Establishing and applying an adaptive framework for imported malaria: a field practice in Anhui Province, China from 2012 to 2022.

BACKGROUND: Anhui Province is currently facing an increase in imported malaria cases as a result of globalization and international travel. In response, Anhui Province has implemented a comprehensive adaptive framework to effectively address this threat. METHODS: This study collected surveillance data from 2012 to 2022 in Anhui Province. Descriptive statistics were used to analyze the epidemiological characteristics of imported malaria cases. Additionally, multivariate logistic regression was employed to identify factors associated with severe malaria. Documents were reviewed to document the evolution of the adaptive framework designed to combat imported malaria. The effectiveness of the adaptive framework was evaluated based on the rates of timely medical visits, timely diagnosis, and species identification. RESULTS: During the study period, a total of 1008 imported malaria cases were reported across 77 out of 105 counties in Anhui Province, representing a coverage of 73.33%. It was found that 10.52% of imported cases went undiagnosed for more than seven days after onset. The multivariate analysis revealed several potential risk factors for severe malaria, including increasing age (OR = 1.049, 95%CI:1.015-1.083), occupation (waitperson vs. worker, OR = 2.698, 95%CI:1.054-6.906), a longer time interval between onset and the initial medical visit (OR = 1.061, 95%CI:1.011-1.114), and misdiagnosis during the first medical visit (OR = 5.167, 95%CI:2.535-10.533). Following the implementation of the adaptive framework, the rates of timely medical visits, timely diagnosis, and species identification reached 100.00%, 78.57%, and 100.00%, respectively. CONCLUSIONS: Anhui Province has successfully developed and implemented an adaptive framework for addressing imported malaria, focusing on robust surveillance, prompt diagnosis, and standardized treatment. The experiences gained from this initiative can serve as a valuable reference for other non-endemic areas.

Analysis of the relapse of imported Plasmodium vivax and Plasmodium ovale in five provinces of China.

BACKGROUND: The global battle against malaria is facing formidable challenges, particularly in controlling Plasmodium vivax and Plasmodium ovale, whose cases have not been reduced as effectively as Plasmodium falciparum because of their relapse. This study investigates the current situation and underlying factors contributing to relapse or recrudescence of imported cases of P. vivax and P. ovale, and seeks to provide a reference for reducing relapse or recrudescence in malaria-free areas and offers a scientific basis for designing strategies to prevent imported re-transmission. METHODS: This study analysed imported P. vivax and P. ovale in Anhui, Zhejiang, Henan, Hubei, and Guangxi provinces during 2014-2021 by retrospective analysis. A case-control study was conducted on patients who experienced relapse or recrudescence. RESULTS: From 2014 to 2021, 306 cases of P.vivax and 896 cases of P.ovale were included in the study, while 75 cases had relapse or recrudescence, including 49 cases of P. ovale (65.33%) and 26 cases of P. vivax (34.67%). Within less than 5 weeks after returning to the country, 122 cases of P. vivax (39.87%, 122/306) and 265 cases of P. ovale (29.58%, 265/896) occurred. Within less than 53 weeks, the ratio of P. vivax was 94.77% (290/306), and that of P. ovale was 89.96% (806/896). Among the cases experiencing relapse or recrudescence, only 1 case of P. vivax (1/26 3.85%) and 3 cases of P. ovale (3/49 6.12%) occurred within less than 5 weeks after the first onset, whereas 21 cases of P. vivax (21/26 80.77%) and 42 cases of P. ovale (42/49 85.71%) occurred within less than 53 weeks after the first onset. The difference in relapse or recrudescence due to different drugs and medication regimens and medical activities at various levels of medical institutions was statistically significant. CONCLUSION: In areas where malaria has been eliminated, routine health screening in a scientific time frame for people returning from at-risk areas can effectively improve the efficiency of preventing re-transmission, thereby reducing prevention costs and disease burden. Preventing patients from self-treating and strengthening medication regulations in health facilities are key measures to reduce relapse or recrudescence.

Clonorchis sinensis Reinfection Rate and Reinfection Determinants: A Prospective Cohort Study in Hengxian County, Guangxi, China.

BACKGROUND: To understand Clonorchis sinensis reinfection and the determinants of reinfection in endemic areas is important in establishment of control measures. METHODS: A prospective cohort study was implemented in Hengxian County, Guangxi, China. Individuals with C. sinensis infection were completely treated, and those cured were enrolled as study subjects and followed up for 3, 6, and 12 months. The reinfection frequency and incidence were calculated, and a multivariable Cox proportional hazard model was constructed to capture reinfection determinants. RESULTS: Among 635 enrolled subjects, 436 (68.7%) completed follow-up. Of these, 177 (40.6%) were reinfected; 133 (75.1%) were reinfected once, 41 (23.2%) twice, and 3 (1.7%) three times. The incidence of reinfection was 64.0 per 100 person-years. Men (adjusted hazard ratio [aHR], 1.67; 95% confidence interval [CI], 1.14-2.44), those with underlying diseases (aHR, 1.41; 95% CI, 1.02-1.95), and those with moderate- or heavy-intensity infections (aHR, 1.45; 95% CI, 1.14-1.85) had increasing reinfection probabilities. CONCLUSIONS: C. sinensis reinfection is high in endemic areas. Men and high-intensity infection are important determinants of reinfection. Repeated chemotherapy is necessary to control reinfection and its associated morbidities, especially in high-risk individuals. In addition, behavioral education is advised to decrease overall reinfection in endemic areas.

Transcriptome analysis uncovers the key pathways and candidate genes related to the treatment of Echinococcus granulosus protoscoleces with the repurposed drug pyronaridine.

BACKGROUND: Cystic echinococcosis (CE) is a life-threatening zoonosis caused by the larval form of Echinococcus granulosus tapeworm. Our previous study showed that an approved drug pyronaridine (PND) is highly effective against CE, both in vitro and in an animal model. To identify possible target genes, transcriptome analysis was performed with E. granulosus sensu stricto protoscoleces treated with PND. RESULTS: A total of 1,321 genes were differentially expressed in protoscoleces treated with PND, including 541 upregulated and 780 downregulated genes. Gene ontology and KEGG analyses revealed that the spliceosome, mitogen-activated protein kinase (MAPK) pathway and ATP-binding cassette (ABC) transporters were the top three enriched pathways. Western blot analysis showed that PND treatment resulted in a dose-dependent increase in protein expression levels of EgMKK1 (MKK3/6-like) and EgMKK2 (MEK1/2-like), two members of MAPK cascades. Interestingly, several heat shock protein (HSP) genes were greatly downregulated including stress-inducible HSPs and their constitutive cognates, and some of them belong to Echinococcus-specific expansion of HSP70. CONCLUSIONS: PND has a great impact on the spliceosome, MAPK pathway and ABC transporters, which may underline the mechanisms by which PND kills E. granulosus protoscoleces. In addition, PND downregulates HSPs expression, suggesting a close relationship between the drug and HSPs.

Epidemiological profile of Plasmodium ovale spp. imported from Africa to Anhui Province, China, 2012-2019.

BACKGROUND: Although autochthonous malaria cases are no longer reported in Anhui Province, China, imported malaria has become a major health concern. The proportion of reported malaria cases caused by Plasmodium ovale spp. increased to levels higher than expected during 2012 to 2019, and showed two peaks, 19.69% in 2015 and 19.35% in 2018. METHODS: A case-based retrospective study was performed using data collected from the China Information System for Disease Control and Prevention (CISDCP) and Information System for Parasitic Disease Control and Prevention (ISPDCP) from 2012 to 2019 to assess the trends and differences between Plasmodium ovale curtisi (P. o. curtisi) and Plasmodium ovale wallikeri (P. o. wallikeri). Epidemiological characteristics were analyzed using descriptive statistics. RESULTS: Plasmodium o. curtisi and P. o. wallikeri were found to simultaneously circulate in 14 African countries. Among 128 patients infected with P. ovale spp., the proportion of co-infection cases was 10.16%. Six cases of co-infection with P. ovale spp. and P. falciparum were noted, each presenting with two clinical attacks (the first attack was due to P. falciparum and the second was due to P. ovale spp.) at different intervals. Accurate identification of the infecting species was achieved among only 20.00% of cases of P. ovale spp. infection. At the reporting units, 32.17% and 6.96% of cases of P. ovale spp. infection were misdiagnosed as P. vivax and P. falciparum infections, respectively. CONCLUSION: The present results indicate that the potential of P. ovale spp. to co-infect with other Plasmodium species has been previously underestimated, as is the incidence of P. ovale spp. in countries where malaria is endemic. P. o. curtisi may have a long latency period of > 3 years and potentially cause residual foci, thus posing challenges to the elimination of malaria in P. ovale spp.-endemic areas. Considering the low rate of species identification, more sensitive point-of-care detection methods need to be developed for P. ovale spp. and introduced in non-endemic areas.

Hypoosmotic stress induced functional alternations of intestinal barrier integrity, inflammatory reactions, and neurotransmission along gut-brain axis in the yellowfin seabream (Acanthopagrus latus).

The gut-brain axis plays a major role in multiple metabolic regulation processes, but studies regarding its responses to environmental stress in fish are still limited. In this study, we performed transcriptome sequencing analysis and enzyme-linked immunosorbent assay (ELISA) in yellowfin seabream (Acanthopagrus latus) exposed to environments with different water salinity (freshwater: 0 ppt; low-saline water: 3 ppt; brackish water: 6 ppt). According to transcriptome analysis, 707 and 1477 genes were identified as differentially expressed genes (DEGs) between freshwater and brackish water treatments in the brain and gut, respectively. Brain DEGs were significantly enriched into a set of Gene Ontology terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways associated with signal transduction, most of which were downregulated. Gut DEGs were enriched into a neurotransmission-relevant KEGG pathway tryptophan metabolism, and the downregulated DEGs were enriched into the KEGG pathway focal adhesion. ELISA demonstrated significant physiological responses of the brain and gut across treatments, as determined by the concentrations of tight junction protein ZO-2, interleukin 1ß, and serotonin. Under hypoosmotic stress, the functions of the gut-brain axis are altered via impairment of intestinal barrier integrity, by disturbance of gut-brain neurotransmission, and through tissue-damaging inflammatory reactions. Our work identified candidate genes which showed significantly differential expression in the gut-brain axis when yellowfin seabream encountered hypoosmotic stress, which could shed lights on the understanding of the potential osmotic regulation mechanisms of the gut-brain axis in teleost.

Imported Schistosomiasis, China, 2010-2018.

China has made remarkable progress in reducing schistosomiasis caused by Schistosoma japonicum over the past 7 decades but now faces a severe threat from imported schistosomiasis. Results from national surveillance during 2010-2018 indicate integrating active surveillance into current surveillance models for imported cases is urgently needed to achieve schistosomiasis elimination in China.

Hypoosmotic stress induced tissue-specific immune responses of yellowfin seabream (Acanthopagrus latus) revealed by transcriptomic analysis.

Salinity is a limiting factor for many marine organisms, including fishes. The shift in the ambient salinity can cause osmotic stress and arouse immune responses in fish. In this study, yellowfin seabream (Acanthopagrus latus), a euryhaline marine teleost, was used to investigate immune responses of different tissues (gill, liver, and muscle) under hypoosmotic stress. Comparative transcriptomic and physiological analyses of three tissues were conducted after fish exposed to the fresh water (FW, salinity = 0 ppt), low-saline water (LW, salinity = 3 ppt), and brackish water (BW, salinity = 6 ppt) for 8 days. The results showed that hypoosmotic stress dramatically altered the gene expression of three tissues in yellowfin seabream; The investigation of differentially expressed genes (DEGs) related to osmoregulation and immune response indicated that T cell-mediate immunity pathways were essential to tackle such stress. In terms of tissues, gill was found to be the most sensitive tissue under hypoosmotic stress by enhancing of Na+K+-ATPase activity and preventing the loss of Na+ and K+; Liver, on the other hand, was under the most sever oxidative stress indicated by the fluctuation of SOD, CAT activities and the MDA content; In contrast, muscle had the least osmoregulation and immune related response. We also identified several potential candidate genes, which may serve as gene indicators to identify the stressor. Overall, this study provides preliminary mechanistic insights into hypoosmotic stress adaption of aquatic organism.

Identification and Comparison of microRNAs in the Gonad of the Yellowfin Seabream (Acanthopagrus Latus).

Yellowfin seabream (Acanthopagrus latus) is a commercially important fish in Asian coastal waters. Although natural sex reversal has been described in yellowfin seabream, the mechanisms underlying sexual differentiation and gonadal development in this species remain unclear. MicroRNAs (miRNAs) have been shown to play crucial roles in gametogenesis and gonadal development. Here, two libraries of small RNAs, constructed from the testes and ovaries of yellowfin seabream, were sequenced. Across both gonads, we identified 324 conserved miRNAs and 92 novel miRNAs: 67 ovary-biased miRNAs, including the miR-200 families, the miR-29 families, miR-21, and miR-725; and 88 testis-biased miRNAs, including the let-7 families, the miR-10 families, miR-7, miR-9, and miR-202-3p. GO (Gene Ontology) annotations and KEGG (Kyoto Encyclopedia of Genes and Genomes) enrichment analyses of putative target genes indicated that many target genes were significantly enriched in the steroid biosynthesis pathway and in the reproductive process. Our integrated miRNA-mRNA analysis demonstrated a putative negatively correlated expression pattern in yellowfin seabream gonads. This study profiled the expression patterns of sex-biased miRNAs in yellowfin seabream gonads, and provided important molecular resources that will help to clarify the miRNA-mediated post-transcriptional regulation of sexual differentiation and gonadal development in this species.

Extensive disseminated cysticercosis: a case report in Yunnan province, China.

BACKGROUND: Cysticercosis is spreading all over the world and it is a major health problem in most countries of Latin America, Africa, and Asia. Extensive disseminated cysticercosis is relatively rare and fewer than 120 case have been reported in the worldwide. We reported a rare case of extensive disseminated cysticercosis in Yunan province, China. CASE PRESENTATION: A rare case of extensive disseminated cysticercosis, in a 61-year-old male Chinese was detected from Yunnan province in 2018. Clinical and etiological examination was performed, as well as the epidemiological investigation. CONCLUSION: The life cycle of T. solium in the area where the case came from is complete. We expect this case could raise the attentions to the control of Taenia solium infection and subsequent cysticercosis there.

Antinuclear antibodies and interleukin responses in patients with Schistosoma japonicum infection.

Schistosomiasis poses a serious threat to public health, and the infection will develop into chronic and advanced late-stage disease if not treated. Apart from the clinical signs due to immune reactions to schistosome eggs trapped in host tissues, it also increases the risk for the development of autoimmunity reflected by dysfunctional, auto-reactive antibodies. Antinuclear antibodies (ANA) have been reported in schistosomiasis due to S. mansoni and S. haematobium. We demonstrate ANA in schistosomiasis japonica and explore the relationship between this infection and autoimmune disease by measuring ANA and interleukin (IL)-10, IL-12 and IL-17 responses in the sera of 125 Chinese patients with different stages of schistosomiasis japonica. The incidence rates of ANA in the patients with acute, chronic and late stages of schistosomiasis infection were 6.7%, 23.3% and 70.0%, respectively, with statistically significant differences between each stage (P = 0.000). IL-17 concentrations were high at the acute stage of schistosomiasis compared to the other stages of the disease (P = 0.000). This pattern was also seen for IL-10 and IL-12 concentrations (P = 0.01). IL concentrations in patients in the chronic and late stages of the disease were low and showed no difference compared to the healthy adults.

In vitro and in vivo efficacies of novel carbazole aminoalcohols in the treatment of cystic echinococcosis.

OBJECTIVES: Cystic echinococcosis (CE), caused by the cestode Echinococcus granulosus, is a worldwide chronic zoonosis. Current chemotherapeutic options are limited to albendazole and mebendazole, which only exert parasitostatic effects and have to be administered at high dosages for long periods. In an effort to find alternative treatment options, the in vitro and in vivo efficacies of novel carbazole aminoalcohols were evaluated. METHODS: Carbazole aminoalcohols were tested against E. granulosus protoscoleces in vitro and metacestodes ex vivo. The in vivo chemotherapeutic effect of representative compounds was assessed in experimentally infected mice. Oral and intravenous pharmacokinetic profiles were determined in mice. RESULTS: The carbazole aminoalcohols exhibited potent protoscolicidal activity with LC50 values ranging from 18.2 to 34.3 µM. Among them, compounds 2 and 24 killed all ex vivo cultured metacestodes at concentrations of 34.3 and 30.6 µM. In vivo studies showed that oral administration of compounds 2 and 24 (25 mg/kg/day) for 30 days led to reductions of 68.4% and 54.3% in parasite weight compared with the untreated group (both groups: P < 0.001). Compound 2 (25 mg/kg/day) and compound 24 (50 mg/kg/day) induced significantly higher cyst mortality rates in comparison with that of the albendazole group (both groups: P < 0.01). Analysis of cysts collected from compound 2- or 24-treated mice by transmission electron microscopy revealed a drug-induced structural destruction. The structural integrity of the germinal layer was lost, and the majority of the microtriches disappeared. Pharmacokinetic profiling of compounds 2 and 24 revealed low clearance and decent oral bioavailability (>70%). CONCLUSIONS: Our study identifies carbazole aminoalcohols as a class of novel anti-CE agents. Compounds 2 and 24 represent promising drug candidates in anti-CE chemotherapy.

Field evaluation of a novel molluscicide (niclosamidate) against Oncomelania hupensis, intermediate host of Schistosoma japonicum.

The molluscicidal activity of a novel molluscicide (niclosamidate) was evaluated in field trials against Oncomelania hupensis, the intermediate host of Schistosoma japonicum. The environmental safety of niclosamidate for local fishes was also studied under field conditions. The results showed that, at the dosages of 8.0 g/m2 and 4.0 g/m3, niclosamidate exhibits highly potent molluscicidal activity in the spraying and immersion trials, resulting in mortality rates of up to 81.8 and 72.7%, respectively. Its performance seems to be target-specific, with good molluscicidal ability observed for Oncomelania hupensis snails, but very low toxicity for local fishes and other aquatic organisms. The results suggest that niclosamidate can be used as an alternative molluscicide for snail control, which would be particularly applicable in semi-commercial or commercial aquaculture ponds.

[Analysis of schistosomiasis prevalence in endemic areas using retrospective space-time permutation scan statistics].

Objective: To analyze the characteristics of schistosomasis prevalence by using the spatial epidemiological method, and test the application of retrospective space-time permutation scan statistics in determining mountainous and lake-type endemic areas of schistosomiasis. Methods: The data of schistosomasis in humans, cattle and snails in Jiangxi Province during 2009-2014 and in Yunnan Province during 2004-2013 were collected and analyzed. The temporal and spatial distribution of schistosomiasis endemic areas in the two provinces was analyzed with retrospective space-time permutation scan statistics. Results: The prevalence of schistosomiasis in residents and Oncomelania snails showed a trend of decline in Jiangxi, from 0.21% and 0.03% in 2009 to 0.01% and zero in 2014. A similar trend was found in cattle, from 1.25% in 2012 to 0.12% in 2014. The average annual percentage change (APC) in residents was-47.36%(P < 0.05). The space-time permutation clustering analysis revealed a temporal and spatial clustering of schistosomiasis prevalence from 2009 to 2014 in residents, cattle, and snails, with 3,2 and 1 clustering areas, respectively, all distributed in Poyang Lake Region. A similar declining trend of schistosomiasis prevalence was found in residents, snails and cattle in Yunnan during 2004-2013, from 2.49%,0.70% and 3.76% in 2004 to no infection in residents and snails and 0.02% in cattle in 2013. The APC in residents was-49.17%(P < 0.05). There was a temporal and spatial clustering of schistosomiasis prevalence during 2004-2013 in residents, cattle, and snails, with 2,2 and 6 clustering areas, respectively. Conclusion: A declining trend of schistosomiasis prevalence is shown in lake-type endemic areas in Jiangxi during 2009-2014 and in mountainous endemic areas in Yunnan during 2004-2013. The retrospective space-time permutation scan statistics reveal a clustering of schistosomiasis in humans, cattle, and snails, suggesting its applicability in analyzing the temporal and spatial distribution of schistosomiasis.

Synthesis, Bioactivity Evaluation, and Toxicity Assessment of Novel Salicylanilide Ester Derivatives as Cercaricides against Schistosoma japonicum and Molluscicides against Oncomelania hupensis.

A series of novel salicylanilide ester derivatives were synthesized, characterized, and evaluated for cercaricidal potential against Schistosoma japonicum and molluscicidal potential against Oncomelania hupensis. Four derivatives exhibited remarkable cercaricidal activity superior to that of niclosamide. Among them, the most active compound, 4-chloro-2-((2-methoxy-4-nitrophenyl)carbamoyl)phenyl 4-methoxybenzoate (compound 4c), showed a marked minimum effective cercaricidal concentration as low as 0.43 µM and significant molluscicidal activity, with a 50% lethal concentration (LC50) of 0.206 g/m(2). Particularly, compound 4c displayed 88-fold decreased fish toxicity on Danio rerio and 44-fold reduced cytotoxicity on human kidney HEK293 cells in comparison with the toxicity of niclosamide. The results indicated that 4c could serve as a promising drug candidate, with environmental safety properties, against Schistosoma japonicum at transmission stages. The preliminary molecular mechanism of target compounds in Schistosoma japonicum cercariae was also investigated. Salicylanilide ester derivatives exhibited an inhibitory effect on nitric oxide synthase (NOS) but no effect on lactate dehydrogenase (LDH) and acetylcholinesterase (AChE), and a strong and significant correlation between NOS inhibitory efficacy and cercaricidal activity was observed. In addition, 4c could downregulate the expression of NOS in a dose-dependent manner. These results suggested that NOS was probably one of the drug targets of salicylanilide esters.

Complete depletion of primordial germ cells in an All-female fish leads to Sex-biased gene expression alteration and sterile All-male occurrence.

BACKGROUND: Gynogenesis is one of unisexual reproduction modes in vertebrates, and produces all-female individuals with identical genetic background. In sexual reproduction vertebrates, the roles of primordial germ cells on sexual dimorphism and gonadal differentiation have been largely studied, and two distinct functional models have been proposed. However, the role of primordial germ cells remains unknown in unisexual animals, and it is also unclear whether the functional models in sexual reproduction animals are common in unisexual animals. RESULTS: To solve these puzzles, we attempt to utilize the gynogenetic superiority of polyploid Carassius gibelio to create a complete germ cell-depleted gonad model by a similar morpholino-mediated knockdown approach used in other examined sexual reproduction fishes. Through the germ cell-depleted gonad model, we have performed comprehensive and comparative transcriptome analysis, and revealed a complete alteration of sex-biased gene expression. Moreover, the expression alteration leads to up-regulation of testis-biased genes and down-regulation of ovary-biased genes, and results in the occurrence of sterile all-males with testis-like gonads and secondary sex characteristics in the germ cell-depleted gynogenetic Carassius gibelio. CONCLUSIONS: Our current results have demonstrated that unisexual gynogenetic embryos remain keeping male sex determination information in the genome, and the complete depletion of primordial germ cells in the all-female fish leads to sex-biased gene expression alteration and sterile all-male occurrence.

[Application of Big Data Mining Technology in Monitoring and Early-warning of Schistosomiasis].

The prevalence of schistosomiasis will soon be controlled to a low level in China. It is therefore imperative to establish a more sensitive and effective early warning system for schistosomiasis, so as to consolidate the achievements of the disease control. By covering four topics including the importance of early warning system for schistosomiasis and its research direction, as well as recent development in big data mining and its application in monitoring and early-warning of schistosomiasis, this review discusses the feasibility of data mining technology for monitoring and early warning of the disease. It is hoped that this technology would increase the efficacy of studies on monitoring and early warning, and promote the elimination of schistosomiasis in China.

[Application of space-time scan statistics in the analysis of spatial and temporal distribution of Oncomelania hupensis snails in Gaoyou County, Jiangsu Province].

OBJECTIVE: To investigate the distribution features of Oncomelania hupensis infested areas in Gaoyou County so as to formulate surveillance and intervention strategies. METHODS: A database was established through collecting data of the snail infested areas during 1970-2009 in the County. The data were input into SaTScan 9.2 software for spatial-temporal cluster analysis to determine the spatial and temporal cluster of the snail habitats. The results were displayed by ArcGIS 10.1 software. RESULTS: There were historically 720 snail habitats in the County in 1970-2009 including 521 in plain region with water networks and 199 in lake & marshland region. Those in water networks covered an area of 456.62 ha distributing mainly in the northern towns/townships of the County, and the latters distributed in the Xinmin Beach between Gaoyou Lake and Shaobo Lake, and Qiaojian Beach close to Tianchang County of Anhui Province with an area of 4 495.75 ha. The spatial-temporal cluster analysis revealed that among all the historical snail habitats, there were two prominent spatial-temporal clusters with a relative risk of >3. One cluster appeared in Xinmin Beach in 1983-2002 and another one located in the north of Gaoyou in 1970-1973. Separate analysis was performed by the regions of water network or lake & marshland, indicating 2 clusters in each of the regions. During 1970-2009, 244 snail habitats were newly found in the County with 130 in water network region and 114 in lake & marshland region. Again, the spatial-temporal cluster analysis displayed 2 prominent clusters. By separate analysis, 2 clusters existed in each of the regions. CONCLUSION: The space-time scan statistics can be applied in detecting the cluster of snail infested areas in two dimensions, which will provide information for guiding specific measures of surveillance and control.

[Assessment on the effect of joint effort for schistosomiasis control in Hubei Province].

OBJECTIVE: To analyze the progress of implementation of integrated strategy with emphasis on the control of infectious sources and effectiveness for joint-project of schistosomiasis control in Hubei province. METHODS: Data on the endemic status and implementation of each integrated intervention in 6 collaborated counties including Gongan, Hanchuan, Honghu, Jiangling, Xiantao and Yangxin during 2009-2013 were collected and analyzed. 18 administrative villages with a history of endemic schistosomisis from 6 counties were selected for field survey. Individuals aged 6-65 years received screening test by IHA, and feces of antibody positive inhabitants were collected and tested by miracidia hatching technique. Hatching technique was conducted to determine the infection rate of schistosomiasis in cattle if there was any cattle existed. RESULTS: Various interventions were conducted with adaption to the local situation by the Departments of Agriculture, Water Conservancy, Forestry, and Health. The total number of cattle decreased from 75 388 at the beginning of 2009 to 1 805 at the end of 2013 in 6 counties with a reduction rate of 97.5%, while the prevalence in cattle reduced to 0-0.3% in 2013. Snail-infested areas were stable but areas with infected snails decreased significantly, and no infected snails were found in 2012-2013. Meanwhile, the infection rate of human beings on county level were less than 1%. No infected snails and cattle were found in 18 selected villages and the prevalence in inhabitants was in the range of 0-0.8%. CONCLUSION: Cooperation between provincial government and the Ministries of Health and Agruiculture accelerates the process to reach the criteria of transmission control of schistosomiasis in Hubei Province. However, sustainable effort in needed as the current endemic situation of schistosomiasis is stillunstable.