Schistosomiasis japonica,caused by the human blood fluke Schistosoma japonicum,remains a major public health problem in China,although great success has been achieved.The control efforts during the past half-decade,no...Schistosomiasis japonica,caused by the human blood fluke Schistosoma japonicum,remains a major public health problem in China,although great success has been achieved.The control efforts during the past half-decade,notably the wide implementation of the new integrated strategy with emphasis on control of the source of S.japonicum infection across the country since 2004,has greatly reduced S.japonicum in humans,livestock,and intermediate host Oncomelania hupensis snails,and transmission control of schistosomiasis was achieved in China in 2015.A two-stage roadmap was therefore proposed for schistosomiasis elimination in 2015,with aims to achieve transmission interruption by 2020 and achieve disease elimination by 2025 in the country.During the last two decades,a variety of approaches,which target the epidemiological factors of schistosomiasis japonica have been developed,in order to block the transmission cycle of the parasite.These approaches have been employed in the national or local schistosomiasis control activities,and facilitated,at least in part,the progress of the schistosomiasis elimination programs.Here,we present an approach to control the source of S.japonicum infection,three new tools for snail control,three approaches for detecting and monitoring S.japonicum infection,and a novel model for health education.These approaches are considered to play a great role in the stage moving towards transmission interruption and elimination of schistosomiasis in China.展开更多
Background:The prevalence of schistosomiasis japonica has decreased significantly,and the responses changing from control to elimination in Jiangsu Province,P.R.China.How to estimate the change in prevalence of schist...Background:The prevalence of schistosomiasis japonica has decreased significantly,and the responses changing from control to elimination in Jiangsu Province,P.R.China.How to estimate the change in prevalence of schistosomiasis using only serological data will be important and useful.Methods:We collected serum samples from 2011 to 2015 to build a serum bank from Dantu County of Jiangsu,China.Serum samples were detected by enzyme-linked immunosorbent assay(ELISA),the positive rate and optical density(OD)value were obtained.The Bayesian model including the prior information of sensitivity and specificity of ELISA was established,and the estimated infection rates were obtained for different years,genders and age groups.Results:There was no significant difference in the mean OD between different years and genders,but there was a significant difference between the different age groups.There were statistically significant differences in the positive rate for different years and age groups,but no significant difference at different genders.The estimated infection rate for the five years was 1.288,1.456,1.032,1.485 and 1.358%,respectively.There was no significant difference between different years and between genders,but a significant difference between different age groups.Conclusions:The risk of schistosomiasis transmission in this area still exists,and risk monitoring of schistosomiasis should be strengthened.展开更多
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 implementati...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 148902 residents from sentinel sites attended this study and 631676 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%(56884/335391,95%CI:16.83–17.09%)in 2005 to 4.28%(18121/423755,95%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%(663/256531,95%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.展开更多
基金This study was supported by the grants from the China UK Global Health Support Programme(grant no.GHSP-OP202)National S&T Major Program(grant no.2012ZX10004-220)+3 种基金National Science&Technology Pillar Program of China(grant no.2009BAI78B06)Shanghai Public Health 3-Year Action Plan(grant no.15GWZK0101)Jiangsu Provincial Science&Technology Project(grant no.BL2014021),Jiangsu Provincial Young Talents in Medical Sciences(grant no.QNRC2016621)Jiangsu Department of Health(grant nos.Q201404 and X201410)。
文摘Schistosomiasis japonica,caused by the human blood fluke Schistosoma japonicum,remains a major public health problem in China,although great success has been achieved.The control efforts during the past half-decade,notably the wide implementation of the new integrated strategy with emphasis on control of the source of S.japonicum infection across the country since 2004,has greatly reduced S.japonicum in humans,livestock,and intermediate host Oncomelania hupensis snails,and transmission control of schistosomiasis was achieved in China in 2015.A two-stage roadmap was therefore proposed for schistosomiasis elimination in 2015,with aims to achieve transmission interruption by 2020 and achieve disease elimination by 2025 in the country.During the last two decades,a variety of approaches,which target the epidemiological factors of schistosomiasis japonica have been developed,in order to block the transmission cycle of the parasite.These approaches have been employed in the national or local schistosomiasis control activities,and facilitated,at least in part,the progress of the schistosomiasis elimination programs.Here,we present an approach to control the source of S.japonicum infection,three new tools for snail control,three approaches for detecting and monitoring S.japonicum infection,and a novel model for health education.These approaches are considered to play a great role in the stage moving towards transmission interruption and elimination of schistosomiasis in China.
基金This project was supported by the National S&T Major Program(grant no.2012ZX10004220)Project of National Natural Science Foundation of China(No.81101275)Capacity improvement project of Jiangsu Public Welfare Institute(No.BM2015024).
文摘Background:The prevalence of schistosomiasis japonica has decreased significantly,and the responses changing from control to elimination in Jiangsu Province,P.R.China.How to estimate the change in prevalence of schistosomiasis using only serological data will be important and useful.Methods:We collected serum samples from 2011 to 2015 to build a serum bank from Dantu County of Jiangsu,China.Serum samples were detected by enzyme-linked immunosorbent assay(ELISA),the positive rate and optical density(OD)value were obtained.The Bayesian model including the prior information of sensitivity and specificity of ELISA was established,and the estimated infection rates were obtained for different years,genders and age groups.Results:There was no significant difference in the mean OD between different years and genders,but there was a significant difference between the different age groups.There were statistically significant differences in the positive rate for different years and age groups,but no significant difference at different genders.The estimated infection rate for the five years was 1.288,1.456,1.032,1.485 and 1.358%,respectively.There was no significant difference between different years and between genders,but a significant difference between different age groups.Conclusions:The risk of schistosomiasis transmission in this area still exists,and risk monitoring of schistosomiasis should be strengthened.
基金This study was financially supported by the Natural Science Foundation of China(No.30590373)the National Special Science and Technology Project for Major Infectious Diseases of China(No.2012ZX10004–220,2016YFC1202000).
文摘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 148902 residents from sentinel sites attended this study and 631676 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%(56884/335391,95%CI:16.83–17.09%)in 2005 to 4.28%(18121/423755,95%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%(663/256531,95%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.
