitats within the high-risk areas of schistosomiasis.
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16
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Integrated control programmes for schistosomiasis and other helminth infections in P.R. China. Acta Trop 2015; 141:332-41. [PMID: 24361182 DOI: 10.1016/j.actatropica.2013.11.028] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 10/26/2013] [Accepted: 11/30/2013] [Indexed: 02/08/2023]
Abstract
The prevalence of human schistosomiasis and soil-transmitted helminthiasis (STH) has decreased significantly in the People's Republic of China (P.R. China), particularly after 2005 when the national control programmes were reinforced by forming of integrated control strategies. Furthermore, social-economic development also contributed to the decrease of schistosome and soil-transmitted helminth infections. The prevalence of the zoonotic helminthiasis, including clonorchiasis and echinococcosis, on the other hand, is either underestimated or has in fact increased due to changes in social and environmental factors. In comparison with the control strategies in force and their effects on those four kinds of helminthiasis, the challenges and control priorities for the potential transfer from control to elimination of each disease is reviewed, to provide evidence for policy-makers to act upon.
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Liang S, Yang C, Zhong B, Guo J, Li H, Carlton EJ, Freeman MC, Remais JV. Surveillance systems for neglected tropical diseases: global lessons from China's evolving schistosomiasis reporting systems, 1949-2014. Emerg Themes Epidemiol 2014; 11:19. [PMID: 26265928 PMCID: PMC4531518 DOI: 10.1186/1742-7622-11-19] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 11/07/2014] [Indexed: 01/28/2023] Open
Abstract
Though it has been a focus of the country’s public health surveillance systems since the 1950s, schistosomiasis represents an ongoing public health challenge in China. Parallel, schistosomiasis-specific surveillance systems have been essential to China’s decades-long campaign to reduce the prevalence of the disease, and have contributed to the successful elimination in five of China’s twelve historically endemic provinces, and to the achievement of morbidity and transmission control in the other seven. More recently, an ambitious goal of achieving nation-wide transmission interruption by 2020 has been proposed. This paper details how schistosomiasis surveillance systems have been structured and restructured within China’s evolving public health system, and how parallel surveillance activities have provided an information system that has been integral to the characterization of, response to, and control of the disease. With the ongoing threat of re-emergence of schistosomiasis in areas previously considered to have achieved transmission control, a critical examination of China’s current surveillance capabilities is needed to direct future investments in health information systems and to enable improved coordination between systems in support of ongoing control. Lessons drawn from China’s experience are applied to the current global movement to reduce the burden of helminthiases, where surveillance capacity based on improved diagnostics is urgently needed.
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Affiliation(s)
- Song Liang
- Department of Environmental and Global Health, College of Public Health and Health Professions, and Emerging Pathogens Institute, University of Florida, 1225 Center Drive, Gainesville, FL 32611 USA
| | - Changhong Yang
- Sichuan Center for Disease Control and Prevention, Institute of Public Health Information, 6 Middle School Road, Chengdu, Sichuan, 610041 China
| | - Bo Zhong
- Sichuan Center for Disease Control and Prevention, Institute of Parasitic Diseases, 6 Middle School Road, Chengdu, Sichuan, 610041 China
| | - Jiagang Guo
- Department of Schistosomiasis, Institute of Parasitic Diseases. Chinese Center for Disease Control and Prevention, Shanghai, China ; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Huazhong Li
- Department of Emergence Response, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Elizabeth J Carlton
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, CO USA
| | - Matthew C Freeman
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA 30322 USA
| | - Justin V Remais
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA 30322 USA
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Shan C, Zhou X, Zhu H. The Dynamics of Growing Islets and Transmission of Schistosomiasis Japonica in the Yangtze River. Bull Math Biol 2014; 76:1194-217. [DOI: 10.1007/s11538-014-9961-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Accepted: 04/09/2014] [Indexed: 10/25/2022]
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Yang K, Xu JF, Zhang JF, Li W, He J, Liang S, Bergquist R. Establishing and applying a schistosomiasis early warning index (SEWI) in the lower Yangtze River Region of Jiangsu Province, China. PLoS One 2014; 9:e94012. [PMID: 24705352 PMCID: PMC3976384 DOI: 10.1371/journal.pone.0094012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 03/12/2014] [Indexed: 12/30/2022] Open
Abstract
Background China has made remarkable progress in schistosomiasis control over the past decades. Transmission control has replaced morbidity control as the country moves towards the goal of elimination and the current challenge is to find a sensitive measure capable of gauging transmission risk in low-prevalence areas. The study aims to develop a Schistosomiasis Early Warning Index (SEWI) and demonstrate its use in Jiangsu Province along the lower Yangtze River. Methodology/Principal Findings The Delphi approach, a structured communication technique, was used to develop the SEWI. Two rounds of interviews with 30 public health experts specialized in schistosomiasis control were conducted using 40 indicators that reflected different aspects of schistosomiasis transmission and control. The necessity, feasibility, and sensitivity of each indicator were assessed and the weight value of each indicator determined based on these experts' judgment. The system included 3 first-order indicators, 7 second-order indicators, and 30 third-order indicators. The 3 first-order indicators were endemic status, control measures, social and environmental factors, with the weight values 0.366, 0.343 and 0.291, respectively. For the 7 second-order indicators, the highest weight value was for control measures for snails (0.175) and the lowest for transmission route (0.110). We estimated and mapped the SEWI for endemic areas at the county scale in Jiangsu Province finding that the majority of the endemic areas were characterized as medium transmission risk (SEWI risk values between 0.3 and 0.6), while areas where transmission interruption had been officially declared showed SEWI values <0.30. A few isolated areas (e.g. endemic islands in the Yangtze River) produced SEWI values >0.60. These estimates are largely in agreement with the endemicity levels based on recent epidemiological surveys. Conclusions/Significance The SEWI should be useful for estimation of schistosomiasis transmission surveillance, particularly with reference to the elimination of the disease in China.
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Affiliation(s)
- Kun Yang
- Jiangsu Institute of Parasitic Diseases, Key Laboratory of Parasitic Disease Control and Prevention (Ministry of Health), Jiangsu Provincial Key Laboratory of Parasite Molecular Biology, Wuxi, Jiangsu Province, China
- * E-mail:
| | - Jun-Fang Xu
- Medicine school, Hubei University for Nationalities, Enshi, Hubei Province, China
| | - Jian-Feng Zhang
- Jiangsu Institute of Parasitic Diseases, Key Laboratory of Parasitic Disease Control and Prevention (Ministry of Health), Jiangsu Provincial Key Laboratory of Parasite Molecular Biology, Wuxi, Jiangsu Province, China
| | - Wei Li
- Jiangsu Institute of Parasitic Diseases, Key Laboratory of Parasitic Disease Control and Prevention (Ministry of Health), Jiangsu Provincial Key Laboratory of Parasite Molecular Biology, Wuxi, Jiangsu Province, China
| | - Jian He
- Jiangsu Institute of Parasitic Diseases, Key Laboratory of Parasitic Disease Control and Prevention (Ministry of Health), Jiangsu Provincial Key Laboratory of Parasite Molecular Biology, Wuxi, Jiangsu Province, China
| | - Song Liang
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, United States of America
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
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New integrated strategy emphasizing infection source control to curb Schistosomiasis japonica in a marshland area of Hubei Province, China: findings from an eight-year longitudinal survey. PLoS One 2014; 9:e89779. [PMID: 24587030 PMCID: PMC3938508 DOI: 10.1371/journal.pone.0089779] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 01/27/2014] [Indexed: 11/19/2022] Open
Abstract
Background Schistosomiasis remains a major public health problem in China. The major endemic foci are the lake and marshland regions of southern China, particularly the regions along the middle and lower reach of the Yangtze River in four provinces (Hubei, Hunan, Jiangxi, and Anhui). The purpose of our study is to assess the effect of a new integrated strategy emphasizing infection source control to curb schistosomiasis in marshland regions. Methods In a longitudinal study, we implemented an integrated control strategy emphasizing infection source control in 16 villages from 2005 through 2012 in marshland regions of Hubei province. The interventions included removing cattle from snail-infested grasslands, providing farmers with mechanized farm equipment, improving sanitation by supplying tap water, building lavatories and latrines, praziquantel chemotherapy, controlling snails, and environmental modification. Results Following the integrated control strategy designed to reduce the role of bovines and humans as sources of Schistosoma japonicum infection, the prevalence of human S. japonicum infection declined from 1.7% in 2005 to 0.4% in 2012 (P<0.001). Reductions were also observed in both sexes, across all age groups, and among high risk occupations. Moreover, the prevalence of bovine S. japonicum infection decreased from 11.7% in 2005 to 0.6% in 2012 (P<0.001). In addition, all the 16 villages achieved the national criteria of infection control in 2008. Conclusion Our findings indicate that the integrated strategy was likely effective in controlling the transmission of S. japonicum in marshland regions in China.
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Wang W, Li TY, Ji Y, Qu GL, Qian YL, Li HJ, Dai JR, Liang YS. Efficacy of artemether and artesunate in mice infected with praziquantel non-susceptible isolate of Schistosoma japonicum. Parasitol Res 2013; 113:925-31. [DOI: 10.1007/s00436-013-3724-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Accepted: 11/27/2013] [Indexed: 10/25/2022]
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Impact and cost-effectiveness of a comprehensive Schistosomiasis japonica control program in the Poyang Lake region of China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:6409-21. [PMID: 24287861 PMCID: PMC3881122 DOI: 10.3390/ijerph10126409] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 10/08/2013] [Accepted: 10/21/2013] [Indexed: 11/15/2022]
Abstract
Schistosomiasis japonica remains a significant public-health problem in China. This study evaluated cost-effectiveness of a comprehensive schistosomiasis control program (2003–2006). The comprehensive control program was implemented in Zhangjia and Jianwu (cases); while standard interventions continued in Koutou and Xiajia (controls). Incurred costs were documented and the schistosomiasis comprehensive impact index (SCI) and cost-effectiveness ratio (Comprehensive Control Program Cost/SCI) were applied. In 2003, prevalence of Schistosoma japonicum infection was 11.3% (Zhangjia), 6.7% (Jianwu), 6.5% (Koutou), and 8.0% (Xiajia). In 2006, the comprehensive control program in Zhangjia and Jianwu reduced infection to 1.6% and 0.6%, respectively; while Koutou and Xiajia had a schistosomiasis prevalence of 3.2% and 13.0%, respectively. The year-by-year SCIs in Zhangjia were 0.28, 105.25, and 47.58, with an overall increase in cost-effectiveness ratio of 374.9%–544.8%. The SCIs in Jianwu were 16.21, 52.95, and 149.58, with increase in cost-effectiveness of 226.7%–1,149.4%. Investment in Koutou and Xiajia remained static (US$10,000 unit cost). The comprehensive control program implemented in the two case villages reduced median prevalence of schistosomiasis 8.5-fold. Further, the cost effectiveness ratio demonstrated that the comprehensive control program was 170% (Zhangjia) and 922.7% (Jianwu) more cost-effective. This work clearly shows the improvements in both cost and disease prevention effectiveness that a comprehensive control program-approach has on schistosomiasis infection prevalence.
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Zhang Z, Bergquist R, Chen D, Yao B, Wang Z, Gao J, Jiang Q. Identification of parasite-host habitats in Anxiang county, Hunan Province, China based on multi-temporal China-Brazil earth resources satellite (CBERS) images. PLoS One 2013; 8:e69447. [PMID: 23922712 PMCID: PMC3726693 DOI: 10.1371/journal.pone.0069447] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 06/08/2013] [Indexed: 11/19/2022] Open
Abstract
Remote sensing is a promising technique for monitoring the distribution and dynamics of various vector-borne diseases. In this study, we used the multi-temporal CBERS images, obtained free of charge, to predict the habitats of the snail Oncomelania hupensis, the sole intermediate host of schistosomiasis japonica, a snail-borne parasitic disease of considerable public health in China. Areas of suitable snail habitats were identified based on the normalized difference vegetation index (NDVI) and the normalized difference water index (NDWI), and the predictive model was tested against sites (snails present or absent) that were surveyed directly for O. hupensis. The model performed well (sensitivity and specificity were 63.64% and 78.09%, respectively), and with further development, we may provide an accurate, inexpensive tool for the broad-scale monitoring and control of schistosomiasis, and other similar vector-borne diseases.
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Affiliation(s)
- Zhijie Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, People's Republic of China.
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Zhou YB, Zhao GM, Jiang QW. Effects of the praziquantel-based control of schistosomiasis japonica in China. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2013; 101:695-703. [DOI: 10.1179/136485907x241488] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Xu JF, Xu J, Li SZ, Jia TW, Huang XB, Zhang HM, Chen M, Yang GJ, Gao SJ, Wang QY, Zhou XN. Transmission risks of schistosomiasis japonica: extraction from back-propagation artificial neural network and logistic regression model. PLoS Negl Trop Dis 2013; 7:e2123. [PMID: 23556015 PMCID: PMC3605232 DOI: 10.1371/journal.pntd.0002123] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Accepted: 02/04/2013] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The transmission of schistosomiasis japonica in a local setting is still poorly understood in the lake regions of the People's Republic of China (P. R. China), and its transmission patterns are closely related to human, social and economic factors. METHODOLOGY/PRINCIPAL FINDINGS We aimed to apply the integrated approach of artificial neural network (ANN) and logistic regression model in assessment of transmission risks of Schistosoma japonicum with epidemiological data collected from 2339 villagers from 1247 households in six villages of Jiangling County, P.R. China. By using the back-propagation (BP) of the ANN model, 16 factors out of 27 factors were screened, and the top five factors ranked by the absolute value of mean impact value (MIV) were mainly related to human behavior, i.e. integration of water contact history and infection history, family with past infection, history of water contact, infection history, and infection times. The top five factors screened by the logistic regression model were mainly related to the social economics, i.e. village level, economic conditions of family, age group, education level, and infection times. The risk of human infection with S. japonicum is higher in the population who are at age 15 or younger, or with lower education, or with the higher infection rate of the village, or with poor family, and in the population with more than one time to be infected. CONCLUSION/SIGNIFICANCE Both BP artificial neural network and logistic regression model established in a small scale suggested that individual behavior and socioeconomic status are the most important risk factors in the transmission of schistosomiasis japonica. It was reviewed that the young population (≤15) in higher-risk areas was the main target to be intervened for the disease transmission control.
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Affiliation(s)
- Jun-Fang Xu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China
- WHO Collaborating Center for Malaria, Schistosomiasis and Filariasis; Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China
| | - Jing Xu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China
- WHO Collaborating Center for Malaria, Schistosomiasis and Filariasis; Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China
| | - Shi-Zhu Li
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China
- WHO Collaborating Center for Malaria, Schistosomiasis and Filariasis; Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China
| | - Tia-Wu Jia
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China
- WHO Collaborating Center for Malaria, Schistosomiasis and Filariasis; Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China
| | - Xi-Bao Huang
- Hubei Center for Disease Control and Prevention, Wuhan, Hubei, People's Republic of China
| | - Hua-Ming Zhang
- Jiangling Institute of Schistosomiasis Control, Jiangling County, Hubei, People's Republic of China
| | - Mei Chen
- Jiangling Institute of Schistosomiasis Control, Jiangling County, Hubei, People's Republic of China
| | - Guo-Jing Yang
- School of Public Health and Primary Care, The Jockey Club Chinese University of Hong Kong, Shatin, Hong Kong
- Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu, People's Republic of China
| | - Shu-Jing Gao
- Normal University of Gannan, Ganzhou, Jiangxi, People's Republic of China
| | - Qing-Yun Wang
- Normal University of Gannan, Ganzhou, Jiangxi, People's Republic of China
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China
- WHO Collaborating Center for Malaria, Schistosomiasis and Filariasis; Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China
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Zhang Z, Zhu R, Ward MP, Xu W, Zhang L, Guo J, Zhao F, Jiang Q. Long-term impact of the World Bank Loan Project for schistosomiasis control: a comparison of the spatial distribution of schistosomiasis risk in China. PLoS Negl Trop Dis 2012; 6:e1620. [PMID: 22530073 PMCID: PMC3328430 DOI: 10.1371/journal.pntd.0001620] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Accepted: 02/21/2012] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The World Bank Loan Project (WBLP) for controlling schistosomiasis in China was implemented during 1992-2001. Its short-term impact has been assessed from non-spatial perspective, but its long-term impact remains unclear and a spatial evaluation has not previously been conducted. Here we compared the spatial distribution of schistosomiasis risk using national datasets in the lake and marshland regions from 1999-2001 and 2007-2008 to evaluate the long-term impact of WBLP strategy on China's schistosomiasis burden. METHODOLOGY/PRINCIPAL FINDINGS A hierarchical Poisson regression model was developed in a Bayesian framework with spatially correlated and uncorrelated heterogeneities at the county-level, modeled using a conditional autoregressive prior structure and a spatially unstructured Gaussian distribution, respectively. There were two important findings from this study. The WBLP strategy was found to have a good short-term impact on schistosomiasis control, but its long-term impact was not ideal. It has successfully reduced the morbidity of schistosomiasis to a low level, but can not contribute further to China's schistosomiasis control because of the current low endemic level. A second finding is that the WBLP strategy could not effectively compress the spatial distribution of schistosomiasis risk. To achieve further reductions in schistosomiasis-affected areas, and for sustainable control, focusing on the intermediate host snail should become the next step to interrupt schistosomiasis transmission within the two most affected regions surrounding the Dongting and Poyang Lakes. Furthermore, in the lower reaches of the Yangtze River, the WBLP's morbidity control strategy may need to continue for some time until snails in the upriver provinces have been well controlled. CONCLUSION It is difficult to further reduce morbidity due to schistosomiasis using a chemotherapy-based control strategy in the lake and marshland regions of China because of the current low endemic levels of infection. The future control strategy for schistosomiasis should instead focus on a snail-based integrated control strategy to maintain the program achievements and sustainably reduce the burden of schistosomiasis in China.
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Affiliation(s)
- Zhijie Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, People's Republic of China.
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Wang W, Li Y, Li H, Xing Y, Qu G, Dai J, Liang Y. Immunodiagnostic efficacy of detection of Schistosoma japonicum human infections in China: a meta analysis. ASIAN PAC J TROP MED 2012; 5:15-23. [DOI: 10.1016/s1995-7645(11)60238-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Revised: 12/15/2011] [Accepted: 01/05/2012] [Indexed: 10/14/2022] Open
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Sun LP, Wang W, Liang YS, Tian ZX, Hong QB, Yang K, Yang GJ, Dai JR, Gao Y. Effect of an integrated control strategy for schistosomiasis japonica in the lower reaches of the Yangtze River, China: an evaluation from 2005 to 2008. Parasit Vectors 2011; 4:243. [PMID: 22208620 PMCID: PMC3285052 DOI: 10.1186/1756-3305-4-243] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2011] [Accepted: 12/30/2011] [Indexed: 01/22/2023] Open
Abstract
Background Schistosomiasis japonica remains a major public health concern in China. There are many interventions implemented to control the transmission of the disease. The purpose of the present study was to investigate the effects of an integrated control strategy for schistosomiasis control. Methods An integrated control strategy for schistosomiasis japonica with emphasis on removing cattle from snail-infested grasslands, providing farmers with mechanized farm equipment, improving sanitation by supplying tap water and building lavatories and latrines and providing boats with fecal-matter containers was implemented in 107 villages of the lower reaches of the Yangtze River, Jiangsu Province, China, during a 32-month period from May 2005 to 2008, and the effectiveness was investigated. Results Following the effects of the comprehensive control, the snail habitat, infected snail habitat, snail infection rate, and S. japonicum prevalence in both humans and livestock all appeared a declining trend year by year, with reductions of 47.88%, 94.29%, 92.55%, 96.94%, and 100% compared with those before the comprehensive control. In addition, all of the 17 counties achieved the infection control in 2007, and 7 reached the criteria of transmission control in 2008. The confirmed snail habitats reduced from 107 to 20, and the acute infections have also been controlled for 2 successive years since 2007. Conclusions The integrated control strategy for schistosomiasis japonica is effective to control the transmission of S. japonicum.
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Affiliation(s)
- Le-Ping Sun
- Jiangsu Institute of Parasitic Diseases, 117 Yangxiang, Meiyuan, Wuxi 214064, Jiangsu Province, People's Republic of China
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Liang YS, Wang W, Xing YT, Li HJ, Xu YL, Shen XH, Qu GL, Li YZ, Dai JR. A strategy for emergency treatment of Schistosoma japonicum-infested water. Parasit Vectors 2011; 4:209. [PMID: 22047607 PMCID: PMC3216251 DOI: 10.1186/1756-3305-4-209] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Accepted: 11/02/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Schistosomiasis japonica, caused by contact with Schistosoma japonicum cercaria-infested water when washing, bathing or production, remains a major public-health concern in China. The purpose of the present study was to investigate the effect of a suspension concentrate of niclosamide (SCN) on killing cercaria of S. japonicum that float on the water surface, and its toxicity to fish, so as to establish an emergency-treatment intervention for rapidly killing cercaria and eliminating water infectivity. RESULTS At 30 min after spraying 100 mg/L SCN, with niclosamide dosages of 0.01, 0.02, 0.03, 0.04 g/m², the water infectivity reduced significantly and no infectivity was found at 60 min after spraying SCN. The surface of static water was sprayed with 100 mg/L SCN, the peak concentration was found at 0 min, and the solution diffused to site with a water depth of 10 cm after 10 min. 30 min later, SCN diffused to the whole water body, and distributed evenly. After spraying 100 mg/L SCN onto the surface of the water with a volume of(3.14 × 202 × 50)cm³, with niclosamide dosages of 0.02 g/m², 96 h later, no death of zebra fish was observed. CONCLUSIONS By spraying 100 mg/L SCN, with a niclosamide dosage of 0.02 g/m² onto the surface of S. japonicum-infested water, infectivity of the water can be eliminated after 30-60 min, and there is no evident toxicity to fish. This cercaria-killing method, as an emergency-treatment intervention for infested water, can be applied in those forecasting and early warning systems for schistosomiasis.
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Affiliation(s)
- You-Sheng Liang
- Jiangsu Institute of Parasitic Diseases, 117 Yangxiang, Meiyuan, Wuxi 214064, Jiangsu Province, People's Republic of China.
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Hu S, Yang L, Wu Z, Wong CS, Fung MC. Suppression of adaptive immunity to heterologous antigens by SJ16 of Schistosoma japonicum. J Parasitol 2011; 98:274-83. [PMID: 22017401 DOI: 10.1645/ge-2692.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Despite the great effort that has been given to control the disease, schistosomiasis remains the most important human helminth infection in terms of morbidity and mortality. Natural infection of schistosomes induces very little protective immunity against reinfection. Moreover, effective schistosome vaccines for practical use have not been developed. These parasites appear to have evolved highly effective modulatory mechanisms on their host's immune system that promote the parasites' survival and also hinder the development of effective strategies for treatment of the disease. Understanding of the mechanisms of schistosome-mediated immune modulation would be most helpful in schistosomiasis prevention and control. Previously, we have identified from Schistosoma japonicum an anti-inflammatory protein, Sj16, which suppresses thioglycollate-induced peritoneal inflammation in BALB/c mice, as well as thioglycollate-mediated peritoneal macrophage maturation, while modulating cytokine and chemokine production from peritoneal cells. In the present study, we have further investigated the modulatory effect of Sj16 on the host's adaptive immunity to heterologous antigens with the use of recombinant Sj16 (rSj16) expressed and purified from Escherichia coli . Results from this study indicate that rSj16 significantly suppresses antibody production, in addition to Th1 and Th2 responses to heterologous antigens in the BALB/c mouse model. Our study also reveals that rSj16 suppresses lipopolysaccharide-induced major histocompatibility complex II expression and IL-12 production, while increasing IL-10 production in resident peritoneal macrophages. These results may partially explain why parasite-related antigens cannot mount a protective immunity during early stages of schistosome infection.
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Affiliation(s)
- Shaomin Hu
- Department of Biology, the Chinese University of Hong Kong, Hong Kong, China
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Effectiveness of a comprehensive schistosomiasis japonica control program in Jiangsu province, China, from 2005 to 2008. Acta Trop 2011; 120 Suppl 1:S151-7. [PMID: 21147056 DOI: 10.1016/j.actatropica.2010.11.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2010] [Revised: 11/12/2010] [Accepted: 11/15/2010] [Indexed: 11/23/2022]
Abstract
The effectiveness of a comprehensive schistosomiasis japonica control program implemented in 8 villages along the Yangtze river in Jiangsu province from 2005 to 2008 was studied. Control measures included snail control, chemotherapy of humans and livestock, health education, and transmission cycle interruption using sanitation in dwellings and at anchorage sites for fishermen and sailors. The Schistosoma japonicum prevalence among residents and livestock, the total area of snail habitats, the Oncomelania hupensis snail density, and the percentage of infected snails served as indicators for the effectiveness of the control efforts. After 4 years of program implementation, the seroprevalence in humans had decreased from 9.03% to 3.24% (P < 0.001) and the parasitological prevalence among males had decreased from 0.42% to 0.12% (P = 0.004). Among females, it remained stable at a low level. The S. japonicum prevalence in livestock had decreased from 2.94% to 0% (P < 0.001). Additionally, the area where infected snails could be found had shrunk from 89.99 hectares (ha) to 16.00 ha, the snail density had decreased from 0.56 to 0.32 per 0.1m(2), and the percentage of infected snails had dropped from 0.38% to 0.12% (all P < 0.001). The results demonstrate that an integrated schistosomiasis japonica control strategy focusing on the main transmission cycles and reservoirs and combines chemotherapy, infrastructure interventions and health education combined with robust surveillance is feasible and allows to effectively control S. japonicum.
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Wu J, Xu W, Ming Z, Dong H, Tang H, Wang Y. Metabolic changes reveal the development of schistosomiasis in mice. PLoS Negl Trop Dis 2010; 4. [PMID: 20824219 PMCID: PMC2930859 DOI: 10.1371/journal.pntd.0000807] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2010] [Accepted: 08/03/2010] [Indexed: 12/18/2022] Open
Abstract
Schistosomiasis is a parasitic zoonosis caused by small trematode worms called schistosomes, amongst which Schistosoma japonicum (S. japonicum) is endemic in Asia. In order to understand the schistosome-induced changes in the host metabolism so as to facilitate early diagnosis of schistosomiasis, we systematically investigated the dynamic metabolic responses of mice biofluids and liver tissues to S. japonicum infection for five weeks using 1H NMR spectroscopy in conjunction with multivariate data analysis. We were able to detect schistosomiasis at the third week post-infection, which was one week earlier than “gold standard” methods. We found that S. japonicum infection caused significant elevation of urinary 3-ureidopropionate, a uracil catabolic product, and disturbance of lipid metabolism, stimulation of glycolysis, depression of tricarboxylic acid cycle and disruption of gut microbiota regulations. We further found that the changes of 3-ureidopropionate and overall metabolic changes in both urinary and plasma samples were closely correlated with the time-course of disease progression. Furthermore, such changes together with liver tissue metabonome were clearly associated with the worm-burdens. These findings provided more insightful understandings of host biological responses to the infection and demonstrated that metabonomic analysis is potentially useful for early detection of schistosomiasis and comprehension of the mechanistic aspects of disease progression. Schistosomiasis is an infectious disease resulting from the infection of parasitic trematode worms called schistosomes. About 600 million people are currently exposed to schistosomiasis and 200 million people are infected in about 76 countries. Current diagnostic methods are unable to detect schistosomiasis at its early stages and thus are incapable of preventing disease causing further complications. In order to understand the effects of schistosome infection on hosts' biochemistry associated with disease progression in a holistic fashion and detect the infection at the early stage, we systematically investigated the metabolite composition (metabonome) changes in mice biofluids and liver tissues induced by Schistosoma japonicum using NMR spectroscopy. We detected infection-induced mice metabonomic alterations at three weeks post-infection, a week earlier than traditional methods. We found that the infection-caused elevation of urinary 3-ureidopropionate was not only associated with disease progression but also worm burden. We further found that overall metabonomic changes were also closely associated with disease progression, and our methods were capable of distinguishing different levels of worm burden at week five post-infection. Our findings provided further understandings in host responses to the infection and demonstrated metabonomics as a potentially useful tool for early diagnosis of S. japonicum infections.
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Affiliation(s)
- Junfang Wu
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Wuhan Center for Magnetic Resonance, Wuhan Institute of Physics and Mathematics, Chinese Academy of Sciences, Wuhan, People's Republic of China
- Graduate School of Chinese Academy of Sciences, Beijing, People's Republic of China
| | - Wenxin Xu
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Wuhan Center for Magnetic Resonance, Wuhan Institute of Physics and Mathematics, Chinese Academy of Sciences, Wuhan, People's Republic of China
- Graduate School of Chinese Academy of Sciences, Beijing, People's Republic of China
| | - Zhenping Ming
- Department of Medical Parasitology, School of Basic Medical Science, Wuhan University, Wuhan, People's Republic of China
| | - Huifen Dong
- Department of Medical Parasitology, School of Basic Medical Science, Wuhan University, Wuhan, People's Republic of China
| | - Huiru Tang
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Wuhan Center for Magnetic Resonance, Wuhan Institute of Physics and Mathematics, Chinese Academy of Sciences, Wuhan, People's Republic of China
- * E-mail: (HT); (YW)
| | - Yulan Wang
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Wuhan Center for Magnetic Resonance, Wuhan Institute of Physics and Mathematics, Chinese Academy of Sciences, Wuhan, People's Republic of China
- * E-mail: (HT); (YW)
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Bergquist R, Tanner M. Controlling Schistosomiasis in Southeast Asia. ADVANCES IN PARASITOLOGY 2010; 72:109-44. [DOI: 10.1016/s0065-308x(10)72005-4] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hu S, Law PK, Fung MC. Microarray analysis of genes highly expressed in cercarial stage of Schistosoma japonicum and the characterization of the antigen Sj20H8. Acta Trop 2009; 112:26-32. [PMID: 19520053 DOI: 10.1016/j.actatropica.2009.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2008] [Revised: 05/29/2009] [Accepted: 06/01/2009] [Indexed: 01/11/2023]
Abstract
Schistosomes have a complex life cycle which alternates between two hosts and includes two short-lived water-born forms. Cercariae are the larval forms of schistosomes responsible for infection of the vertebrate hosts. The infection is initiated when the cercariae penetrate host skin. During penetration, cercariae will undergo profound changes and release excretory/secretory products to adapt to the new environment and to escape from host's immune attack. Part of these events should be determined, to some degree, by the activation of certain genes in the cercariae. In this study, we performed cDNA microarray analysis to monitor the profile of the genes actively expressed in Schistosoma japonicum cercariae. Microarray analysis showed that 76 of 3840 cDNA clones were expressed more than 20-fold in cercariae compared to adult worms. After cluster analysis, 19 non-redundant expressed sequence tags (ESTs) were obtained, 4 of which represented functionally annotated genes, 14 of which represented functionally un-characterized genes, and 1 of which represented a novel gene sequence. The full-length cDNA of the second most abundant EST, Sj20H8, was cloned and preliminarily characterized. Although the precise biological role of all cercarial actively expressed transcripts identified in this investigation awaits further functional analysis, our findings may offer insight into novel control strategies or help to develop potential vaccine candidates against schistosomiasis.
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Contrasting reservoirs for Schistosoma japonicum between marshland and hilly regions in Anhui, China--a two-year longitudinal parasitological survey. Parasitology 2009; 137:99-110. [PMID: 19723358 DOI: 10.1017/s003118200999103x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Schistosoma japonicum remains highly endemic in many counties in China and has recently re-emerged, to a large extent, in previously controlled areas. To test the hypothesis that small rodents and less agriculturally important domestic animals such as dogs and cats may play an important role in the transmission and potential re-emergence of this disease, an annual investigation of S. japonicum among humans, domestic animals and rodents, combined with detailed surveys of the snail intermediate host, was performed across 3 marshland villages and 3 hilly villages in Anhui province of China over 2 consecutive years. The highest infection prevalence and intensity observed across all mammals was in rodents in the hilly region; while in the marshland, bovines were suspected as the main reservoirs. However, relatively high infection prevalence levels were also found in dogs and cats in both regions. Such results may have implications for the current human- and bovine-oriented control policy for this medically and veterinarily important disease, particularly within the hilly regions of mainland China.
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Rudge JW, Lu DB, Fang GR, Wang TP, Basáñez MG, Webster JP. Parasite genetic differentiation by habitat type and host species: molecular epidemiology of Schistosoma japonicum in hilly and marshland areas of Anhui Province, China. Mol Ecol 2009; 18:2134-47. [PMID: 19389178 DOI: 10.1111/j.1365-294x.2009.04181.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Schistosoma japonicum, a parasite of significant public health importance in parts of China and Southeast Asia, is a true generalist pathogen with over 40 species of mammals suspected as definitive host reservoirs. In order to characterize levels of parasite gene flow across host species and identify the most important zoonotic reservoirs, S. japonicum larvae (miracidia) were sampled from a range of definitive host species in two contrasting habitat types within Anhui Province, China: a low-lying marshland region, and a hilly region, where animal reservoir populations may be predicted to differ substantially. Miracidia samples were genotyped using seven multiplexed microsatellite markers. Hierarchical F-statistics and clustering analyses revealed substantial geographical structuring of S. japonicum populations within Anhui, with strong parasite genetic differentiation between habitat types. Within most villages, there was very little or no parasite genetic differentiation among host species, suggesting frequent S. japonicum gene flow, and thus also transmission, across species. Moreover, the data provide novel molecular evidence that rodents and dogs are potentially very important infection reservoirs in hilly regions, in contrast to bovines in the marshland regions. The parasite genetic differentiation between habitat types might therefore be associated with contrasting host reservoirs. The high levels of parasite gene flow observed across host species in sympatric areas have important implications for S. japonicum control, particularly in hilly regions where control of infection among wild rodent populations could be challenging.
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Affiliation(s)
- James W Rudge
- Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, London, UK.
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Sensitivity of pooled serum testing for screening antibody of schistosomiasis japonica by IHA in a mountainous area of Yunnan, China. Parasitology 2009; 136:267-72. [PMID: 19154655 DOI: 10.1017/s0031182008005489] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Pooled sample testing (PST) as a strategy for avoiding testing the majority of individual negative samples has been proposed for screening of diseases in low prevalence areas. There has been no standard guideline for PST in screening of Schistosoma japonicum infection of Yunnan, China. To document the optimum pool size with acceptable sensitivity of PST for screening of Schistosoma japonicum infection in this setting, an experimental pooling of each of 31 positive sera by IHA with various numbers of 24 negative sera was done. The results were used to create a statistical model which was subsequently used for simulation to predict sensitivity of the pooled serum tests in the population with varying prevalence and pool size. We found that to keep the sensitivity of PST above 90%, 1:05 should be the maximum dilution, that is, the optimum pool size should not be greater than 6. Antigen will have rather little interference if the prevalence of infection is low e.g. 1% or the antigen:antibody ratio is 1:100 or below. Pooled serum testing by IHA is an acceptable sensitive method for detecting antibody for Schistosoma japonicum infection in this area.
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38
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Zhang Z, Clark AB, Bivand R, Chen Y, Carpenter TE, Peng W, Zhou Y, Zhao G, Jiang Q. Nonparametric spatial analysis to detect high-risk regions for schistosomiasis in Guichi, China. Trans R Soc Trop Med Hyg 2008; 103:1045-52. [PMID: 19117584 DOI: 10.1016/j.trstmh.2008.11.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2008] [Revised: 11/17/2008] [Accepted: 11/17/2008] [Indexed: 11/17/2022] Open
Abstract
Schistosomiasis control in China is facing a new challenge due to the rebound of epidemics in many areas and the unsustainable effects of the chemotherapy-based control strategy. Identifying high-risk regions for schistosomiasis is an important first step for an effective and sustainable strategy. Direct surveillance of snail habitats to detect high-risk regions is costly and no longer a desirable approach, while indirect monitoring of acute schistosomiasis may be a satisfactory alternative. To identify high-risk regions for schistosomiasis, we jointly used multiplicative and additive models with the kernel smoothing technique as the main approach to estimate the relative risk (RR) and excess risk (ER) surfaces by analyzing surveillance data for acute schistosomiasis. The feasibility of detecting high-risk regions for schistosomiasis through nonparametric spatial analysis was explored and confirmed in this study, and two significant high-risk regions were identified. The results provide useful hints for improving the national surveillance network for acute schistosomiasis and possible approaches to utilizing surveillance data more efficiently. In addition, the commonly used epidemiological indices, RR and ER, are examined and emphasized from the spatial point of view, which will be helpful for exploring many other epidemiological indices.
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Affiliation(s)
- Zhijie Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, People's Republic of China
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Zhou YB, Yang MX, Tao P, Jiang QL, Zhao GM, Wei JG, Jiang QW. A longitudinal study of comparison of the Kato-Katz technique and indirect hemagglutination assay (IHA) for the detection of schistosomiasis japonica in China, 2001-2006. Acta Trop 2008; 107:251-4. [PMID: 18675244 DOI: 10.1016/j.actatropica.2008.06.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2007] [Revised: 06/03/2008] [Accepted: 06/24/2008] [Indexed: 11/18/2022]
Abstract
From 2001 to 2006, about one-third of the residents aged 5-65 years were selected as the subjects in a schistosome-endemic village located in Jiangxi Province, China. Every 1 year, all participants were analyzed by the Kato-Katz parasitologic examination and indirect hemagglutination assay (IHA). Statistical analysis of the results showed the k indices ranged from 0.250 to 0.347 between the two methods. Assuming the Kato-Katz results as the gold standard reference, the specificity of the IHA was from 60% to 77%, the positive predictive value of this method was from 19% to 30%, and its sensitivity and negative predictive value were more than 97%. The IHA method is unsuitable for individual screening in endemic community with relatively high prevalence (e.g. with >10% or more prevalence). A search for a better diagnostic test that can be applied in field situations in China is essential and should be given high priority.
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Affiliation(s)
- Yi-Biao Zhou
- Department of Epidemiology, School of Public Health, Fudan University, 138 Yixueyuan Road, Shanghai 200032, China. z
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Zhang Z, Carpenter TE, Chen Y, Clark AB, Lynn HS, Peng W, Zhou Y, Zhao G, Jiang Q. Identifying high-risk regions for schistosomiasis in Guichi, China: a spatial analysis. Acta Trop 2008; 107:217-23. [PMID: 18722565 DOI: 10.1016/j.actatropica.2008.04.027] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2007] [Revised: 03/25/2008] [Accepted: 04/28/2008] [Indexed: 11/28/2022]
Abstract
Schistosomiasis epidemic is reemerging in some areas of China. The extensive snail habitat is a major challenge for a sustainable schistosomiasis control. Direct surveillance on snails for the disease control is no longer a desirable disease control approach due to current low density of infected snails and reduced funding. In this study the benefit of indirect monitoring of acute schistosomiasis cases, using spatial methods including disease mapping and spatial clustering analysis was explored in Guichi, China. Significant global clustering existed for acute cases and two statistically significant spatial clusters were detected, and subsequently validated by field surveys. Our study indicates that the application of geographic information system (GIS) and spatial methods are useful in the epidemiologic surveillance and risk assessment for acute schistosomiasis, providing an alternative approach with minimal funds required.
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Affiliation(s)
- Zhijie Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, People's Republic of China
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Li YS, Raso G, Zhao ZY, He YK, Ellis MK, McManus DP. Large water management projects and schistosomiasis control, Dongting Lake region, China. Emerg Infect Dis 2008; 13:973-9. [PMID: 18214167 DOI: 10.3201/eid1307.060848] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Construction of the Three Gorges Dam across the Yangtze River will substantially change the ecology of the Dongting Lake in southern China. In addition, the Chinese Central and Hunan Provinces' governmental authorities have instigated a Return Land to Lake Program that will extend the Dongting Lake surface area from the current 2,681 km2 to 4,350 km2. The previous construction of embankments and the large silt deposits made by the Yangtze River and other connecting rivers have contributed to frequent disastrous flooding. As a consequence of the 2 water projects, > 2 million persons and their domestic animals are being resettled. This article provides an overview of the historical background of these 2 large water management projects, the associated population movement, and their impact on future transmission and control of schistosomiasis in the Dongting Lake area. The dam will likely substantially extend the range of the snail habitats and increase schistosome transmission and schistosomiasis cases.
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Affiliation(s)
- Yue-Sheng Li
- Hunan Institute of Parasitic Diseases, Yueyang, People's Republic of China
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42
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Zhou XN, Guo JG, Wu XH, Jiang QW, Zheng J, Dang H, Wang XH, Xu J, Zhu HQ, Wu GL, Li YS, Xu XJ, Chen HG, Wang TP, Zhu YC, Qiu DC, Dong XQ, Zhao GM, Zhang SJ, Zhao NQ, Xia G, Wang LY, Zhang SQ, Lin DD, Chen MG, Hao Y. Epidemiology of schistosomiasis in the People's Republic of China, 2004. Emerg Infect Dis 2007; 13:1470-6. [PMID: 18257989 PMCID: PMC2851518 DOI: 10.3201/eid1310.061423] [Citation(s) in RCA: 191] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Results from the third nationwide cluster sampling survey on the epidemiology of schistosomiasis in the People's Republic of China, conducted by the Ministry of Health in 2004, are presented. A stratified cluster random sampling technique was used, and 239 villages were selected in 7 provinces where Schistosoma japonicum remains endemic. A total of 250,987 residents 6-65 years of age were included in the survey. Estimated prevalence rates in the provinces of Hunan, Hubei, Jiangxi, Anhui, Yunnan, Sichuan, and Jiangsu were 4.2%, 3.8%, 3.1%, 2.2%, 1.7%, 0.9%, and 0.3%, respectively. The highest prevalence rates were in the lake and marshland region (3.8%) and the lowest rates were in the plain region with waterway networks (0.06%). Extrapolation to all residents in schistosome-endemic areas indicated 726,112 infections. This indicates a reduction of 16.1% compared with a nationwide survey conducted in 1995. However, human infection rates increased by 3.9% in settings where transmission is ongoing.
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Affiliation(s)
- Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Shanghai, People's Republic of China.
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Balen J, Zhao ZY, Williams GM, McManus DP, Raso G, Utzinger J, Zhou J, Li YS. Prevalence, intensity and associated morbidity of Schistosoma japonicum infection in the Dongting Lake region, China. Bull World Health Organ 2007; 85:519-26. [PMID: 17768500 PMCID: PMC2636368 DOI: 10.2471/blt.06.034033] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2006] [Accepted: 10/30/2006] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE To determine the prevalence and intensity of Schistosoma japonicum infection and associated morbidity, and to estimate the infected human and buffalo populations in the Dongting Lake region, Hunan province, China. METHODS We used data from the third national schistosomiasis periodic epidemiological survey (PES) of 2004. These included 47 144 human serological and 7205 stool examinations, 3893 clinical examinations and questionnaire surveys, and 874 buffalo stool examinations, carried out in 47 villages in Hunan province. Serological examinations were performed using the enzyme linked immunosorbent assay technique and human stool samples were examined by the Kato-Katz method. Stools from buffaloes and other domestic animals were examined for schistosome infection by the miracidial hatching test. FINDINGS Sero-prevalence was 11.9% (range: 1.3-34.9% at the village level), and the rate of egg-positive stools was estimated at 1.9% (0-10.9%) for the same population. The prevalence of infection among buffaloes was 9.5% (0-66.7%). Extrapolating to the entire population of the Dongting Lake region, an estimated 73 225 people and 13 973 buffaloes were infected. Most frequently reported symptoms were abdominal pain (6.2%) and bloody stools (2.7%). More than half of the clinically examined people reported having had at least one prior antischistosomal treatment. CONCLUSION There was a significant reduction in the number of humans infected with S. japonicum since the previous national PES carried out in 1995, partially explained by large-scale chemotherapy campaigns. However, a near-stable number of buffalo infections suggest continuing human re-infection, which may lead to future increases in human prevalence.
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Affiliation(s)
- Julie Balen
- Queensland Institute of Medical Research, Brisbane, Queensland, Australia
- School of Population Health, University of Queensland, Brisbane, Queensland, Australia
| | - Zheng-Yuan Zhao
- Hunan Institute of Parasitic Diseases, Yueyang, Hunan province, China
- School of Public Health, Central South University, Changsha, Hunan province, China
| | - Gail M Williams
- School of Population Health, University of Queensland, Brisbane, Queensland, Australia
| | - Donald P McManus
- Queensland Institute of Medical Research, Brisbane, Queensland, Australia
| | - Giovanna Raso
- Queensland Institute of Medical Research, Brisbane, Queensland, Australia
| | - Jürg Utzinger
- Department of Public Health and Epidemiology, Swiss Tropical Institute, Basel, Switzerland
| | - Jie Zhou
- Hunan Institute of Parasitic Diseases, Yueyang, Hunan province, China
| | - Yue-Sheng Li
- Queensland Institute of Medical Research, Brisbane, Queensland, Australia
- Hunan Institute of Parasitic Diseases, Yueyang, Hunan province, China
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Fernandez TJ, Tarafder MR, Balolong E, Joseph L, Willingham AL, Bélisle P, Webster JP, Olveda RM, McGarvey ST, Carabin H. Prevalence of Schistosoma japonicum infection among animals in fifty villages of Samar province, the Philippines. Vector Borne Zoonotic Dis 2007; 7:147-55. [PMID: 17627431 DOI: 10.1089/vbz.2006.0565] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In the Philippines, there is a need to understand the contribution of different domestic and wild animals in transmitting Schistosoma japonicum infection to humans better. The current study describes variation in animal S. japonicum prevalence across 50 endemic villages of Samar Province, the Philippines. A total of 50 villages were selected, 25 with predominantly rain-fed farms and 25 with some irrigation system. At least 35 cats, dogs, pigs, and water buffaloes each were randomly selected and 30 rat traps were set in each village. Fecal samples were collected for up to three consecutive days for each species. The Danish Bilharziasis Laboratory method (DBL method) was used to determine S. japonicum infection status. A hierarchical logistic regression model with clustering by village and with adjustment for measurement error of the DBL method was used to estimate the prevalence of infection per village and species. Stool samples were collected from 23.4% (1189), 28.6% (1274), 36.3% (1899), and 49.4% (873) of the censused dogs, cats, pigs, and water buffaloes, respectively, and from 663 rats. The adjusted prevalence of S. japonicum infection varied greatly across villages ranging from 1.6% (95% Bayesian Credible Interval: 0.1%-10.2%) to 86.3% (65.9%-97.8%) for dogs, from 0.1% (0%-2.1%) to 21.7% (4.7%-51.2%) for cats, from 0.01% (0.0%%-1.0%) to 18.4% (7.1%-34.7%) for pigs, from less than 0.1% (0.0%-1.2%) to 72.5% (46.0%-97.4%) for water buffaloes, and from 0.7% (0.0%-9.0%) to 95.4% (77.2%-99.9%) for rats. This is the most comprehensive study of animal S. japonicum infection conducted to date. Our results show that, unlike what has been reported in China, very few water buffaloes were infected whereas rats and dogs show high prevalence proportions of infection. This, combined with significant village-to-village variation in prevalence of S. japonicum infection, suggest possible different transmission dynamics of the infection in the Province of Samar in the Philippines and China.
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Affiliation(s)
- T J Fernandez
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
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Li YS, Raso G, Zhao ZY, He YK, Ellis MK, McManus DP. Large water management projects and schistosomiasis control, Dongting Lake region, China. Emerg Infect Dis 2007; 13. [PMID: 18214167 PMCID: PMC2878251 DOI: 10.3201/eid1307.070848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Construction of the Three Gorges Dam across the Yangtze River will substantially change the ecology of the Dongting Lake in southern China. In addition, the Chinese Central and Hunan Provinces' governmental authorities have instigated a Return Land to Lake Program that will extend the Dongting Lake surface area from the current 2,681 km2 to 4,350 km2. The previous construction of embankments and the large silt deposits made by the Yangtze River and other connecting rivers have contributed to frequent disastrous flooding. As a consequence of the 2 water projects, > 2 million persons and their domestic animals are being resettled. This article provides an overview of the historical background of these 2 large water management projects, the associated population movement, and their impact on future transmission and control of schistosomiasis in the Dongting Lake area. The dam will likely substantially extend the range of the snail habitats and increase schistosome transmission and schistosomiasis cases.
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Affiliation(s)
- Yue-Sheng Li
- Hunan Institute of Parasitic Diseases, Yueyang, People’s Republic of China,Queensland Institute of Medical Research, Brisbane, Queensland, Australia
| | - Giovanna Raso
- Queensland Institute of Medical Research, Brisbane, Queensland, Australia,University of Queensland, Brisbane, Queensland, Australia
| | - Zheng-Yuan Zhao
- Hunan Institute of Parasitic Diseases, Yueyang, People’s Republic of China,Central South University, Changsha, People’s Republic of China
| | - Yong-Kang He
- Hunan Institute of Parasitic Diseases, Yueyang, People’s Republic of China
| | - Magda K. Ellis
- Queensland Institute of Medical Research, Brisbane, Queensland, Australia
| | - Donald P. McManus
- Queensland Institute of Medical Research, Brisbane, Queensland, Australia
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Yu JM, de Vlas SJ, Jiang QW, Gryseels B. Comparison of the Kato-Katz technique, hatching test and indirect hemagglutination assay (IHA) for the diagnosis of Schistosoma japonicum infection in China. Parasitol Int 2006; 56:45-9. [PMID: 17188018 DOI: 10.1016/j.parint.2006.11.002] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2006] [Revised: 11/12/2006] [Accepted: 11/17/2006] [Indexed: 11/24/2022]
Abstract
The Kato-Katz technique (duplicate 41.7 mg fecal smears), hatching test and indirect hemagglutination assay (IHA) were compared for their ability to detect human Schistosoma japonicum infection in two endemic villages (Zhonjiang and Zhuxi) in rural China. The hatching test (using a nylon bag, and based on about 30 g of feces) and IHA are conventional Chinese diagnostic methods. In both villages, the trends of prevalences with age and sex were comparable for the different methods. In Zhuxi, Kato-Katz examinations of stools from 7 different days and hatching were available, which could be used as a reliable gold standard. This resulted for IHA in a sensitivity of 80% and a specificity of 48%. The sensitivity of the Kato-Katz technique using one stool specimen was 68%, twice that of hatching (33%). In Zhonjiang, however, hatching resulted in more positive cases than Kato-Katz (prevalence 31% vs. 24%). Apparently, the result of the hatching test depends on environmental factors such as temperature and water quality. Although imperfect, Kato-Katz is recommended out of the three evaluated techniques as the method of choice for large-scale screening of S. japonicum. Hatching is much more tedious, provides inconsistent and only qualitative results, and is not much more sensitive than Kato-Katz. Its poor specificity makes IHA unsuitable for individual screening, but it may be more effective for community diagnosis.
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Affiliation(s)
- J M Yu
- Department of Preventive Medicine, Medical College, Tongji University, Shanghai 200092, PR China.
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Zhou XN, Wang LY, Chen MG, Wu XH, Jiang QW, Chen XY, Zheng J, Utzinger J. The public health significance and control of schistosomiasis in China--then and now. Acta Trop 2005; 96:97-105. [PMID: 16125655 DOI: 10.1016/j.actatropica.2005.07.005] [Citation(s) in RCA: 306] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The description of schistosomiasis in China dates back more than two millennia. The disease caused social and economic hardship, and the rates of morbidity and mortality were high. In the mid 1950s, when China's population was approximately 600 million, an estimated 11.6 million people were infected with Schistosoma japonicum. Hence, a national control programme was launched, with an emphasis on intermediate host snail control by means of environmental management. Over the past 50 years, the national control programme has made great progress and praziquantel-based morbidity control became the mainstay of control. In 2000, the number of infected people had been reduced to an estimated 694,788, the snail-infested area has been abridged by over 75%, and the disease had been eliminated in five of the 12 previously endemic provinces. Between the mid 1980s and 2003, the criteria of transmission interruption have been reached in 260 counties (60.0%), transmission control has been achieved in 63 counties (14.5%), but the disease was still endemic in the remaining 110 counties (25.4%). Comparison between the number of cases in 2000 and 2003 suggests that schistosomiasis has re-emerged; an estimated 843,011 people were infected with S. japonicum in 2003. Here, we provide a short historical account of the pubic health significance of schistosomiasis in China, highlight the progress made to date with the national control programme, and place particular emphasis on the most recent trends. Finally, we discuss remaining challenges for schistosomiasis control with the ultimate goal of disease elimination.
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Affiliation(s)
- Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China.
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