The contribution of domestic animals to the transmission of schistosomiasis japonica in the Lindu Subdistrict of the Central Sulawesi Province, Indonesia

Spatial Cluster Change of Schistosoma japonicum Transmission Foci in Indonesia During the Schistosomiasis Elimination Program

PURPOSE

The Government of Indonesia committed to eliminating schistosomiasis by 2025. Collaboratively snail control became one of the crucial strategies to ensure that the prevalence of Schistosoma japonicum in Oncomelania hupensis lindoensis reaches zero by the end of the program. This research investigated the spatial cluster change of S. japonicum transmission foci in Indonesia between 2017 and 2021.

METHODS

We mapped the snail foci, collected the snails, and calculated the snail density. We also conducted laboratory tests to detect the existence of cercariae in the snails. Identified infected snails were used to calculate the infection rate (IR) or snails' prevalence of schistosome cercariae among freshwater snails. We then analysed the spatial cluster using the Getis-Ord Gi* statistic to identify the hot and cold spots.

RESULTS

The 5-year schistosomiasis elimination program successfully declined 18.84% of the snail foci and reduced 40.37% of the infected snail foci. Local spatial autocorrelation of snail density and infection rate identified that in 2017 and 2021, the number of cold spots decreased by 53.91% and 0%, while hot spots increased by 2.63% and 56.1%. The presence of more hot spots suggests a rise in the number of foci with high snail density and infection rates. The implementation of snail control was not optimal, and the parasite transmission through domestic animals still existed, causing the spatial cluster of hot spots to change during this period. Most hotspots have been observed near settlements, primarily in cocoa plantations, developed and deserted rice fields, grassland, and bush wetlands.

CONCLUSION

During the schistosomiasis elimination program, the number of hot spots increased while cold spots decreased, and there were notable changes in the geographical distribution of hot spots, indicating a shift in the clustering pattern of schistosomiasis cases. The findings become essential for policymakers, particularly in selecting priority areas for intervention. In the Discussion section, we demonstrated the selection process based on the existence of hot and cold spots. Furthermore, we proposed that enhancing cross-sector integration is crucial, particularly in connection with the management of S. japonicum transmission through domestic animals.

Transmission-Blocking Vaccines against Schistosomiasis Japonica

Control of schistosomiasis japonica, endemic in Asia, including the Philippines, China, and Indonesia, is extremely challenging. Schistosoma japonicum is a highly pathogenic helminth parasite, with disease arising predominantly from an immune reaction to entrapped parasite eggs in tissues. Females of this species can generate 1000-2200 eggs per day, which is about 3- to 15-fold greater than the egg output of other schistosome species. Bovines (water buffalo and cattle) are the predominant definitive hosts and are estimated to generate up to 90% of parasite eggs released into the environment in rural endemic areas where these hosts and humans are present. Here, we highlight the necessity of developing veterinary transmission-blocking vaccines for bovines to better control the disease and review potential vaccine candidates. We also point out that the approach to producing efficacious transmission-blocking animal-based vaccines before moving on to human vaccines is crucial. This will result in effective and feasible public health outcomes in agreement with the One Health concept to achieve optimum health for people, animals, and the environment. Indeed, incorporating a veterinary-based transmission vaccine, coupled with interventions such as human mass drug administration, improved sanitation and hygiene, health education, and snail control, would be invaluable to eliminating zoonotic schistosomiasis.

Reaching the World Health Organization elimination targets for schistosomiasis: the importance of a One Health perspective

The past three years has seen the launch of a new World Health Organization (WHO) neglected tropical diseases (NTDs) roadmap, together with revised control and elimination guidelines. Across all, there is now a clear emphasis on the need to incorporate a One Health approach, recognizing the critical links between human and animal health and the environment. Schistosomiasis, caused by Schistosoma spp. trematodes, is a NTD of global medical and veterinary importance, with over 220 million people and untold millions of livestock currently infected. Its burden remains extremely high in certain regions, particularly within sub-Saharan Africa, despite over two decades of mass preventive chemotherapy (mass drug administration), predominantly to school-aged children. In Africa, in contrast to Asia, any zoonotic component of schistosomiasis transmission and its implications for disease control has, until recently, been largely ignored. Here, we review recent epidemiological, clinical, molecular, and modelling work across both Asia and Africa. We outline the evolutionary history and transmission dynamics of Schistosoma species, and emphasize the emerging risk raised by both wildlife reservoirs and viable hybridization between human and animal schistosomes. To achieve the 2030 WHO roadmap elimination targets, a truly multi-disciplinary One Health perspective must be implemented. This article is part of the theme issue 'Challenges and opportunities in the fight against neglected tropical diseases: a decade from the London Declaration on NTDs'.

Measurement in the study of human exposure to animal feces: A systematic review and audit

BACKGROUND

Human exposure to animal feces is increasingly recognized as an important transmission route of enteric pathogens. Yet, there are no consistent or standardized approaches to measurement of this exposure, limiting assessment of the human health effects and scope of the issue.

OBJECTIVE

To inform and improve approaches to the measurement of human exposure to animal feces, we audited existing measurement in low- and middle-income countries.

METHODS

We systematically searched peer-reviewed and gray literature databases for studies with quantitative measures of human exposure to animal feces and we classified measures in two ways. First, using a novel conceptual model, we categorized measures into three 'Exposure Components' identified a priori (i.e., Animal, Environmental, Human Behavioral); one additional Component (Evidence of Exposure) inductively emerged. Second, using the exposure science conceptual framework, we determined where measures fell along the source-to-outcome continuum.

RESULTS

We identified 1,428 measures across 184 included studies. Although studies overwhelmingly included more than one single-item measure, the majority only captured one Exposure Component. For example, many studies used several single-item measures to capture the same attribute for different animals, all of which were classified as the same Component. Most measures captured information about the source (e.g. animal presence) and contaminant (e.g. animal-sourced pathogens), which are most distal from exposure on the source-to-outcome continuum.

DISCUSSION

We found that measurement of human exposure to animal feces is diverse and largely distal from exposure. To facilitate better assessment of the human health effects of exposure and scope of the issue, rigorous and consistent measures are needed. We recommend a list of key factors from the Animal, Environmental, and Human Behavioral Exposure Components to measure. We also propose using the exposure science conceptual framework to identify proximal measurement approaches.

Zoonotic helminths - why the challenge remains

Helminth zoonoses remain a global problem to public health and the economy of many countries. Polymerase chain reaction-based techniques and sequencing have resolved many taxonomic issues and are now essential to understanding the epidemiology of helminth zoonotic infections and the ecology of the causative agents. This is clearly demonstrated from research on Echinococcus (echinococcosis) and Trichinella (trichinosis). Unfortunately, a variety of anthropogenic factors are worsening the problems caused by helminth zoonoses. These include cultural factors, urbanization and climate change. Wildlife plays an increasingly important role in the maintenance of many helminth zoonoses making surveillance and control increasingly difficult. The emergence or re-emergence of helminth zoonoses such as Ancylostoma ceylanicum, Toxocara, Dracunculus and Thelazia exacerbate an already discouraging scenario compounding the control of a group of long neglected diseases.

Development of a novel real-time polymerase chain reaction assay for the sensitive detection of Schistosoma japonicum in human stool

BACKGROUND

Elimination and control of Schistosoma japonicum, the most virulent of the schistosomiasis-causing blood flukes, requires the development of sensitive and specific diagnostic tools capable of providing an accurate measurement of the infection prevalence in endemic areas. Typically, detection of S. japonicum has occurred using the Kato-Katz technique, but this methodology, which requires skilled microscopists, has been shown to radically underestimate levels of infection. With the ever-improving capabilities of next-generation sequencing and bioinformatic analysis tools, identification of satellite sequences and other highly repetitive genomic elements for use as real-time PCR diagnostic targets is becoming increasingly common. Assays developed using these targets have the ability to improve the sensitivity and specificity of results for epidemiological studies that can in turn be used to inform mass drug administration and programmatic decision making.

METHODOLOGY/PRINCIPAL FINDINGS

Utilizing Tandem Repeat Analyzer (TAREAN) and RepeatExplorer2, a cluster-based analysis of the S. japonicum genome was performed and a tandemly arranged genomic repeat, which we named SjTR1 (Schistosoma japonicum Tandem Repeat 1), was selected as the target for a real-time PCR diagnostic assay. Based on these analyses, a primer/probe set was designed and the assay was optimized. The resulting real-time PCR test was shown to reliably detect as little as 200 ag of S. japonicum genomic DNA and as little as 1 egg per gram of human stool. Based on these results, the index assay reported in this manuscript is more sensitive than previously published real-time PCR assays for the detection of S. japonicum.

CONCLUSIONS/SIGNIFICANCE

The extremely sensitive and specific diagnostic assay described in this manuscript will facilitate the accurate detection of S. japonicum, particularly in regions with low levels of endemicity. This assay will be useful in providing data to inform programmatic decision makers, aiding disease control and elimination efforts.

Humoral responses to Schistosoma japonicum soluble egg antigens in domestic animals in Lindu Subdistrict, Central Sulawesi Province, Indonesia

Background and Aim: Schistosomiasis japonica, a disease caused by Schistosoma japonicum, is a public health problem in the Philippines, the Republic of Indonesia, and the People's Republic of China. The disease is known as zoonotic, meaning other than humans, animals are involved as the reservoirs. In Indonesia, schistosomiasis surveillance in animals is not continuous. Thus, the study to determine the prevalence of the disease in animals is needed. The study was aimed to determine the seroprevalence of S. japonicum infection among four species of domestic animals in the Lindu Sub-district, Central Sulawesi Province of Indonesia. Materials and Methods: Blood samples of domestic animals were collected and analyzed for the presence of anti-S. japonicum immunoglobulin G antibodies against S. japonicum soluble egg antigens using the indirect hemagglutination assay. Animal stool samples were collected, and the miracidia-hatching assay was used for the detection of S. japonicum infection. Additional data concerning the animal identity and the management practices were obtained through a questionnaire used in surveys and interviews. Results: A total of 146 sera from 13 cattle, 24 buffaloes, 54 pigs, and 55 dogs were collected. The overall schistosomiasis seroprevalence was 64.4%. The serology prevalence in cattle, buffalo, pig, and dog was 100.0%, 41.7%, 74.1%, and 56.4%, respectively. Domestic animals in all of five villages have previous exposure with S. japonicum as seropositive animals detected in every village. A total of 104 animal stool samples from 146 animals sampled were obtained. The overall schistosomiasis prevalence determined by the miracidia hatching assay was 16.35%. The sensitivity and specificity of indirect hemagglutination assay (IHA) in the current study were 88.24% and 41.37%, respectively, with miracidia hatching assay as the gold-standard method. Conclusion: This study has shown a high seroprevalence of schistosomiasis japonica among domestic animals in the Lindu Subdistrict. IHA can be used as the screening method for the detection of S. japonicum infection in domestic animals. Chemotherapy and animal livestock grazing management programs to reduce the parasite burden and Schistosoma egg contamination in the environment must be implemented as part of one health approaches, in addition to other control measures.

Prevalence and risk factors of trematode infection in swamp buffaloes reared under different agro-climatic conditions in Java Island of Indonesia

Background and Aims:

This study was conducted to estimate the prevalence and intensity and to identify the associated risk factors and impact of trematode infection in swamp buffaloes reared under different agro-climatic conditions in Java, Indonesia.

Materials and Methods:

A total of 580 fecal samples were collected from swamp buffaloes in five different agro-climatic areas in Banten and Central Java Provinces, Indonesia. The fecal samples were examined using the Danish Bilharziasis Laboratory Technique to determine the prevalence and intensity of trematode infection. The risk factors for infection were determined from an in-depth interview of owners/keepers, and the results were analyzed using Chi-square tests and multiple logistic regression. The infection was also correlated with swamp buffalo production parameters (body weight and body condition score [BCS]).

Results:

From all fecal samples, the overall prevalence of trematode infection was 64.83%, which comprised Fasciola spp. (16.03%; mean eggs per gram [EPG]±SD: 1.02±0.43) and Paramphistomatidae (62.93%; mean EPG±SD: 1.01±0.66). The main risk factor for trematode infection was feeding animals with rice straw (odds ratio [OR]: 40.124); the risk of trematode infection was 40.142 times higher in buffaloes that consumed rice straw. Other risk factors included the frequency of anthelmintic treatment (OR: 4.666), age (OR: 0.449), and drinking water source (OR: 0.358). Trematode infection did not significantly affect the body weight or BCS of swamp buffaloes.

Conclusion:

Although the prevalence of trematode infection was high in swamp buffaloes, the intensity of infection was low, and the infection did not affect the animals’ physical parameters.