Prevalence and incidence of advanced schistosomiasis and risk factors for case fatality in Hunan Province, China

Characteristics of peripheral lymphocyte subsets in patients with different stages of schistosomiasis japonica

Immune cells are important for the development of schistosomiasis japonica and are also critical for the treatment of schistosomiasis. The immune cells in the peripheral blood help assess the immune state. The peripheral lymphocytes in schistosomiasis mansoni were well studied; however, immune cells in patients with different stages of schistosomiasis japonica are not well analysed. Here, we performed a preliminary study to explore characteristics of peripheral lymphocyte subsets in patients with different stages of schistosomiasis japonica. 135 patients with Schistosoma japonicum infection and 25 healthy volunteers were included in this study, including 84 patients with chronic S. japonicum infection and 51 patients with advanced S. japonicum infection. Flow cytometry analysis was performed to evaluate peripheral lymphocytes including T cells, B cells, and natural killer (NK) cells. Blood routine and liver function test data were analysed. Ultrasound examination was used to access liver fibrosis according to the World Health Organization standard about ultrasound in schistosomiasis. Demographic data analysis suggested there was no difference in age and gender in patients with S. japonicum infection and health control group. Liver function tests showed that patients with advanced schistosomiasis had a higher incidence of liver function abnormality and blood lipid than those with chronic schistosomiasis. Blood routine results reflected that haemoglobin, red blood cells, platelets, as well as lymphocytes in the advanced group were significantly less than that in the chronic group. Furthermore, flow cytometry analysis indicated that the percentage of CD4+ T cells was lower in the advanced group, but the percentage of CD19+ B cells was higher in the advanced group. In addition, the number of CD3+ T cells, CD3+ CD4+ T cells, CD3+ CD8+ T cells, and NK cells was less in the advanced group when compared with those in the chronic group. In addition, there was a correlation between the decrease in CD4+ T cells and more severe fibrosis on ultrasound images. Our results indicated that the immune state in the peripheral is different in different stages of S. japonicum infection. Lymphocyte subset analysis has potential to facilitate differential diagnosis of different stages of schistosomiasis japonica and even to be a prognostic factor.

Development of New Technologies for Risk Identification of Schistosomiasis Transmission in China

Schistosomiasis is serious parasitic disease with an estimated global prevalence of active infections of more than 190 million. Accurate methods for the assessment of schistosomiasis risk are crucial for schistosomiasis prevention and control in China. Traditional approaches to the identification of epidemiological risk factors include pathogen biology, immunology, imaging, and molecular biology techniques. Identification of schistosomiasis risk has been revolutionized by the advent of computer network communication technologies, including 3S, mathematical modeling, big data, and artificial intelligence (AI). In this review, we analyze the development of traditional and new technologies for risk identification of schistosomiasis transmission in China. New technologies allow for the integration of environmental and socio-economic factors for accurate prediction of the risk population and regions. The combination of traditional and new techniques provides a foundation for the development of more effective approaches to accelerate the process of schistosomiasis elimination.