Spatiotemporal heterogeneity of schistosomiasis in China's Mainland:Evidence from a multi-stage continuous downscaling sentinel monitoring

Objective:To determine the spatiotemporal distribution of Schistosoma(S.)japonicum infections in humans,livestock,and Oncomelania(O.)hupensis across the endemic foci of China.Methods:Based on multi-stage continuous downscaling of sentinel monitoring,county-based schistosomiasis surveillance data were captured from the national schistosomiasis surveillance sites of China from 2005 to 2019.The data included S.japonicum infections in humans,livestock,and O.hupensis.The spatiotemporal trends for schistosomiasis were detected using a Joinpoint regression model,with a standard deviational ellipse(SDE)tool,which determined the central tendency and dispersion in the spatial distribution of schistosomiasis.Further,more spatiotemporal clusters of S.japonicum infections in humans,livestock,and O.hupensis were evaluated by the Poisson model.Results:The prevalence of S.japonicum human infections decreased from 2.06%to zero based on data of the national schistosomiasis surveillance sites of China from 2005 to 2019,with a reduction from 9.42%to zero for the prevalence of S.japonicum infections in livestock,and from 0.26%to zero for the prevalence of S.japonicum infections in O.hupensis.Analysis using an SDE tool showed that schistosomiasis-affected regions were reduced yearly from 2005 to 2014 in the endemic provinces of Hunan,Hubei,Jiangxi,and Anhui,as well as in the Poyang and Dongting Lake regions.Poisson model revealed 11 clusters of S.japonicum human infections,six clusters of S.japonicum infections in livestock,and nine clusters of S.japonicum infections in O.hupensis.The clusters of human infection were highly consistent with clusters of S.japonicum infections in livestock and O.hupensis.They were in the 5 provinces of Hunan,Hubei,Jiangxi,Anhui,and Jiangsu,as well as along the middle and lower reaches of the Yangtze River.Humans,livestock,and O.hupensis infections with S.japonicum were mainly concentrated in the north of the Hunan Province,south of the Hubei Province,north of the Jiangxi Province,and southwestern portion of Anhui Province.In the 2 mountainous provinces of Sichuan and Yunnan,human,livestock,and O.hupensis infections with S.japonicum were mainly concentrated in the northwestern portion of the Yunnan Province,the Daliangshan area in the south of Sichuan Province,and the hilly regions in the middle of Sichuan Province.Conclusions:A remarkable decline in the disease prevalence of S.japonicum infection was observed in endemic schistosomiasis in China between 2005 and 2019.However,there remains a long-term risk of transmission in local areas,with the highest-risk areas primarily in Poyang Lake and Dongting Lake regions,requiring to focus on vigilance against the rebound of the epidemic.Development of high-sensitivity detection methods and integrating the transmission links such as human and livestock infection,wild animal infection,and O.hupensis into the surveillance-response system will ensure the elimination of schistosomiasis in China by 2030.

Social insights on the implementation of One Health in zoonosis prevention and control: a scoping review

Background:The One Health (OH) concept has been promoted widely around the globe. OH framework is expected to be applied as an integrated approach to support addressing zoonotic diseases as a significant global health issue and to improve the efficiency and effectiveness of zoonosis prevention and control. This review is intended to overview the social impact of the implementation of OH on zoonosis prevention and control.Methods:A scoping review of studies in the past 10 years was performed to overview the integration feature of OH in zoonosis prevention and control and the social impacts of OH. PubMed and Web of Science were searched for studies published in English between January 2011 and June 2021. The included studies were selected based on predefined criteria.Results:Thirty-two studies were included in this review, and most of them adopted qualitative and semi-qualitative methods. More than 50% of the studies focused on zoonosis prevention and control. Most studies were conducted in low- and middle-income countries in Africa and Asia. Applying OH approach in diseases control integrates policymakers, stakeholders, and academics from various backgrounds. The impact of OH on economic is estimated that it may alleviate the burden of diseases and poverty in the long term, even though more financial support might be needed at the initial stage of OH implementation. OH implementation considers social and ecological factors related to zoonosis transmission and provides comprehensive strategies to assess and address related risks in different communities according to regions and customs.Conclusions:Based on reviewed literature, although there seems to be a lack of guidelines for assessing and visualizing the outcomes of OH implementation, which may limit the large-scale adoption of it, evidence on the contributions of implementing OH concepts on zoonosis prevention and control indicates long-term benefits to society, including a better integration of politics, stakeholders and academics to improve their cooperation, a potential to address economic issues caused by zoonosis, and a comprehensive consideration on social determinants of health during zoonosis prevention and control.

Establishment of an indicator framework for global One Health Intrinsic Drivers index based on the grounded theory and fuzzy analytical hierarchy-entropy weight method

Background:One Health has become a global consensus to deal with complex health problems.However,the pro‑gress of One Health implementation in many countries is still relatively slow,and there is a lack of systematic evalua‑tion index.The purpose of this study was to establish an indicator framework for global One Health Intrinsic Drivers index(GOH-IDI)to evaluate human,animal and environmental health development process globally.Method:First,82 studies were deeply analyzed by a grounded theory(GT)method,including open coding,axial coding,and selective coding,to establish a three-level indicator framework,which was composed of three selective codes,19 axial codes,and 79 open codes.Then,through semi-structured interviews with 28 health-related experts,the indicators were further integrated and simplifed according to the inclusion criteria of the indicators.Finally,the fuzzy analytical hierarchy process combined with the entropy weight method was used to assign weights to the indi‑cators,thus,forming the evaluation indicator framework of human,animal and environmental health development process.Results:An indicator framework for GOH-IDI was formed consisting of three selective codes,15 axial codes and 61 open codes.There were six axial codes for“Human Health”,of which“Infectious Diseases”had the highest weight(19.76%)and“Injuries and Violence”had the lowest weight(11.72%).There were four axial codes for“Animal Health”,of which“Animal Epidemic Disease”had the highest weight(39.28%)and“Animal Nutritional Status”had the low‑est weight(11.59%).Five axial codes were set under“Environmental Health”,among which,“Air Quality and Climate Change”had the highest weight(22.63%)and“Hazardous Chemicals”had the lowest weight(17.82%).Conclusions:An indicator framework for GOH-IDI was established in this study.The framework were universal,balanced,and scientifc,which hopefully to be a tool for evaluation of the joint development of human,animal and environmental health in diferent regions globally.

Assessment of the Health-Related Quality of Life in Neurocysticercosis Patients in Hot Spot Areas—China,2017–2018

Summary What is already known about this topic?Neurocysticercosis is the most severe form of infection caused by ingesting cysticerci,the larval cysts of the pork tapeworm,Taenia solium.Approximately 50 million people worldwide have neurocysticercosis,which is the leading cause of acquired epilepsy in many endemic countries.What is added by this report?The health of neurocysticercosis patients can be seriously impaired,including through loss of mobility,inability to do self-care,impairment of usual activities,pain/discomfort,anxiety/depression,and impaired cognition.Cognitive impairment is the major consequence of neurocysticercosis and significant contributor to decreased health-related quality of life.Our study made the first estimate of disability weight from neurocysticercosis as a key parameter for disease burden assessment in China.What are the implications for public health practice?To prevent severe health outcomes from neurocysticercosis in China,it is necessary to improve public awareness of neurocysticercosis and relevant health behaviors.