[Prevalence and control of schistosomiasis in Jiangxi Province during 2002-2012].

OBJECTIVE: To analyze the status of prevalence and control of schistosomiasis in Jiangxi Province from 2002 to 2012. METHODS: Endemic status and control effectiveness during the period from 2002 to 2012 was analyzed by using a combination of field survey, data collection and retrospective investigation. RESULTS: From 2002 to 2012, schistosomiasis control made significant achievements in Jiangxi Province. The number of counties which have reached the criteria of transmission interruption of schistosomiasis increased from 19 in 2002 to 22 in 2012. The number of patients with schistosome infection decreased from 128 331 in 2002 to 73 102 in 2012. The positive rate of serological test and fecal examination in residents decreased from 12.2% and 4.2% in 2002 to 5.2% and 0.4% in 2012, respectively. Acute infection reduced from 146 cases in 2002 to 3 cases in 2012, but advanced cases increased by 42.4%. The positive rate of fecal examination in cattle reduced from 4.7% in 2002 to 1.3% in 2012. The density of living snails and infected snails significantly decreased to 0.083 5/0.1 a? and 0.000 037/0.1 m2 in 2012, respectively. However, the snail-ridden areas slightly increased. Jiangxi Province reached the criteria of endemic control for schistosomiasis in 2008. During 2002-2012, control activities were intensified. Examination and chemotherapy for human increased by 65.2% and 65.5%, while 23.4% and 251.1% for cattle. Mean while, area with snail control activities increased by 617.8%. An integrated strategy of infection source control was implemented in the Province. CONCLUSION: During 2002 to 2012, endemic index of schistosomiasis in Jiangxi showed a steady decline after 2005. Currently, schistosomiasis prevalence shows a low level. The endemic indicators of infection in human and livestock as well as Oncomelania snails have been kept stable at low level.

A strategy to control transmission of Schistosoma japonicum in China.

BACKGROUND: Schistosoma japonicum causes an infection involving humans, livestock, and snails and is a significant cause of morbidity in China. METHODS: We evaluated a comprehensive control strategy in two intervention villages and two control villages along Poyang Lake in the southeastern province of Jiangxi, where annual synchronous chemotherapy is routinely used. New interventions, implemented from 2005 through 2007, included removing cattle from snail-infested grasslands, providing farmers with mechanized farm equipment, improving sanitation by supplying tap water and building lavatories and latrines, providing boats with fecal-matter containers, and implementing an intensive health-education program. During the intervention period, we observed changes in S. japonicum infection in humans, measured the rate of infection in snails, and tested the infectivity of lake water in mice. RESULTS: After three transmission seasons, the rate of infection in humans decreased to less than 1.0% in the intervention villages, from 11.3% to 0.7% in one village and from 4.0% to 0.9% in the other (P<0.001 for both comparisons). The rate of infection in humans in control villages fluctuated but remained at baseline levels. In intervention villages, the percentage of sampling sites with infected snails decreased from 2.2% to 0.1% in one grassland area and from 0.3% to no infection in the other (P<0.001 for both comparisons). The rate of infection in mice after exposure to lake water decreased from 79% to no infection (P<0.001). CONCLUSIONS: A comprehensive control strategy based on interventions to reduce the rate of transmission of S. japonicum infection from cattle and humans to snails was highly effective. These interventions have been adopted as the national strategy to control schistosomiasis in China.

[Gene synthesis, expression and characterization of egg protein IPSE of Schistosoma mansoni].

OBJECTIVE: To synthesize and express the gene of egg protein IPSE (IL-4-inducing principle of Schistosoma mansoni eggs) and evaluate its immunologic characteristics. METHODS: The IPSE gene of S. mansoni was synthesized by overlapping PCR, and confirmed by DNA sequencing, The recombinant plasmid IPSE-pET32a(+) was constructed by inserting the gene of IPSE into expression vector pET32a(+) at the downstream of thioredoxin (Trx) coding sequence. The recombinant plasmid IPSE-pET32a(+) was transformed into E. coli BL21(DE3) and followed by expression of the protein induced by IPTG. Large-scale fusion protein was prepared and purified with Ni affinity chromatography gel under denaturing conditions. A small amount of soluble Trx-IPSE was obtained by dialyzing the fusion protein in a large volume of PBS. Western blotting was used to detect if the recombinant IPSE was recognized by the IgG antibody in the pooled patient sera of schistosomiasis japonica and its binding capacity to the non-specific IgE antibody in the sera of healthy persons. RESULTS: DNA sequencing confirmed that the nucleotide sequence of synthesized IPSE gene was completely identical to the native one. SDS-PAGE showed that the recombinant plasmid IPSE/pET32a(+) expressed a fusion protein with an Mr 35700 after being induced by IPTG. The pure fusion protein Trx-IPSE reacted positively with the pooled sera of schistosomiasis patients under either denaturing or renaturing conditions. The protein Trx-IPSE also reacted with the nonspecific IgE in the sera of healthy persons. CONCLUSION: The IPSE gene of Schistosoma mansoni has been synthesized, and the recombinant can react with natural antibody IgG against S. japonicum and non-specifically bind to IgE antibody.

[Comparative evaluation of five test kits for antibody detection in Schistosoma japonicum endemic areas of Poyang Lake region].

OBJECTIVE: To evaluate the efficacy of five diagnostic test kits for the detection of antibodies to Schistosoma japonicum in endemic areas of Poyang Lake. METHODS: Residents over 5 years old in three schistosomiasis-endemic administrative villages in the lake region were simultaneously examined by modified Kato-Katz thick smears and nylon bag sedimentation/hatching method. At the same time, five sero-diagnostic test kits for detection of IgG antibody against soluble egg antigen of S. japonicum were carried out. RESULTS: The distribution of seropositive rates of S. japonicum IgG antibodies determined by sero-diagnostic tests showed similar trends with that of egg positive rates in different age groups, but the seropositive rate (33.1%-57.1%) was significantly higher than that of egg positive rate (5.0%-8.2%), both reached a peak in 40-49-year-old group. The antibody positive rates determined by each test increased with the infection intensity. The sensitivity of the evaluated test kits ranged from 81.2%-94.5%. 26.9% to 46.1% among those egg negatives were antibody positive by the kits. Furthermore, 5.5%-18.8% of the egg positives were antibody negative by the kits. CONCLUSION: The five sero-diagnostic kits can be used for epidemiological survey in schistosomiasis endemic areas at community level. Among them, enzyme-linked immunosorbent assay shows higher sensitivity.

China's new strategy to block Schistosoma japonicum transmission: experiences and impact beyond schistosomiasis.

Despite sustained efforts for its control made over the past 50+ years, the re-emergence of schistosomiasis in China was noted around the turn of the new millennium. Consequently, a new integrated strategy was proposed to stop the contamination of schistosome eggs to the environment, which emphasizes health education, access to clean water and adequate sanitation, mechanization of agriculture and fencing of water buffaloes, along with chemotherapy. Validation of this integrated control strategy in four pilot counties in the provinces of Anhui, Hubei, Hunan and Jiangxi revealed significant reductions in the rate of Schistosoma japonicum infection in humans and intermediate host snails. Importantly, this strategy showed an impact on diseases beyond schistosomiasis, signified by concomitant reductions in the prevalence of soil-transmitted helminth infections. In view of China's new integrated strategy for transmission control of schistosomiasis showing an ancillary benefit on other helminthic diseases, we encourage others to investigate the scope and limits of integrated control of neglected tropical diseases.

[Cost-effectiveness and cost-benefit analysis on the integrated schistosomiasis control strategies with emphasis on infection source in Poyang Lake region].

OBJECTIVE: To evaluate the cost-effectiveness and cost-benefit on the integrated schistosomiasis control strategies with emphasis on infection source, and provide scientific basis for the improvement of schistosomiasis control strategy. METHODS: Aiguo and Xinhe villages in Jinxian County were selected as intervention group where the new comprehensive strategy was implemented, while Ximiao and Zuxi villages in Xinzi County served as control where routine control program was implemented. New strategy of interventions included removing cattle from snail-infested grasslands and providing farmers with farm machinery, improving sanitation by supplying tap water and building lavatories and methane gas tanks, and implementing an intensive health education program. Routine interventions were carried out in the control villages including diagnosis and treatment for human and cattle, health education, and focal mollusciciding. Data were collected from retrospective investigation and field survey for the analysis and comparison of cost-effectiveness and cost-benefit between intervention and control groups. RESULTS: The control effect of the intervention group was better than that of the control. The cost for 1% decrease of infection rate per 100 people, 100 cattle, and 100 snails in intervention group was 480.01, 6 851.24, and 683.63 Yuan, respectively, which were about 2.70, 4.37 and 20.25 times as those in the control respectively. The total cost/benefit ratio (BCR) was lower than 1 (0.94 in intervention group and 0.08 in the control). But the total benefit of intervention group was higher than that of the control from 2005 to 2008. The forecasting analysis indicated that the total BCR in intervention group would be 1.13 at the 4th year and all cost could be recalled. Sensitivity analysis revealed that the BCR in intervention group changed in the range around 1.0 and that of the control ranged blow 0.5. The cost-benefit of intervention group was evidently higher than that of the control. CONCLUSIONS: The integrated control strategy focusing on infection source control brings about triplex benefits in schistosomiasis control, social development (and ecological protection) and economic efficacy, and shows better effects and benefits than the conventional control strategy.

Effect of integrated control intervention on soil-transmitted helminth infections in Jiangxi province in southeast China.

Soil transmitted helminths (STHs) burden was enormous in China several decades ago, however, rigorous control efforts have been successful with appreciable reduction in diseases burden. Here, we assessed provincial-level data derived from cross sectional surveys, executed in 1989, 2002 and 2014, on the prevalence of STHs among populations in Jiangxi province, China. This study, also, reported STHs integrated control intervention aimed at reducing STHs transmission and worm burden among population at county-level. The intervention strategies included mass drug administration (MDA), health education, improved water supply for drinking, improved sanitary facilities and environmental modification in Guixi municipality. The overall infection rate of STHs in Jiangxi province decreased from 77.7% (1989) to 6.3% (2014), while Ascaris lumbricoides, hookworm and Trichuris trichiura decreased from 71.1%, 17.6% and 17.0% (1989) to 0.9%, 4.7% and 1.0% (2014), respectively. STHs infection rates in female population were higher than male in the three surveys. Reduction in STHs prevalence was observed in all age groups, but the decline was less in higher age group. STHs prevalence in Guixi intervention region indicated remarkable reduction from 31.8% (2006) to 6.1% (2009) (χ2＝255.22, P＜0.01). A. lumbricoides, hookworm and T. trichiura infection rates decreased from 10.4%, 17.0% and 7.1% (2006) to 0.1%, 4.1% and 2.2%, respectively (2009) (X2A.l = 110.23, P<0.01; X2hk = 103.57, P < 0.01; X2T.t = 32.0, P < 0.01). A. lumbricoides infection rate declined the most of all STHs. Following control efforts with integrated control intervention strategies, STHs prevalence in Jiangxi province experienced remarkable trend in decline between 1989 and 2014. Consolidating control efforts with sustained integrated control strategies is, therefore, important to achieving STHs elimination in China.

Epidemiology of schistosomiasis in the People's Republic of China, 2004.

Results from the third nationwide cluster sampling survey on the epidemiology of schistosomiasis in the People's Republic of China, conducted by the Ministry of Health in 2004, are presented. A stratified cluster random sampling technique was used, and 239 villages were selected in 7 provinces where Schistosoma japonicum remains endemic. A total of 250,987 residents 6-65 years of age were included in the survey. Estimated prevalence rates in the provinces of Hunan, Hubei, Jiangxi, Anhui, Yunnan, Sichuan, and Jiangsu were 4.2%, 3.8%, 3.1%, 2.2%, 1.7%, 0.9%, and 0.3%, respectively. The highest prevalence rates were in the lake and marshland region (3.8%) and the lowest rates were in the plain region with waterway networks (0.06%). Extrapolation to all residents in schistosome-endemic areas indicated 726,112 infections. This indicates a reduction of 16.1% compared with a nationwide survey conducted in 1995. However, human infection rates increased by 3.9% in settings where transmission is ongoing.

Familial aggregation of human susceptibility to co- and multiple helminth infections in a population from the Poyang Lake region, China.

Human helminthiases are common in China, especially in rural areas where sanitation conditions are poor. Co- and multiple infections with helminths are strikingly frequent. A cross-sectional parasitological and questionnaire survey was carried out in a population of 3205 individuals belonging to 498 families from five villages in the Poyang Lake region, Jiangxi Province, China, to assess their helminth infection status and to collect information on risk factors for infection. The prevalences for Ascaris lumbricoides, Schistosoma japonicum and Trichuris trichiura were 30.9%, 15.7% and 47%, respectively. Hookworm infection prevalence was low (0.7%). A significant association was observed between A. lumbricoides and T. trichiura infection, and also between S. japonicum and T. trichiura infection. Variance components analysis was undertaken to investigate the aggregation of S. japonicum and the soil-transmitted helminths, A. lumbricoides and T. trichiura. While A. lumbricoides was found to aggregate only at a household level, T. trichiura was shown to cluster predominantly in families. Both genetic and household effects were found to be important in determining the risk of infection with S. japonicum. Variance components analysis for A. lumbricoides/T. trichiura co-infections indicated a significant domestic environmental effect, attributable for 32.7% of the co-infection risk. Aggregation of S. japonicum/T. trichiura co-infection was also observed at a household level. The risk of infection with multiple helminth species, although mainly environmentally influenced, was also shown to have significant involvement of genetic and household components. The results of this study indicate that a shared household is a major contributing risk factor for helminth co-infections and emphasises the need for increased standards of sanitation and hygiene to prevent parasite transmission. Further, the results suggest that susceptibility to one helminth infection is not completely independent of another, and that there exist common genetic factors underlying infection with multiple helminth species.

[Effectiveness of routinely used assays for the diagnosis of schistosomiasis japonica in the field].

OBJECTIVE: To evaluate the effectiveness of routinely used assays for schistosomiasis diagnosis in the field. METHODS: From late November to early December 2005, 6-65 years old inhabitants from 3 endemic villages were examined by Kato-Katz technique (3 thick smears) and nylon bag sedimentation/hatching method. At the same time, dipstick dye immunoassay(DDIA), fast enzyme linked immunosorbent assay (F-ELISA), indirect haemagglutination test A (IHA-A) and B ( IHA-B) were carried out in parallel RESULTS: 1864 people were examined by stool examination with an average positive rate of 9.7%. The missing rate of DDIA was relatively stable in medium and heavily endemic areas of schistosomiasis. The missing rate of nylon bag sedimentation/hatching method was 25% and relatively stable when the number of eggs per gram of feces(EPG) was larger than 100. The average positive rate of DDIA, F-ELISA, IHA-A and IHA-B was 47.8%, 50.0%, 66.3% and 40.1% respectively. Using stool examination as the gold standard, the sensitivity of DDIA, F-ELISA, IHA-A and IHA-B was 75.3%, 65.8%, 85.6% and 76.0%; and the specificity was 55.1%, 51.7%, 35.7% and 63.6%, respectively. Among the four sero-diagnostics, the specificity, Youden index, positive likelihood rate and coincidence of IHA-B were the highest. CONCLUSION: Kato-Katz method is more stable and effective than nylon bag sedimentation/hatching method in medium and heavily endemic areas of schistosomiasis japonica. The sensitivity and specificity of these four diagnosis kits are lower than 90%.

[Study of the efficacy of a monoclonal antibody biotin-avidin system for the diagnosis of schistosomiasis japonica].

OBJECTIVE: To explore the diagnostic efficiency of circulating antigen using the TM5.28 mAB-biotin-avidin system for the detection of schistosomiasis japonica. METHODS: A mAb-biotin-avidin system was set up using a TM5.28 mAB which was prepared against a gut associated antigen of Schistosoma japonicum. Detection was performed on the sera from 50 acute schistosomiasis patients, 224 chronic patients, 49 advanced patients and 46 schistosomiasis patients who were followed up at 6 months and 12 months post treatment. In addition, 19 cases of clonorchiasis, 31 cases of paragonimiasis, 23 cases of hepatitis B and 100 healthy individuals were also included. RESULTS: The system showed sensitivity of 83.1% and specificity of 94.0% when applied to detect chronic schistosomiasis and healthy persons respectively, while 94.0% to acute schistosomiasis. The Youden's index of the system was 0.771. The rate of cross-reaction to paragonimiasis, clonorchiasis and hepatitis B was 12.9%, 15.8% and 13.0% respectively. The rates of negative turning were 43.9% and 62.1% respectively in chronic schistosomiasis at the 6 month and 12 month intervals after treatment. Geometric mean of the OD values also decreased from 0.172 before treatment to 0.081 at 6 months and 0.068 at 12 months after treatment with a reduction rate of 60.30%. The detection rate in the heavy infected population reached a maximum of 90.0%. This was similar in moderate and light infected populations, i.e., 83.9% and 82.1%, respectively. CONCLUSION: The TM5.28 mAb-biotin-avidin system showed a relatively high efficiency in the diagnosis of schistosomiasis and a high negative turning rate after treatment. It is, therefore, a valuable tool for the estimation of prevalence in endemic populations, as well as individual diagnosis and for assessing the effect of chemotherapy.

A double-blind field trial on the effects of artemether on Schistosoma japonicum infection in a highly endemic focus in southern China.

To further strengthen the evidence-base of artemether for the control of schistosomiasis japonica, a randomised controlled trial was carried out in the Poyang Lake region, a highly endemic area in southern China. A total of 783 individuals, aged 6-60 years, were enrolled. They were first given a single oral dose of praziquantel (50 mg/kg). Then, they were randomly assigned oral artemether (6 mg/kg) or placebo, administered once every 2 weeks for 9-11 doses, covering the entire transmission season for Schistosoma japonicum in 2004. Stool examination 1 month after the final dosing revealed eggs of S. japonicum in 3/373 (0.8%) of the artemether recipients and 56/361 (15.0%) in placebo recipients (chi2=53.69, P<0.001). Compared to the baseline, the geometric mean intensity of S. japonicum infection had decreased by 96.1% in the artemether group, and increased by 50.8% in the placebo group. No acute cases of schistosomiasis japonica were observed in the artemether group, whereas three such cases were reported from the placebo group. Compliance with regard to multi-doses of artemether and placebo was 84.9, and 77.9%, respectively. This study confirms that repeated oral artemether produces no drug-related adverse effects, significantly reduces incidence and intensity of patent S. japonicum infection and results in high compliance. Hence it can be used as an additional tool for the control of schistosomiasis japonica in the lake regions of China.

[Evaluation on molluscicidal effect of chlorosalicylicamide on Oncomelania hupensis in schistosomiaisis endemic areas of eight provinces in China].

OBJECTIVE: To evaluate the effects of a novel molluscicide, the salt quinoid-2', 5-dichloro-4'-nitrosalicylanilide from niclosamide (LDS), with 10% wettable powder, in main schistosomiasis epidemic areas of China, including Hunan, Jiangxi, Hubei, Anhui, Jiangsu, Sichuan, Yunnan and Zhejiang Province. METHODS: In the immersion test, 6 effective concentrations of 10% LDS were tested respectively: 0.1, 0.2, 0.4, 0.6, 0.8, 1.0 g/m3 in the field; at the same time, 50% wettable powder of niclosamide ethanolamine salt (WPN) with effective concentrations of 1.0 g/m was used as the molluscicide control, and the fresh water as the blank control, then the mortality rates of 0. hupensis snails were recorded at 24 h, 48 h and 72 h after the immersion. In the spraying test and powder-spraying test, 5 effective dosages of 10% LDS were tested respectively: 0.2, 0.4, 0.6, 0.8, 1.0 g/m2, while 50% WPN 1.0 g/m2 was used as the molluscicide control, and the fresh water as the blank control in the field for 1 d, 3 d and 7 d, then the mortality rates of O. hupensis snails were recorded at 1 d, 3 d and 7 d after the spraying and powder-spraying. RESULTS: The snail mortality rates of LDS using the immersion test for 72 h were more than 95% in the field of eight provinces (0.1 g/m in Sichuan, Jiangxi, Jiangsu and Zhejiang provinces, 0.2 g/m3 in Yunnan, Hunan and Hubei provinces, and 0.4 g/min Anhui Province); the snail mortality rates of LDS using the spraying test for 7 d were more than 85% (0.2 g/m2 in Hunan, Hubei, Jiangxi and Zhejiang provinces, 0.4 g/m2 in Sichuan and Anhui provinces, 0.6 g/m2 in Yunnan and Jiangsu provinces). The snail mortality rates of LDS the powder-spraying test for 7 d were more than 85% (0.6 g/m2 in Yunnan, Sichuan, Hubei, Jiangxi, Anhui, Jiangsu and Zhejiang provinces). According to the standards of "Efficacy test methods and evaluation of molluscicide for pesticide registration (NY/T 1617-2008)", LDS is a qualified molluscicide. CONCLUSIONS: LDS has good molluscicidal effects through the immersion, spraying and powder-spraying test in the fields. It is suitable for a variety of environments to control O. hupensis snails of schistosomiasis endemic areas in China. The recommended dosages of LDS are 0.1-0.2 g/m3 by the immersion method, 0.2-0.4 g/m2 by the spraying method, and 0.4-0.6 g/m2 by the powder-spraying method in the fields.

A baseline study of importance of bovines for human Schistosoma japonicum infections around Poyang Lake, China: villages studied and snail sampling strategy.

An epidemiologic survey among four administrative villages around Poyang Lake, in Jiangxi Province, China (two experimental and two controls) is being conducted to determine if bovine infections are responsible for the persistence of human schistosomiasis transmission on Yangtze River marshlands. A previously published paper presented the experimental design and baseline data for humans and bovines. This paper presents basic data for the four villages using remote sensing, and baseline data for snails that includes geographic information systems and remote sensing technology to classify the areas of bovine grazing ranges and habitats suitable for snails. A new method for sampling Oncomelania snails in China is used to determine the distribution, density, and infection rates of snails throughout the grazing ranges from season to season over a four-year period. Hypothetically, treating bovines should reduce infection rates in snails to below the critical number necessary to maintain infections in man and bovines.

[Application of multivariate regression in analyzing factors of schistosomiasis japonica transmission in Poyang lake].

OBJECTIVE: To analyze factors affecting transmission of schistosomiasis japonica in Poyang Lake. METHODS: Successive surveillance data for at least three years from 1992 to 1998 at the schistosomiasis endemic administrative villages surrounding Poyang Lake were collected, including the egg positive rate by stool examination, investment on treatment of patients and mollusciciding in snail habitat, risk areas, bovine infection rate. Data on rainfall and temperature were also obtained from the relevant agencies. Step-wised regression method was employed to analyze the data. RESULTS: The regression model established is statistically significant, R2 equals 0.735, P < 0.01. The accepted variables affecting the transmission of the disease were natural logarithm of human infection rate in last year, risk areas, infection rate of bovine, investment values of niclosamide per risk area and value of praziquantel administered per infection rate. CONCLUSION: Chemotherapy and mollusciciding effectively reduced schistosomiasis transmission in Poyang lake region, while the infection rate, risk areas, bovine infection rate still drive the transmission.

Application of remote sensing for surveillance of snail habitats in Poyang Lake, China.

OBJECTIVE: To identify snail habitats and monitor the changes by combining remote sensing technique with the ground-based ecological data. METHODS: Of 100 survey sites selected throughout Poyang Lake, 75 were randomly identified from 574 land mass units: 50 were from snail habitats and 25 were from non-snail habitats based on a historical survey (1982-1984); 25 sites with habitats that did not have snails were also selected. Each site, covering 10,000 m2, was divided into a grid of 100 cells from which 20 cells were randomly selected. Snails, when present, were collected from a 4 m2 frame placed in the center of the selected cell. Satellite Landsat TM images were obtained for the same period as the ground survey data collected. Unsupervised classification was used to classify the images. Identified land-cover types were correlated with snail habitat. RESULTS: The sensitivity and specificity of classified snail habitat were 90.0%-95.6% and 61.1%-68.6%, respectively. Based on the classification, estimated snail habitat areas in Poyang Lake increased from 623.4 km2 in 1999 to 762.8 km2 in 2000. CONCLUSION: Snail habitats are associated with grassland-covered areas. Classified images can be used to identify snail habitats, determine their areas, and monitor snail habitat changes caused by annual fluctuations of key environmental factors.

[Analysis of characteristics of schistosome cercarial infested water contacts of residents in Poyang Lake endemic areas after operation of Three Gorges Project].

OBJECTIVE: To understand the characteristics of schistosome cercarial infested water contact of residents in Poyang Lake endemic areas after the operation of Three Gorges Project, so as to provide the evidence for formulating a well-directed control strategy. METHODS: The residents in two villages in schistosomiasis endemic areas were selected and surveyed for their activities of infested water contacts by questionnaire. RESULTS: The proportion and frequency of infested water contacts of residents in Poyang Lake region were high and the average rate of infested water contacts was 69.77%, and 98.96% of infested water contacts occurred in spring, summer and autumn. The main ways of infested water contacts were fishing/swimming/playing for adult men, washing clothes/fishing for adult women, and swimming/playing for school children, respectively. The rates of infested water contacts were 73.33%, 71.63% and 61.87% in adult men, women and school children, respectively. The frequencies of infested water contacts > 1 time/week, 1 time/week-1 time/month, and < 1 time/month were 62.61%, 23.74% and 13.66% respectively. CONCLUSIONS: The infested water contacts mainly occurs in spring, summer and autumn, and the main way of infested water contacts was fishing. Farming and mowing grass, which had been the primary way, now become the secondary way for the adult residents.

[Studies on changes of vegetation and Oncomelania hupensis snails in Poyang Lake after impoundment of Three Gorges Project].

OBJECTIVE: To explore the impact and change regularity of Oncomelania hupensis snails and vegetation in the marshlands of Poyang Lake caused by the impoundment of the Three Gorges Project. METHODS: By using the methods of stratified systematic sampling and pinpoint navigation, the succession of vegetation was observed and the distribution of O. hupensis snails was investigated in a period of 8 years on 4 typical marshlands in Poyang Lake. The regularity of changes in vegetation and 0. hupensis snails was analyzed on the marshlands at high, medium and low elevations, respectively. RESULTS: After the impoundment of Three Gorges Project, the average flooding days of these 4 marshlands in 2004 and in 2008 were reduced of 74.8 and 65.8 days compared with those in 2002, the year just before the impoundment of the project, respectively. The change of spatial distribution pattern and the succession of dominant species of vegetation on the marshlands of Poyang Lake have taken place since 2005, and several vegetations showed a trend of moving toward the center of the lake. The hygrophilous vegetation has degenerated and gradually been replaced by mesophily meadow in the marshland area above 14 m elevation. Carex, Phalaris arundinacea and Polygonum appeared in large area and expanded slowly towards the center of the lake on the marshland below 14 m elevation. O. hupensis snails were mostly found under the Carex association. The tendency of decreasing in density of snails and of migration of snail habitats towards low terrain was observed. CONCLUSIONS: The impoundment of Three Gorges Project has had a significant impact on hydrological regimes, and a new succession of vegetation has taken place in the marshlands of Poyang Lake. O. hupensis snails and the mesophily vegetation show a trend of migrating slowly to the areas of low elevation in the marshlands.

Immune responses result in misdiagnosis of Schistosoma japonicum by immunodiagnosis kits in egg-positive patients living in a low schistosomiasis transmission area of China.

BACKGROUND: In recent field surveys, we failed to detect the presence of specific antibody against Schistosoma japonicum in some egg-positive patients by commonly used immunodiagnostic kits. To find out whether low levels of specific antibody truly exist among egg-positive individuals and elucidate the underlying immune mechanisms, we carried out a cross-sectional epidemiologic study in a S. japonicum low transmission endemic area of Poyang Lake region, China and compared the humoral and cellular immune characteristics between S. japonicum high and low antibody responders. METHODS: Kato-Katz thick smear assay was used to determine the schistosomiasis status of 3,384 participants residing in two Poyang Lake region villages, Jiangxi, China. Among the 142 stool egg-positive participants, we identified low and high S. japonicum antibody responders with soluble egg antigen (SEA) and adult worm antigen (AWA) specific IgG levels by adopting ROC curve analysis. To compare the humoral and cellular immune responses between high and low S. japonicum antibody responders, serum specific antibody levels as well as the percentage of T lymphocyte subpopulation in PMBC, and cell stimulated cytokines (IFN- gamma and interlukin-10) were detected. RESULTS: Eight S. japonicum egg-positive participants were defined as low antibody responders. Although the percentage of CD3⁺T cells in low responders was slightly higher and the percentage of CD4⁺ T cells, CD8⁺ T cells, the ratio of CD4⁺/CD8⁺ and CD4⁺ CD25⁺ Treg cells were lower than those in high responders, the differences between the two groups were not significant (P > 0.05). AWA -stimulated interlukin-10 level was significantly higher in high responders, while other cytokines did not show differences between two groups. For antibody profiles, except AWA specific IgA, significant differences of each antibody isotype between low and high responders were detected (P < 0.05). CONCLUSIONS: Our study confirmed that there are S. japonicum antibody low responders among schistosome egg-positive residents in S. japonicum low-transmission areas in China. Thus, mis-diagnosis using immune-diagnosis kits do exist. Significant differences of responding antibody levels between low and high responders were detected, while no major cellular response changes were observed.

[The changes of hydrological regime in Poyang Lake after runs of Three Gorges Project and its impact on prevalence of schistosomiasis in the lake region].

OBJECTIVE: To clarify new features of hydrological regime in the Poyang Lake after runs of the Three Gorges Project and its impact on the prevalence of schistosomiasis in this region. METHODS: It is collected information of Three Gorges Project, average daily water level from 2002 to 2012 at Duchang hydrological station in Poyang Lake and the data of prevalence and control of schistosomiasis in 12 endemic counties along the lake. It was analyzed the trends of prevalence of schistosomiasis under the changed condition of hydrologic situation. RESULTS: Effects of impoundment of Three Gorges reservoir running on water level of Poyang Lake are mainly shown in: Water levels of the lake are suppressed throughout the year which was characterized by high water level in flood season dropped, lower water level appeared in the spring, water withdrew earlier and quicker in the fall and to an even lower level in dry season. After impoundment of Three Gorges Project, infection rate of Schistosomajaponica in human and in bovine decreased by 92.65% and 76.37% respectively in endemic areas around the lake. The density of Oncomelania snails decreased by 94.21%. Prevalent of schistosomiasis in this region showed a significant downward trend. CONCLUSIONS: After runs of the Three Gorges Project, regularized changes hydrologic conditions has taken place in Poyang Lake which is characterized by lower water level and thus might lead to lower density of Oncomelania snails on marshlands and reducing of prevalence of schistosomiasis. Significant strengthening of schistosomiasis control efforts might also contributed to the stable and low level of prevalence of schistosomiasis in the region.