Addressing schistosomiasis in the Philippines:Need for a coordinated intersectoral effort

The World Health Organization(WHO)recognized schistosomiasis as one of the neglected tropical diseases(NTDs)caused by parasitic blood flukes.With a 4.68%national prevalence in 2017,schistosomiasis is endemic in 28 provinces in the Philippines[1,2].Having agriculture as a common source of livelihood,the country is vulnerable to schistosomiasis as this disease is transmitted when a larva,released by freshwater snails,penetrates the skin of a susceptible individual.In fact,it was estimated that 12.4 million Filipinos are at risk,while 2.7 million are directly exposed to the parasite[2].This remains to be a major public health concern as it contributes to a considerable morbidity and mortality.In children,this disease causes malnutrition and impaired cognitive development.Globally,schistosomiasis as an NTD puts the burden on poverty-stricken areas,especially in low-and middle-income countries,exacerbating the health inequality within a country and across the globe.

Prevalence and intensity of urinary schistosomiasis and soil-transmitted helminths among women of reproductive age in Mwaluphamba,Kwale

Objective:To assess the epidemiology of urinary schistosomiasis and soil-transmitted helminthiasis among women of reproductive age in Mwaluphamba,Kwale County,Kenya.Methods:A community-based cross-sectional study design was employed to randomly sample 422 women of reproductive age(15-<50 years)from four villages in Mwaluphamba location.Stool specimens were collected and examined using the Kato-Katz method,while filtration technique was used to analyze urine specimens.Participants’sociodemographic details were obtained using a standardized questionnaire.Results:Urinary schistosomiasis prevalence was at 4.7%(20/422,95%CI 2.8%-6.9%)while the prevalence of soil-transmitted helminthiasis infection was 4.5%(19/422,95%CI 2.6%-6.7%).The infection intensities of urinary schistosomiasis among the study participants ranged from 1 to 120 eggs/10 mL of urine with median egg count of 18.45 eggs/10 mL.The patients were diagnosed with light infection,of 56.16 egg/gram and 48.48 egg/gram for Trichuris trichiura and hookworms,respectively.Women without latrines had 15.7 times higher risk of having urinary schistosomiasis compared to those with a latrine.Similarly,use of surface water(aOR=1.0,95%CI 0.2-1.4,P=0.010)and crossing the river to go to a place(aOR=1.1,95%CI 0.3-1.6,P=0.009)were statistically significant risk factors for getting urinary schistosomiasis.In bivariable regression analysis,defecating around the water source(OR=4.3,95%CI 1.5-12.9)had a statistically significant association with the prevalence of soil-transmitted helminthiasis(P=0.008).Conclusions:This study has given an insight on the prevalence and intensity of urinary schistosomiasis and soil-transmitted helminthiasis in Mwaluphamba location that form a basis for strengthening the control and elimination programmes for these neglected tropical diseases.

Colonic schistosomiasis mimicking cancer,polyp,and inflammatory bowel disease:Five case reports and review of literature

BACKGROUND Schistosomiasis,officially named as a neglected tropical disease by The World Health Organization,is a serious parasitic disease caused by trematode flukes of the genus Schistosoma.It is a common infectious disease,endemic in more than 78 countries.The disease can involve various organs and poses far-reaching public health challenges.CASE SUMMARY Here,we present a series of five patients with variable presentations:an asymptomatic patient who was diagnosed with colonic schistosomiasis upon screening colonoscopy;2 patients with clinical suspicion of colonic cancer;and 2 patients with a clinical diagnosis of inflammatory bowel disease.All patients were subsequently confirmed to have colonic schistosomiasis after colonoscopy and histopathologic examination.The clinical manifestations,colonoscopy features and histologic findings of the patients are described.Most of the patients showed significant clinical improvement following administration of oral praziquantel.CONCLUSION Intestinal schistosomiasis can present with features mimicking other gastrointestinal conditions.This disease should be a diagnostic consideration in patients who live in or have traveled to endemic areas.

Epidemiological, Clinical and Therapeutic Aspects of Bladder Tumors in a Schistosomiasis-Endemic Country

Introduction: Bladder tumors are common in our country;Mali is a bilharzial endemic country. In our context, urinary bilharzia is common, and bladder tumors arouse particular interest in the field of urological oncology, because of their frequency, their diagnosis, their difficulty in management and their histological particularity. The objective of our work was to study the epidemiological, clinical and therapeutic aspects of bladder tumors. Materials and Methods: This is a cross-sectional, descriptive study with a retrospective and prospective collection that took place over 3 years from January 1, 2020 to December 31, 2022. Results: We identified 316 cases of bladder tumors during this period. Bladder tumors are a common pathology representing 35.95% of all hospitalized patients, and occupying the 1st rank of tumors in urology in the Urology Department of the Pr Bocar Sidy Sall University Hospital in Kati. Bladder tumors were more common in men with 56.33%. The average age of our patients was 50 years ± 25.8 years and the extreme ages were 20 and 87 years. Urinary schistosomiasis, considered a predisposing factor, was found in 66.78% of cases in our patients as a history. Transurethral resection of the bladder was performed in 100% of our patients, nephrostomy in 1.90% of cases, ureterostomy in 1.58% of cases, Bricker type urinary diversion in 1.27% of cases, and a neobladder in 0.32% of cases. Squamous cell carcinoma is the dominant histological type (88.29%). The postoperative outcome was 99% favorable after resection. Conclusion: Bladder tumors were mainly tumors infiltrating the bladder muscle. The main risk factor was urinary bilharzia. Squamous cell carcinoma is the most common histological type with a diagnostic delay, thus limiting radical treatment after resection of the bladder tumor.

Endoscopic findings and clinicopathologic characteristics of colonic schistosomiasis:A report of 46 cases

AIM:To make a retrospective analysis of endoscopy findings and clinicopathologic characteristics of colonic schistosomiasis in order to further improve our understanding of the disease and decrease its misdiagnosis. METHODS:Endoscopy findings and clinicopathologic characteristics of 46 intestinal schistosomiasis patients were retrospectively analyzed.All the patients underwent colonoscopy and all biopsy specimens stained with hematoxylin and eosin were observed under a light microscope. RESULTS:Of the 46 colonic schistosomiasis patients,1 was diagnosed as acute schistosomal colitis,16 as chronic schistosomal colitis and 29 as chronic active schistosomal colitis according to their endoscopic findings and pathology.Not all patients were suspected of or diagnosed as colonic schistosomiasis.Of the 12 misdiagnosed patients,4 were misdiagnosed as ulcerativecolitis,1 as Crohn's disease,and 7 as ischemic colitis.The segments of rectum and sigmoid colon were involved in 29 patients(63.0%) .Intact Schistosoma ova were deposited in colonic mucosa accompanying infiltration of eosinocytes,lymphocytes,and plasma cells in acute schistosomal colitis patients.Submucosal fibrosis was found in chronic schistosomal colitis patients.Among the 17 patients with a signal polyp,hyperplastic polyp,canalicular adenoma with a low-grade intraepithelial neoplastic change,tubulovillous adenoma with a highgrade intraepithelial neoplastic change were observed in 10,5,and 2 patients,respectively.Eight out of the 46 patients were diagnosed as colonic carcinoma. CONCLUSION:Endoscopy contributes to the diagnosis of colonic schistosomiasis although it is nonspecific. A correct diagnosis of colonic schistosomiasis can be established by endoscopy in combination with its clinicopathologic characteristics.

Infection of Schistosomiasis japanicum is likely to enhance proliferation and migration of human breast cancer cells:mechanism of action of differential expression of MMP2 and MMP9

Objective:To study whether the infection of Schistosomiasis japanicum(S.japanicum) is related to enhanced proliferation and migration of cancer cells,and the molecular mechanism pertains to cancer cell metastasis in human host.Methods:The gene of S.japanicum glutathione transferase(sjGST) cloned from 5.japanicum was expressed,purified and applied in a series of assays to explore the effect of sjGST on proliferation and migration of MDA-MB-435S,and the expression of MMP2 and MMP9.Immunofluorescence assay for the binding of sjGST to MDA-MB-435S was also carried out.Results:Results showed that sjGST enhanced proliferation and migration in human breast cancer cell MDA-MB-435S signifycantly at 50-200 nM,but did not enhance them in human lung cancer cell A549.Immunofluorescence assay for the binding of sjGST to MDA-MB-435S and A549 showed that GST was readily hound to the breast cancer cells,but showed almost no binding to human lung cancer cells.The assays for gelatinase activity showed that both MMP2 and MMP9 activities were increased significantly in the presence of sjGST(50-200 nM) in MDA-MB-435S, but they were not significant in A549.Conclusions:Our current results show strongly that S. japanicum GST binds to MDA-MB-435S probably via its i'eceptor,and enhances proliferation and migration of the cancer cells by up-regulatory expression of MMP2 and MMP9.

Effects of in vitro cultivated Calculus Bovis compound on pulmonary lesions in rabbits with schistosomiasis

AIM:To explore the interventional effects and mechanism of in vitro cultivated Calculus Bovis compound preparation(ICCBco) on pulmonary lesions in portal hypertensive rabbits with schistosomiasis. METHODS:The experimental group included 20 portal hypertensive rabbits with schistosomiasis treated by ICCBco.The control group included 20 portal hypertensive rabbits with schistosomiasis treated by praziquantel. The morphological changes of the pulmonary tissues were observed under light and electron microscopy.The expression of fibronectin(FN) and laminin(LN) in the lung tissues was analyzed by immunohistochemistry. RESULTS:Under light microscope,the alveolar exudation in the lung tissue was more frequently observed in the control group,while the alveolar space was fairly dry in the lung tissue of ICCBco group.Under electron microscope,more alveolar exudation in the lung tissue,and moremacrophages,alveolar angiotelectasis and the blurred three-tier structure of alveolar-capillary barrier could be seen in the control group.In ICCBco group,fibers within the alveolar interspace slightly increased in some lung regions,and the structure of typeⅠepithelium,basement membrane and endodermis was complete,and no obvious exudation from the alveolar space,and novascular congestion could be observed.There was a positive or strong positive expression of FN and LN in the lung tissue of the control group,while there was a negative or weak positive expression of FN and LN in ICCBco group. CONCLUSION:ICCBco can effectively prevent pulmonary complications in portal hypertensive rabbits with schistosomiasis by means of improving lung microcirculation and lowering the content of extracellular matrix.

Effects of propranolol or propranolol plus isosorbide-5-mononitrate on variceal pressure in schistosomiasis

AIM: To compare the effects of propranolol (PR) to that of PR plus isosorbide-5-mononitrate (ISMN) on variceal pressure in patients with schistosomiasis. METHODS: Forty-eight patients with schistosomiasis who had no previous variceal bleeding were treated with PR alone or PR plus ISMN. Seven patients refused variceal pressure manometry (3 receiving PR and 4 receiving PR plus ISMN). One patient withdrew from the trial due to headache after taking ISMN. At the time of termination, twenty patients were randomly assigned to treatment with PR plus ISMN or PR alone. The dose of PR was adjusted until the resting heart rate had been reduced by 25% or was less than 55 bpm. In the PR plus ISMN group, after PR was titrated to the same target, the dose of ISMN was increased up to 20 mg orally twice a day. Variceal pressure was measured using a noninvasive endoscopic balloon technique at the end of the 6-mo treatment period. RESULTS: In 40 patients (20 in the PR group and 20 in the PR plus ISMN group), variceal pressure was measured before treatment and at the end of the 6-mo treatment period. PR or PR plus ISMN treatment caused a significant reduction in variceal pressure (PR group: from 24.15 ± 6.05 mmHg to 22.68 ± 5.70 mmHg, P = 0.001; PR plus ISMN group: from 25.69 ± 5.26 mmHg to 20.48 ± 5.43 mmHg; P < 0.001). The percentage decrease in variceal pressure was significant after PR plus ISMN compared with that after PR alone (15.93% ± 8.37% vs 6.05% ± 3.67%, P = 0.01). One patient in the PR plus ISMN group and two patients in the PR group had variceal bleeding during follow-up. There were no significant differences between the two groups regarding the incidence of variceal bleeding. In the PR plus ISMN group, three patients had headache and hypotension. The headache was mild and transient and promptly disappeared after continuation of the relevant drug in two patients. Only one patient withdrew from the trial due to severe and lasting headache after taking ISMN. No side effects occurred in the PR group. CONCLUSION: PR plus ISMN therapy may be an alternative treatment for patients with schistosomiasis who have a high risk of bleeding.

Aspartate transaminase to platelet ratio index in hepatitis C virus and Schistosomiasis coinfection

AIM: To assess the diagnostic accuracy,of aminotransferase-to-platelet ratio index(APRI) alone and with antischistosomal antibody(Ab) in patients with hepatitis C virus(HCV) and schistosomiasis coinfection. METHODS: This retrospective study included medical records of three hundred and eighty three Egyptianmen patients who had undergone percutaneous liver biopsy between January 2006 to April 2014 in tertiary care hospital in Qatar for diagnosis or monitoring purpose were selected. Data of patients > 18 years of age were included in the study. The values of HCV RNA titer and antischistosomal antibody titer were also taken into consideration. Patients were excluded from the study if they had any other concomitant chronic liver disease,including; history of previous antiviral or interferon therapy,immunosuppressive,therapy,chronic hepatitis B infection,human immunodeficiency virus co-infection,autoimmune hepatitis,decompensated liver disease,hepatocellular carcinoma,prior liver transplantation,and if no data about the liver biopsy present. RESULTS: Median age of patients was 46 years. About 7.1% had no fibrosis,whereas 30.4%,37.5%,20.4%,and 4.6% had fibrosis of stage Ⅰ,Ⅱ,Ⅲ,and Ⅳ respectively. In bivariate analysis,APRI score,levels of AST,platelet count and age of patient showed statistically significant association with liver fibrosis(P < 0.0001); whereas antischistosomal antibody titer(P = 0.52) and HCV RNA titer(P = 0.79) failed to show a significant association. The respective AUC values for no fibrosis,significant fibrosis,severe fibrosis and cirrhosis of APRI score were 63%,73.2%,81.1% and 88.9% respectively. This showed good sensitivity and specificity of APRI alone for grading of liver fibrosis. But the inclusion of anti-Schistosoma antibody did not improve the prediction of fibrosis stage. CONCLUSION: The study results suggest that noninvasive biochemical markers like APRI are sensitive and specific in diagnosing the degree of fibrosis and cirrhosis in patients with coinfection of HCV and schistosomiasis as compared to biopsy. The addition of antischistosomal Ab to APRI did not improve sensitivity for predicting the degree of cirrhosis.

Effect of Chinese herbal compound on liver fibrosis in rabbits with schistosomiasis by B-ultrasound

Objective: To explore the value of B-ultrasound on the evaluation of the effects of traditional Chinese medicine compound of Radix astragali , Salvia miltiorrhiza and Angelica sinensis , and TCM + praziquantel on liver fibrosis in rabbits with schistosomiasis. Methods: The hepatic fibrosis model in rabbits with schistosomiasis was established. The experimental animals (24 rabbits) were randomly divided into four groups (group A, B, C and D, n =6). Group A (control group) was only treated by praziquantel; Group B was treated by mixture of Radix astragali and Salvia miltiorrhiza + praziquantel; Group C was treated by mixture of Radix astragali and Angelica sinensis + praziquantel; Group D was treated by mixture of Radix astragali, Salvia miltiorrhiza and Angelica sinensis + praziquantel. Then B-ultrasonogram was used to evaluate the effects. Results: Each group showed certain curative effect on liver fibrosis in rabbits with schistosomiasis. The efficacy of group B, C and D was better than group A, and that of group D was the best. The differences in long diameter, thickness diameter, transverse diameter and portal vein inner diameter of liver before and after treatment were statistically significant ( P <0.05). The liver function indexes and liver fibrosis indexes were significantly improved after treatment ( P <0.05). Conclusions: The mixture of Radix astragali, Salvia miltiorrhiza and Angelica sinensis combined with Western medicine treatment can obviously improve the efficacy on liver fibrosis of schistosomiasis.

Experimental evaluation of Candonocypris novaezelandiae(Crustacea:Ostracoda) in the biocontrol of Schistosomiasis mansoni transmission

Objective:To test Candonocypris novaezelandiae(Baird)(C.novaezelandiae),sub-class Ostracoda,obtained from the Nile,Egypt for its predatory activity on snail,Biomphalaria alexandrina(B.alexandrina),intermediate host of Schistosoma mansoni(S.mansoni)and on the free-living larval stages of this parasite(miracidia and cercariae).Methods:The predatory activity of C.novaezelandiae was determined on B.alexandrina snail(several densities of eggs,newly hatched and juveniles).This activity was also determined on S.mansoni miracidia and cercariae using different volumes of water and different numbers of larvae.C.novaezelandiae was also tested for its effect on infection of snails and on the cercarial production.Results:C.novaezelandiae was found to feed on the eggs,newly hatched and juvenile snails,but with significant reduction in the consumption in the presence of other diet like the blue green algae(Nostoc muscorum).This ostracod also showed considerable predatory activity on the free-living larval stages of S.mansoni which was affected by certain environmental factors such as volume of water,density of C.novaezelandiae and number of larvae of the parasite.Conclusions:The presence of this ostracod in the aquatic habitat led to significant reduction of snail population,infection rate of snails with schistosme miracidia as well as of cercarial production from the infected snails.This may suggest that introducing C.novaezelandiae into the habitat at schistosome riskv sites could suppress the transmission of the disease.

Efficacy and side effects of praziquantel in the treatment of Schistosomiasis mansoni in schoolchildren in Shesha Kekele Elementary School,Wondo Genet,Southern Ethiopia

Objective:To evaluate the efficacy and side effects of praziquantel(PZQ) in the treatment of schistosomiasis in Ethiopia.Methods:In a cross-sectional study,stool specimens were collected from randomly selected 299 school children in Shesha Kekele Elementary School,Wondo Genet, Southern Ethiopia,in April 2010.Stool specimens were examined using a single Kato-Katz thick smear for Schistosoma mansoni(5.mansoni) ova.Children who were found positive for S.mansoni were treated with a single oral dose of PZQ at 40 mg/kg bw and interviewed for treatment-related symptoms 24 hours after drug administration.Four weeks post-treatment,stool specimens were collected from the same children and examined following the same procedure as in the pretreatment.Drug efficacy was determined based on cure and egg reduction rates.Results:Pretreatment prevalence of S.mansoni infection was 74.9%with geometric mean egg count of 268. The evaluated generic PZQ produced an overall cure rate of 73.6%(P<0.000 1,OR:8.33,CI:5.3-13.1) and egg reduction rate of 68.2%(P=0.03,F=0.64).The cure rate showed significant association with age(x^2=H,P=0.004),the highest rate being observed in the 15-22 age group.83%of S. mansoni infected children showed various treatment-related symptoms,the most frerjiient being headache,nausea,and abdominal pain.These symptoms were associated with age(P<0.001) and pre-treatment intensity of infection(P<0.05).Conclusions:The present observations revealed relatively lower cure and egg reduction rates of the PZQ evaluated as compared to previous reports for other PZQ brands in Ethiopia.Hence,in depth studies are recommended to clarify whether the present relatively lower cure rate is the actual cure rate of the praziquantel evaluated,treatment failure,or reduced susceptibility of the parasite.Treatment-related side effects observed were transient and tolerable.

CHARACTERISTIC MAGNETIC RESONANCE ENHANCEMENT PATTERN IN CEREBRAL SCHISTOSOMIASIS

Objective To describe the characteristic magnetic resonance imaging （MRI） appearance of cerebral schistosomiasis. Methods Twenty-five patients whose diagnosis of central nervous system （CNS） schistosomiasis had been pathologically （n = 8 ） and clinically （n = 17） confLrmed were randomly selected. MRI was performed on a Signal 1.5T MRI scanner before and after the intravenous administration of gadopentetate dimeghimine constrast medium. We reviewed the MRI studies obtained at the time of initial presentation, as well as follow-up studies obtained during and after medical treatment Results ImmunoLogicaL tests in L5 patients indicated schistosomiasis haematobium. Contrast-enhanced TL-weighted images in 22 cases showed central linear enhancement surrounded by multiple enhancing punctate nodules, which ap- peared “arborized”. Through operation and pathological examination, 8 cases had the granuloma formation of schistoso- mal eggs extensive surrounded by inflammation and venous congestion. And 17 cases were treated with praziquantel and corticosteroid therapy. And they were followed up for 2 months by taking MRI, which turned out to be complete resolution of the enhancing structure and edema. At follow-up, all the patients＇ initial symptoms also resolved. Conclnsion The specified MRI enhancement pattern of cerebral schistosomiasis is common in most cases of CNS schistosomiasis, so it should be taken account into the diagnosis of cerebral schistosomiasis.

Development of new lateral-flow immunochromatographic strip using colloidal gold and mesoporous silica nanoparticles for rapid diagnosis of active schistosomiasis

Objective: To develop a new sandwich based lateral flow immunochromatographic strip for rapid detection of circulating Schistosoma mansoni antigen in serum and urine samples of patients with active schistosomiasis. Methods: This lateral flow immunochromatographic strip was prepared by using anti-Schistosoma mansoni soluble egg antigen monoclonal antibody conjugated gold nanoparticles (MAb-AuNPs) as antigen-detecting antibody, while crystalline material (MCM)-41-MAb bioconjugate was immobilized at the test line as antigen-capturing antibody. Both antigen capturing and detecting antibodies formed sandwich complexes with circulating Schistosoma mansoni antigen in the positive samples. Sandwich complexes immobilized at the test line gave distinct red color. The assay reliability was examined by using urine and serum samples of 60 Schistosoma mansoni infected patients, 20 patients infected with parasites other than Schistosoma, and 20 healthy individuals as negative controls. Results were compared with those obtained via sandwich enzyme linked immunosorbent assay (ELISA). Results: The detection limit of circulating Schistosoma mansoni antigen by lateral flow immunochromatographic strip was lower (3 ng/mL) than the detection limit by ELISA (30 ng/mL). The sensitivity and specificity of lateral flow immunochromatographic strip in urine samples were 98.3% and 97.5%, respectively compared to 93.5% and 90.0% by ELISA. In serum samples, they were 100.0% and 97.5%, respectively compared to 97.0% and 95.0% by ELISA. The strip test took approximately 10 min to complete. Conclusions: This new lateral flow immunochromatographic strip offers a sensitive, rapid, and field applicable technique for diagnosis of active schistosomiasis.

Evidence of increasing risk of schistosomiasis among school-age children in municipality of Calatrava,Province of Negros Occidental,Philippines

Objective:To explore risk of school-age children being infected with schistosomiasis in selected villages in the municipality of Calatrava,province of Negros Occidental,Philippines.Methods:As part of the monitoring and evaluation of the helminth control program in the province of Negros Occidental,parasitological monitoring,through the use microscopy of stool samples processed using Kato-Katz technique,was conducted to describe the baseline and follow-up parasitological status of school-age children in 2010 and 2012.respectively.Seven villages from the municipality of Calatrava were selected as study sites.Results:During baseline assessment,only one case of schistosomiasis was reported from the village of Marcelo.During follow-up assessment,32 cases(6.9%) of schistosomiasis were reported and the prevalence of moderate-heavy intensity infection was 13% in six villages.Among the seven villages included in the follow-up,Minapasuk had the highest prevalence at 14.6%.while San Isidro reported no case of schistosomiasis.Conclusions:Non-endemic villages,which have reported positive cases in school-age children,may need to be assessed for possible cndemicity for schistosomiasis.Transmission of the disease may need to be determined in these villages through active parasitological and malacological surveillance.Other nonendemic villages adjacent to or share river networks with endemic villages in Calatrava may need to be explored for possible introduction of the disease,especially after typhoons and Hooding.Establishing endemicity for schistosomiasis in these villages will help infected and at risk individuals to receive yearly treatment to reduce morbidities caused by this disease.

Institution-based Network on China-Africa Cooperation for Schistosomiasis Elimination (INCAS): Driving schistosomiasis elimination in Africa

The burden of schistosomiasis remains a global public health problem,especially in sub-Saharan Africa despite progress in terms of morbidity control.Successful control efforts achieved by China in the last six decades came with considerable experience and lessons that could benefit schistosomiasis control programs in other endemic countries.China's role and commitment to global health cooperation has become increasingly important;this has created a platform for partnership with developing partners for the establishment of Forum on China-Africa health cooperation which prioritizes the pursuit of global elimination target for schistosomiasis and malaria,control of HIV/AIDS,and improved access to reproductive health care.Chinese government's commitment towards achieving schistosomiasis elimination in Africa prompted the establishment of Institution-based Network on China-Africa Cooperation for Schistosomiasis Elimination (INCAS),by the National Institute of Parasitic Diseases to promote schistosomiasis elimination in Africa.Schistosomiasis experts from six provincial institutions and counterparts from 10 African countries participated in the first workshop on China-Africa cooperation for Schistosomiasis Elimination in Africa at Lilongwe,Malawi,in 2015.Experts at the inaugural meeting shared experiences from their national schistosomiasis control programs,as well as identified areas for collaborative synergy targeting schistosomiasis elimination in Africa.The establishment of INCAS,which comprises of 28 member-institutions from China and Africa,was proposed at this meeting.We,therefore,provide information on INCAS activities,cooperation mechanism,as well as assess the strengths,weaknesses,opportunities,and threats as we target schistosomiasis elimination in Africa using the INCAS platform.

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.

Construction of a hepatic stellate cells subtracted cDNA library of differentially expressed genes in normal mice and mice with Schistosomiasis japonica

To construct a hepatic stellate cells (HSCs) subtracted cDNA library to find differentially expressed genes in normal mice and mice infected with Schistosoma japonicum (S. japonicum). Suppression subtractive hybridization (SSH) was used. The cDNA fragments of normal mouse were compared to those of schistosoma-infected mice to find differentially expressed genes. Then differentially expressed cDNA fragments were directly inserted into T/A cloning vector to set up the subtractive library. Amplification of the library was carried out with transformation of DH5α. The amplified library contained more than 400 positive bacterial clones, which were then hybridized with forward and backward subtracted probes for differential screening. One hundred positive bacterial clones were randomly selected for sequencing and BLAST analysis. Finally, virtual Northern Blot confirmed such differential expression. The subtracted cDNA library of differentially expressed genes of HSCs was constructed successfully, the library is efficient and lays foundation for screening and cloning new and specific genes of schistosomiasis.

Publication output of the new integrated strategy for schistosomiasis japonica control in China: a PubMed-based bibliometric assessment

Background:Although sustainable control since 1950s has achieved great successes,schistosomiasis japonica remains a major public health problem in China.Since 2004,a new integrated strategy was developed aiming to control the transmission of Schistosoma japonicum through the implementation of a package of interventions.To date,no systematic review or meta-analysis assessing the effectiveness of this new integrated strategy for schistosomiasis control in China has been published.We performed a PubMed-based bibliometric assessment of publications on the new integrated strategy for schistosomiasis japonica control in China,to understand the global transmissibility and sharing of the new integrated strategy.Methods:An in-depth bibliometric analysis of all publications on the new integrated strategy for schistosomiasis japonica control in China was performed through a PubMed search using the terms 'schistosomiasis' and 'China,'from January 1,2004 to August 31,2018.All titles and abstracts were read carefully,and the publications reporting the effectiveness,experiences,lessons,or problems of the new integrated strategy were included in the bibliometric analysis.Results:Overall,2,361 titles were screened,and 70 eligible publications were accessed for analyses,including 23 studies in English,published in 15 international journals,and 47 studies in Chinese with abstracts in English,published in 3 national journals.Chinese Journal of Schistosomiasis Control (Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi) published 60% of the research output,Research articles (48.6%) and short reports (37.1%) were the dominant manuscript types.Furthermore,471 contributing authors from 277 affiliations across 9 countries produced these 70 publications.Conclusion:This is the first PubMed-based quantitative analysis of the research output of the new integrated strategy,and our data indicate a low global transmissibility of Chinese new integrated strategy.We therefore call for more research outputs of the new integrated strategy for schistosomiasis japonica control in China to be communicated through international platforms.

Compounds from African Medicinal Plants with Activities Against Selected Parasitic Diseases:Schistosomiasis,Trypanosomiasis and Leishmaniasis

Parasitic diseases continue to represent a threat on a global scale,particularly among the poorest countries in the world.This is particularly because of the absence of vaccines,and in some cases,resistance against available drugs,currently being used for their treatment.In this review emphasis is laid on natural products and scaffolds from African medicinal plants(AMPs)for lead drug discovery and possible further development of drugs for the treatment of parasitic diseases.In the discussion,emphasis has been laid on alkaloids,terpenoids,quinones,flavonoids and narrower compound classes of compounds with micromolar range activities against Schistosoma,Trypanosoma and Leishmania species.In each subparagraph,emphasis is laid on the compound subclasses with most promising in vitro and/or in vivo activities of plant extracts and isolated compounds.Suggestions for future drug development from African medicinal plants have also been provided.This review covering 167 references,including 82 compounds,provides information published within two decades(1997-2017).