Background:The development of agenda for global schistosomiasis elimination as a public health problem generates enthusiasms among global health communities,motivating great interests in both research and practice.Rec...Background:The development of agenda for global schistosomiasis elimination as a public health problem generates enthusiasms among global health communities,motivating great interests in both research and practice.Recent China-Africa schistosomiasis control initiatives,aiming to enhance collaboration on disease control in African countries,reflect in part that momentum.Yet there is a pressing need to know whether the Chinese experiences can be translated and applied in African settings.Main body:China’s remarkable achievements in schistosomiasis control programme,associated experiences and lessons,have much to offer to those combating the disease.Central to the success of China’s control programmes is a strategy termed“integrated control”-integrating environmental approaches(e.g.improved sanitation,agricultural and hydrological development and management),which target different phases of the parasite transmission system,to chemical-based drug treatment and mollusciciding.Yet,despite significant measurable public health benefits,such integration is usually based on field experience and remains largely uncharacterized in an ecological context.This has limited our knowledge on relative contributions of varying components of the integrated control programme to the suppression of disease transmission,making it challenging to generalize the strategy elsewhere.In this opinion article,we have described and discussed these challenges,along with opportunities and research needs to move forward.Conclusions:There is an urgent need to formalize an ecological framework for the integrated control programme that would allow research towards improved mechanistic understanding,quantification,and prediction of the control efforts.展开更多
Background:Historically,the target in the schistosomiasis control has shifted from infection to morbidity,then back to infection,but now as a public health problem,before moving on to transmission control.Currently,al...Background:Historically,the target in the schistosomiasis control has shifted from infection to morbidity,then back to infection,but now as a public health problem,before moving on to transmission control.Currently,all endemic countries are encouraged to increase control efforts and move towards elimination as required by the World Health Organization(WHO)roadmap for the global control of the neglected tropical diseases(NTDs)and the WHA65.21 resolution issued by the World Health Assembly.However,schistosomiasis prevalence is still alarmingly high and the global number of disability-adjusted life years(DALYs)due to this infection has in fact increased due to inclusion of some‘subtle’clinical symptoms not previously counted.Main body:There is a need to restart and improve efforts to reach the elimination goal.To that end,the first conference of the Global Schistosomiasis Alliance(GSA)Research Working Group was held in mid-June 2016 in Shanghai,People’s Republic of China.It reviewed current progress in schistosomiasis control and elimination,identified pressing operational research gaps that need to be addressed and discussed new tools and strategies required to make elimination a reality.The articles emanating from the lectures and discussions during this meeting,together with some additional invited papers,have been collected as a special issue of the‘Infectious Diseases of Poverty’entitled‘Schistosomiasis Research:Providing the Tools Needed for Elimination’,consisting of 26 papers in all.This paper refers to these papers and discusses critical questions arising at the conference related to elimination of schistosomiasis.Conclusion:The currently most burning questions are the following:Can schistosomiasis be eliminated?Does it require better,more highly sensitive diagnostics?What is the role of preventive chemotherapy at the elimination stage?Is praziquantel sufficient or do we need new drugs?Contemplating these questions,it is felt that the heterogeneity of the endemic areas in the world requires WHO policies to be upgraded instituting new,differentiated guidelines.展开更多
Background Fine-scale mapping of schistosomiasis to guide micro-targeting of interventions will gain importance in elimination settings,where the heterogeneity of transmission is often pronounced.Novel mobile applicat...Background Fine-scale mapping of schistosomiasis to guide micro-targeting of interventions will gain importance in elimination settings,where the heterogeneity of transmission is often pronounced.Novel mobile applications offer new opportunities for disease mapping.We provide a practical introduction and documentation of the strengths and shortcomings of GPS-based household identification and participant recruitment using tablet-based applications for fine-scale schistosomiasis mapping at sub-district level in a remote area in Pemba,Tanzania.Methods A community-based household survey for urogenital schistosomiasis assessment was conducted from November 2020 until February 2021 in 20 small administrative areas in Pemba.For the survey,1400 housing structures were prospectively and randomly selected from shapefile data.To identify pre-selected structures and collect survey-related data,field enumerators searched for the houses’geolocation using the mobile applications Open Data Kit(ODK)and MAPS.ME.The number of inhabited and uninhabited structures,the median distance between the pre-selected and recorded locations,and the dropout rates due to non-participation or non-submission of urine samples of sufficient volume for schistosomiasis testing was assessed.Results Among the 1400 randomly selected housing structures,1396(99.7%)were identified by the enumerators.The median distance between the pre-selected and recorded structures was 5.4 m.A total of 1098(78.7%)were residential houses.Among them,99(9.0%)were dropped due to continuous absence of residents and 40(3.6%)households refused to participate.In 797(83.1%)among the 959 participating households,all eligible household members or all but one provided a urine sample of sufficient volume.Conclusions The fine-scale mapping approach using a combination of ODK and an offline navigation application installed on tablet computers allows a very precise identification of housing structures.Dropouts due to non-residential housing structures,absence,non-participation and lack of urine need to be considered in survey designs.Our findings can guide the planning and implementation of future household-based mapping or longitudinal surveys and thus support micro-targeting and follow-up of interventions for schistosomiasis control and elimination in remote areas.展开更多
基金This work was supported by the National Key Research and Development Program of China(No.2016YFC1202001)the International Development Research Center(IDRC)+2 种基金Canada(grant No.108100–001)as well as by the China-UK Global Health Support Programme funded by UK DFID(fund code:GHSP-CS-OP4-D02)Song Liang is supported in part by the National Institutes of Health grant R01AI125842Eniola Michael Abe and Xiao-Nong Zhou were financially supported by the Fourth Round of Three-Year Public Health Action Plan(2015–2017)in Shanghai(grant No.GWTD2015S06).
文摘Background:The development of agenda for global schistosomiasis elimination as a public health problem generates enthusiasms among global health communities,motivating great interests in both research and practice.Recent China-Africa schistosomiasis control initiatives,aiming to enhance collaboration on disease control in African countries,reflect in part that momentum.Yet there is a pressing need to know whether the Chinese experiences can be translated and applied in African settings.Main body:China’s remarkable achievements in schistosomiasis control programme,associated experiences and lessons,have much to offer to those combating the disease.Central to the success of China’s control programmes is a strategy termed“integrated control”-integrating environmental approaches(e.g.improved sanitation,agricultural and hydrological development and management),which target different phases of the parasite transmission system,to chemical-based drug treatment and mollusciciding.Yet,despite significant measurable public health benefits,such integration is usually based on field experience and remains largely uncharacterized in an ecological context.This has limited our knowledge on relative contributions of varying components of the integrated control programme to the suppression of disease transmission,making it challenging to generalize the strategy elsewhere.In this opinion article,we have described and discussed these challenges,along with opportunities and research needs to move forward.Conclusions:There is an urgent need to formalize an ecological framework for the integrated control programme that would allow research towards improved mechanistic understanding,quantification,and prediction of the control efforts.
基金XN Zhou was supported by the National Special Science and Technology Project for Major Infectious Diseases of China(2016ZX10004222-004)the Fourth Round of Three-Year Public Health Action Plan of Shanghai,China(No.15GWZK0101,GWIV-29)The funders had no role in study design,data collection and analysis,decision to publish,or preparation of the manuscript。
文摘Background:Historically,the target in the schistosomiasis control has shifted from infection to morbidity,then back to infection,but now as a public health problem,before moving on to transmission control.Currently,all endemic countries are encouraged to increase control efforts and move towards elimination as required by the World Health Organization(WHO)roadmap for the global control of the neglected tropical diseases(NTDs)and the WHA65.21 resolution issued by the World Health Assembly.However,schistosomiasis prevalence is still alarmingly high and the global number of disability-adjusted life years(DALYs)due to this infection has in fact increased due to inclusion of some‘subtle’clinical symptoms not previously counted.Main body:There is a need to restart and improve efforts to reach the elimination goal.To that end,the first conference of the Global Schistosomiasis Alliance(GSA)Research Working Group was held in mid-June 2016 in Shanghai,People’s Republic of China.It reviewed current progress in schistosomiasis control and elimination,identified pressing operational research gaps that need to be addressed and discussed new tools and strategies required to make elimination a reality.The articles emanating from the lectures and discussions during this meeting,together with some additional invited papers,have been collected as a special issue of the‘Infectious Diseases of Poverty’entitled‘Schistosomiasis Research:Providing the Tools Needed for Elimination’,consisting of 26 papers in all.This paper refers to these papers and discusses critical questions arising at the conference related to elimination of schistosomiasis.Conclusion:The currently most burning questions are the following:Can schistosomiasis be eliminated?Does it require better,more highly sensitive diagnostics?What is the role of preventive chemotherapy at the elimination stage?Is praziquantel sufficient or do we need new drugs?Contemplating these questions,it is felt that the heterogeneity of the endemic areas in the world requires WHO policies to be upgraded instituting new,differentiated guidelines.
文摘Background Fine-scale mapping of schistosomiasis to guide micro-targeting of interventions will gain importance in elimination settings,where the heterogeneity of transmission is often pronounced.Novel mobile applications offer new opportunities for disease mapping.We provide a practical introduction and documentation of the strengths and shortcomings of GPS-based household identification and participant recruitment using tablet-based applications for fine-scale schistosomiasis mapping at sub-district level in a remote area in Pemba,Tanzania.Methods A community-based household survey for urogenital schistosomiasis assessment was conducted from November 2020 until February 2021 in 20 small administrative areas in Pemba.For the survey,1400 housing structures were prospectively and randomly selected from shapefile data.To identify pre-selected structures and collect survey-related data,field enumerators searched for the houses’geolocation using the mobile applications Open Data Kit(ODK)and MAPS.ME.The number of inhabited and uninhabited structures,the median distance between the pre-selected and recorded locations,and the dropout rates due to non-participation or non-submission of urine samples of sufficient volume for schistosomiasis testing was assessed.Results Among the 1400 randomly selected housing structures,1396(99.7%)were identified by the enumerators.The median distance between the pre-selected and recorded structures was 5.4 m.A total of 1098(78.7%)were residential houses.Among them,99(9.0%)were dropped due to continuous absence of residents and 40(3.6%)households refused to participate.In 797(83.1%)among the 959 participating households,all eligible household members or all but one provided a urine sample of sufficient volume.Conclusions The fine-scale mapping approach using a combination of ODK and an offline navigation application installed on tablet computers allows a very precise identification of housing structures.Dropouts due to non-residential housing structures,absence,non-participation and lack of urine need to be considered in survey designs.Our findings can guide the planning and implementation of future household-based mapping or longitudinal surveys and thus support micro-targeting and follow-up of interventions for schistosomiasis control and elimination in remote areas.
