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BACKGROUND: Hubei Province, China, has been operating a malaria elimination programme. This study aimed at investigating the epidemiologic characteristics of malaria in Hubei Province (2005-2016) to plan resource allocation for malaria elimination. METHODS: Data on all malaria cases from 2005 to 2016 in all counties of Hubei Province were extracted from a web-based reporting system. The numbers of indigenous and imported cases during the disease control (2005-2010) and elimination (2011-2016) stages, as well as their spatiotemporal distribution, were compared. RESULTS: A total of 8109 malaria cases were reported from 2005 to 2016 (7270 and 839 cases during the control and elimination stages, respectively). Between 2005 and 2010, indigenous malaria cases comprised the majority of total cases (7114/7270; 97.9%), and Plasmodium vivax malaria cases accounted for most malaria cases (5572/7270; 76.6%). No indigenous malaria cases have been reported in Hubei Province since 2013. Imported malaria cases showed a gradually increasing trend from 2011 to 2016, Plasmodium falciparum was the predominant species in these cases, and the number of counties with imported cases increased from 4 in 2005 to 47 in 2016. During the control and elimination stages, the most likely spatial clusters for indigenous cases included 13 and 11 counties, respectively. However, the cluster of indigenous malaria cases has not been identified since September 2011. For imported cases, the most likely cluster and three secondary clusters during both stages were identified. CONCLUSIONS: Hubei Province has made significant achievements in controlling and eliminating malaria; however, the region now faces some challenges associated with the increasing number and distribution of imported malaria cases. Priorities for malaria elimination should include better management of imported malaria cases, prevention of secondary malaria transmission, and ensuring the sustainability of malaria surveillance.
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Control de Enfermedades Transmisibles/métodos , Erradicación de la Enfermedad/métodos , Malaria Falciparum/prevención & control , Malaria Vivax/prevención & control , Plasmodium falciparum/aislamiento & purificación , Plasmodium vivax/aislamiento & purificación , China/epidemiología , Incidencia , Malaria Falciparum/epidemiología , Malaria Falciparum/parasitología , Malaria Vivax/epidemiología , Malaria Vivax/parasitología , PrevalenciaRESUMEN
Conventional adaptive T cell responses contribute to the pathogenesis of Schistosoma japonicum infection, leading to liver fibrosis. However, the role of gamma-delta (γδ) T cells in this disease is less clear. γδ T cells are known to secrete interleukin-17 (IL-17) in response to infection, exerting either protective or pathogenic functions. In the present study, mice infected with S. japonicum are used to characterize the role of γδ T cells. Combined with the infection of S. japonicum, an extremely significant increase in the percentage of neutrophils in the CD45+ cells was detected (from approximately 2.45% to 46.10% in blood and from 0.18% to 7.34% in spleen). Further analysis identified two different γδ T cell subsets that have different functions in the formation of granulomas in S. japonicum-infected mice. The Vγ1 T cells secrete gamma interferon (IFN-γ) only, while the Vγ2 T cells secrete both IL-17A and IFN-γ. Both subtypes lose the ability to secrete cytokine during the late stage of infection (12 weeks postinfection). When we depleted the Vγ2 T cells in infected mice, the percentage of neutrophils in blood and spleen decreased significantly, the liver fibrosis in the granulomas was reduced, and the level of IL-17A in the serum decreased (P < 0.05). These results suggest that during S. japonicum infection, Vγ2 T cells can recruit neutrophils and aggravate liver fibrosis by secreting IL-17A. This is the first report that a subset of γδ T cells plays a partial role in the pathological process of schistosome infection.
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Cirrosis Hepática/inmunología , Cirrosis Hepática/microbiología , Neutrófilos/inmunología , Schistosoma japonicum/inmunología , Subgrupos de Linfocitos T/inmunología , Animales , Citocinas/inmunología , Interferón gamma/inmunología , Interleucina-17/inmunología , Cirrosis Hepática/fisiopatología , Ratones , Ratones Endogámicos C57BL , Receptores de Antígenos de Linfocitos T gamma-delta/inmunologíaRESUMEN
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.
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Esquistosomiasis/epidemiología , Adolescente , Adulto , Anciano , Animales , Bovinos , Niño , China/epidemiología , Enfermedades Transmisibles , Heces , Necesidades y Demandas de Servicios de Salud , Humanos , Persona de Mediana Edad , Prevalencia , Caracoles , Adulto JovenRESUMEN
OBJECTIVE: To evaluate the effect of comprehensive measures with an emphasis on schistosomiasis infection source control by replacing cattle with machine. METHODS: In 2011, 2 villages from each of Jingzhou District, Jianli County and Jiangling County, Hubei Province, were selected as intervention group where the comprehensive measures were implemented, while 2 villages from Shishou City served as control with routine control activities. A cluster random sampling was carried out in the 8 villages with more than 300 people in each village were sampled. Stool examination using modified Kato-Katz was applied for identification of the infected persons and hatching test for cattle survey. The systemic sampling was applied for snail survey, fecal specimens from the field were examined by hatching test. Each sample was examined three times. Data were collected for the analysis of control effect between intervention and control groups in 2007 (baseline), 2009 (before implementation of comprehensive measures) and 2011 (post-intervention). RESULTS: In intervention villages, the overall prevalence in human reduced significantly from 3.6% (135/3 772) in 2007 and 2.0% (63/3 116) in 2009 to 0.9% (21/2 396) in 2011 (chi2 = 43.411, chi2 = 11.840, P < 0.05). Until 2011, there were no cattle in intervention group; the prevalence decreased by 52.6% in human and about 100% in cattle from 2010 to 2011. In control group, the infection rate in residents in 2007, 2009 and 2011 was 4.5% (64/1 410), 2.6% (34/1 294) and 1.8% (24/1,320), respectively (chi2 = 16.178, P < 0.05), and 5.1% (8/158) in 2007, 1.6% (3/187) in 2009 and 1.6% (3/189) in 2011 in cattle, respectively (chi2 = 3.387, P > 0.05). The infection rate in human and cattle fell by 25.0% and 5.9% from 2010 to 2011, respectively. There was a significant difference in human infection rate between the intervention and control groups after intervention (chi2 = 6.309, P < 0.05). No infected snails were detected in intervention and control groups. No positive feces from the field was found in the intervention group, 7.5% positive rate was recorded in the control. CONCLUSION: The comprehensive measures focused on infection source control by replacing cattle with machine can effectively control Schistosoma japonicum transmission, with a significant decrease of the prevalence in human and cattle.
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Enfermedades de los Bovinos/prevención & control , Esquistosomiasis/prevención & control , Animales , Estudios de Casos y Controles , Bovinos , Enfermedades de los Bovinos/epidemiología , Enfermedades de los Bovinos/parasitología , China/epidemiología , Heces/parasitología , Humanos , Incidencia , Prevalencia , Esquistosomiasis/epidemiología , Esquistosomiasis/parasitología , Caracoles/parasitologíaRESUMEN
Chikungunya fever, an acute infectious disease caused by Chikungunya virus (CHIKV), is transmitted by Aedes aegypti mosquitoes, with fever, rash, and joint pain as the main features. 1952, the first outbreak of Chikungunya fever was in Tanzania, Africa, and the virus was isolated in 1953. The epidemic has expanded from Africa to South Asia, the Indian Ocean islands and the Americas, and is now present in more than 100 countries and territories worldwide, causing approximately 1 million infections worldwide each year. In addition, fatal cases have been reported, making CHIKV a relevant public health disease. The evolution of the virus, globalization, and climate change may have contributed to the spread of CHIKV. 2005-2006 saw the most severe outbreak on Reunion Island, affecting nearly 35% of the population. Since 2005, cases of Chikungunya fever have spread mainly in tropical and subtropical regions, eventually reaching the Americas through the Caribbean island. Today, CHIKV is widely spread worldwide and is a global public health problem. In addition, the lack of a preventive vaccine and approved antiviral treatment makes CHIKV a major global health threat. In this review, we discuss the current knowledge on the pathogenesis of CHIKV, focusing on the atypical disease manifestations. We also provide an updated review of the current development of CHIKV vaccines. Overall, these aspects represent some of the most recent advances in our understanding of CHIKV pathogenesis and also provide important insights into the current development of CHIKV and potential CHIKV vaccines for current development and clinical trials.
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Fiebre Chikungunya , Virus Chikungunya , Animales , Humanos , Fiebre Chikungunya/epidemiología , Mosquitos Vectores , Brotes de Enfermedades , Tanzanía/epidemiologíaRESUMEN
Background and aims: Spinal serum 25-hydroxyvitamin D [25[OH]D] status plays an important role in mediating innate immune responses by acting as a cofactor for induction of antimycobacterial activity and is thus involved in the development of Tuberculosis (TB). Results reported regarding the association of vitamin D with TB remained controversial. We aimed to identify any common association between 25[OH]D status and TB in the Chinese Han population. Methods: 280 subjects (70 TB patients and 210 matched controls) were recruited. TB cases were diagnosed based on the presence of acid-fast bacilli on smears from sputum and MTB isolation. Healthy controls were randomly selected from four local community-based populations. 25[OH]D was detected by electrochemiluminescence immunoassay (ECLIA) on Roche Elecsys before the initial treatment. Multivariable logistic regression analysis was used to examine the association of Vitamin D with TB. Results: There was no significant difference in the serum vitamin D level between total cases and controls, but we found a strong tendency toward a higher serum vitamin D level in male population (P < 0.05) with TB but not in females. High serum vitamin D increased the risk of TB in the Chinese Han population (OR = 1.035, 95%CI: 1.001-1.070, P < 0.05). The serum vitamin D level was significantly decreased with age increasing in cases and controls (all P < 0.001). Conclusions: High serum vitamin D may be an independent risk factor for TB in the Chinese Han population.
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BACKGROUND: The Hubei province is one of the most schistosomiasis-epidemic-prone provinces in China. A series of strategies were adopted by the government to curb the rebound schistosomiasis endemic status that has prevailed since the early 2000s. This study aimed to elucidate the trends of schistosomiasis transmission and to appraise the effectiveness of the integrated control strategy in lake and marshland areas. METHODS: Surveillance data of schistosomiasis in the Hubei province between 2005 and 2018 were analyzed, including conventional health control measures, integrated strategies, and measures that focused on the infection source. According to the local annual plan for schistosomiasis control in endemic counties, previous measures were human and snail control and surveillance. Residents aged 6-65 years were screened by an immunological detection method called indirect hemagglutination assay (IHA) after the transmission season each year. All residents who tested positive were then asked to provide a fecal sample for examination by the miracidium hatching technique (MHT) to detect the presence of schistosomes. Moreover, systematic snail surveys were conducted as a part of the combined environmental sampling method. The latter included integrated strategies and measures that focused on the infection source. Bovine stool samples were also collected and concurrently assessed using the MHT by the agriculture department, river-hardening slope protection was constructed by the water conservancy department, and forestation promotion was conducted by the forest department. The effectiveness of the integrated control strategy was assessed using two indicators of resident and livestock infection rates and three indicators of snail epidemics across all endemic areas. RESULTS: From 2005 to 2018, a total of 28. 46 million and 2. 05 million residents were assessed by immunological (IHA) and etiological (MHT) detection techniques, respectively. Snail surveys and molluscicide application were performed in 2. 26 hectares and 0. 37 hectares, respectively. Moreover, 2. 60 million bovines were assessed by etiological detection techniques (MHT). The river-hardening slope protection project was implemented in 503 places, and 46 thousand hectares in endemic areas underwent environmental modification. Forestation was implemented at an area of 0. 15 million hectares. Between 2005 and 2018, the epidemic indicators, including resident and livestock infection rates and the infested areas and infection rate of snails, all presented downward trends. The resident infection rate decreased from 3. 78% in 2005 to 0% in 2016, which persisted through 2018. The livestock infection rate decreased from 5. 63% in 2005 to 0% in 2013, which also persisted through 2018. From 2005 to 2018, the snail-inhabited area was slightly reduced, but the area of infected snails decreased to 0 in 2012; this persisted through 2018. All counties met the goal for schistosomiasis infection control, transmission control, and disruption of schistosomiasis activity in 2008, 2013, and 2018 separately. That means the goal has been achieved in each stage. CONCLUSIONS: The decline of the schistosomiasis epidemic rate demonstrates that the Chinese government was successful in meeting its public health goal in Hubei province. In the next decade, precision interventions must be implemented in endemic counties with a relatively low epidemic status to achieve the goals of the Outline of the Healthy China 2030 Plan. A similar strategy can be applied in other countries to eliminate schistosomiasis globally.
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Moluscocidas , Esquistosomiasis , Animales , Bovinos , China/epidemiología , Humanos , Ganado , Salud Pública , Schistosoma , Esquistosomiasis/epidemiología , Esquistosomiasis/prevención & controlRESUMEN
BACKGROUND: Control of snail intermediate hosts has been proved to be a fast and efficient approach for interrupting the transmission of schistosomiasis. Some plant extracts have shown obvious molluscicidal activity, and a new compound Luo-Wei, also named tea-seed distilled saponin (TDS), was developed based on the saponins extracted from Camellia oleifera seeds. We aimed to test the molluscicidal activity of 4% TDS against the intermediate host snails in China and Egypt, and evaluate its environmental safety to non-target organisms. METHODS: In the laboratory, Oncomelania hupensis, Biomphalaria alexandrina and Bulinus truncatus were exposed to 4% TDS, and the median lethal concentration (LC50) was estimated at 24, 48 and 72 h. In the field, snail mortalities were assessed 1, 2, 3 and 7 d post-immersion with 2.5 g/m3 4% TDS and 1, 3, 7 and 15 d post-spraying with 5 g/m2 4% TDS. In addition, the acute toxicity of 4% TDS to Japanese quail (Coturnix japonica), zebrafish (Brachydanio rerio) and freshwater shrimp (Macrobrachium nipponense) was assessed by estimations of LC50 or median lethal dose (LD50). RESULTS: In the laboratory, the LC50 values of 4% TDS for O. hupensis were 0.701, 0.371 and 0.33 mg/L at 24, 48 and 72 h, respectively, and 4% TDS showed a 1.975 mg/L [corrected] 24 h LC50 against B. alexandrina, and a 1.396 mg/L 24 h LC50 against B. truncatus. Across all study regions, the pooled mortalities of O. hupensis were 72, 86, 94 and 98% at 1, 2, 3 and 7 d, following field immersion of 4% TDS at a dose of 2.5 g/m3, and were 69, 77, 85 and 88% at 1, 3, 7 and 15 d, following field spraying at 5 g/m2, respectively. 4% TDS had moderate toxicity to Japanese quail (7 d LD50 > 60 mg/kg) and to shrimp (96 h LC50 = 6.28 mg/L; 95% CI: 3.53-11.2 mg/L), whereas its toxicity to zebrafish was high (96 h LC50 = 0.15 mg/L; 95% CI: 0.14-0.17 mg/L). CONCLUSIONS: 4% TDS is active against O. hupensis, B. alexandrina and B. truncatus under laboratory and field conditions, and it may be a candidate molluscicide of plant origin.
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Moluscocidas/administración & dosificación , Moluscocidas/toxicidad , Schistosoma/efectos de los fármacos , Caracoles/efectos de los fármacos , Caracoles/parasitología , Animales , Biomphalaria , Bulinus , China , Egipto , Dosificación Letal Mediana , Extractos Vegetales , Codorniz , Esquistosomiasis/prevención & control , Pruebas de ToxicidadRESUMEN
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Schistosomiasis caused by parasitic flatworms of blood flukes, remains a major public health concern in China. The significant progress in controlling schistosomiasis in China over the past decades has resulted in the remarkable reduction in the prevalence and intensity of Schistosoma japonicum infection to an extremely low level. Therefore, the elimination of schistosomiasis has been promoted by the Chinese national government. Hubei Province is the major endemic area, that is, along the middle and low reaches of the Yangtze River in the lake and marshland regions of southern China. Eliminating the transmission of schistosomiasis in Hubei Province is challenging. The current issue is to determine the distributions and clusters of schistosomiasis transmission. In this study, we assessed the spatial distribution of schistosomiasis and the risk at the county level in Hubei Province from 2011 to 2015 to provide guidance on the elimination of schistosomiasis transmission in lake and marshland regions. Spatial database of human S.japonicum infection from 2011 to 2015 at the county level in the study area was built based on the annual schistosomias is surveillance data. Moran's I, the global spatial autocorrelation statistics, was utilized to describe the spatial autocorrelation of human S. japonicum infection. In addition, purely spatial scan statistics combined with space-time scan statistics were used to determine the epidemic clusters. Infection rates of S. japonicum decreased in each endemic county in Hubei from 2011 to 2015. Human S. japonicum infection rate showed statistical significance by global autocorrelation analysis during the study period (Moran's Iâ¯>â¯0, Pâ¯<â¯0.01). This result suggested that there were spatial clusters present in the distribution of S. japonicum infection for the five years. Purely spatial analysis of human S. japonicum infection showed one most likely cluster and one secondary cluster from 2011 to 2015, which covered four and one counties, respectively. Spatiotemporal clustering analysis determined one most likely cluster and one secondary cluster both in 2011-2012, which appeared in 4 and 5 counties, respectively. However, the number of clustering foci decreased with time, and no cluster was detected after 2013.The clustering foci were both located at the Jianghan Plain, along the middle reaches of the Yangtze River and its connecting branch Hanbei River. Spatial distribution of human S. japonicum infections did not change temporally at the county level in Hubei Province. A declining trend in spatiotemporal clustering was observed between 2011 and 2015. However, effective control strategies and integrated prevention should be continuously performed, especially at the Jianghan Plain area along the Yangtze and Hanbei River Basin. Multivariate statistical analysis was carried out to investigate the risk of missing examinations, missing treatment, and unstandardized treatment events. The results showed that age, education level and Sanitary latrines are risk factors for missing examinations (bâ¯>â¯0, OR >1), and treatment times in past and feeding cattle in village group are protective factors (bâ¯<â¯0, OR <1). We also found that age and education level are risk factors for missing treatment (bâ¯>â¯0, OR >1). Study of the risk for un-standardized treatment revealed that occupation is risk factors (bâ¯>â¯0, OR >1), though, education level is protective factors (bâ¯<â¯0, OR <1). Therefore, precise prevention and control should be mainly targeted at these special populations.
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Schistosoma/crecimiento & desarrollo , Esquistosomiasis/epidemiología , Análisis Espacio-Temporal , Animales , Bovinos , China/epidemiología , Bases de Datos Factuales , Epidemias , Humanos , Lagos/parasitología , Prevalencia , Factores de Riesgo , Ríos/parasitología , Esquistosomiasis/parasitología , Agrupamiento Espacio-Temporal , Cuartos de BañoRESUMEN
BACKGROUND: The province of Hubei is located in the middle of China, near the middle and lower reaches of the River Yangtze, and is an area where schistosomiasis is endemic. It is challenging to control this disease in this environment, and it would be useful to identify clusters of infection and transmission, as well as their distributions during recent years. Therefore, this study aimed to analyze the spatial distribution of schistosomiasis in Hubei, in order to facilitate the effective control and elimination of this disease. METHODS: We collected schistosomiasis surveillance data from all endemic counties in Hubei during 2009-2014. A geographical information system (ArcGIS, version 10.1) was used to link the counties' geographical data with the epidemiological data, and the spatial scanning method (FleXScan v3.1.2) was used to identify spatial clusters of human infections with Schistosoma japonicum. RESULTS: In Hubei, patients who exhibited stool test results that were positive for S. japonicum accounted for > 50 % of all cases in China during 2009-2014. However, each endemic county in Hubei exhibited a declining trend in the number of human S. japonicum infections during the study period. The ArcGIS analyses revealed that the middle reaches of the River Yangtze were highly endemic for S. japonicum infections. Spatial scan analyses revealed the following infection clusters: two clusters in ten counties during 2009, two clusters in nine counties during 2010, three clusters in 12 counties during 2011, two clusters in 12 counties during both 2012 and 2013 and two clusters in ten counties during 2014. Most of the cluster regions were located in the lake and marshland regions along the basins of the River Yangtze. CONCLUSION: We successfully identified schistosomiasis clusters at the county level in Hubei during 2009-2014, and our results revealed that the clusters were typically located in lake and marshland regions. These data may be useful for controlling and eliminating schistosomiasis in other high-risk areas.
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Monitoreo Epidemiológico , Schistosoma japonicum/aislamiento & purificación , Esquistosomiasis Japónica/epidemiología , Caracoles/parasitología , Análisis Espacial , Adolescente , Adulto , Anciano , Animales , Niño , China/epidemiología , Heces/parasitología , Femenino , Sistemas de Información Geográfica/estadística & datos numéricos , Humanos , Lagos/parasitología , Ganado/parasitología , Masculino , Persona de Mediana Edad , Ríos/parasitología , Esquistosomiasis Japónica/parasitología , Esquistosomiasis Japónica/transmisión , Adulto JovenRESUMEN
BACKGROUND: Schistosomiasis remains a major public health problem in China. The major endemic areas are located in the lake and marshland regions of southern China, particularly in areas along the middle and low reach of the Yangtze River. Spatial analytical techniques are often used in epidemiology to identify spatial clusters in disease regions. This study assesses the spatial distribution of schistosomiasis and explores high-risk regions in Hubei Province, China to provide guidance on schistosomiasis control in marshland regions. METHODS: In this study, spatial autocorrelation methodologies, including global Moran's I and local Getis-Ord statistics, were utilized to describe and map spatial clusters and areas where human Schistosoma japonicum infection is prevalent at the county level in Hubei province. In addition, linear logistic regression model was used to determine the characteristics of spatial autocorrelation with time. RESULTS: The infection rates of S. japonicum decreased from 2009 to 2013. The global autocorrelation analysis results on the infection rate of S. japonicum for five years showed statistical significance (Moran's I > 0, P < 0.01), which suggested that spatial clusters were present in the distribution of S. japonicum infection from 2009 to 2013. Local autocorrelation analysis results showed that the number of highly aggregated areas ranged from eight to eleven within the five-year analysis period. The highly aggregated areas were mainly distributed in eight counties. CONCLUSIONS: The spatial distribution of human S. japonicum infections did not exhibit a temporal change at the county level in Hubei Province. The risk factors that influence human S. japonicum transmission may not have changed after achieving the national criterion of infection control. The findings indicated that spatial-temporal surveillance of S. japonicum transmission plays a significant role on schistosomiasis control. Timely and integrated prevention should be continued, especially in the Yangtze River Basin of Jianghan Plain area.
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Sistemas de Información Geográfica , Schistosoma japonicum/patogenicidad , Esquistosomiasis/epidemiología , Esquistosomiasis/parasitología , Análisis Espacial , Adolescente , Adulto , Anciano , Animales , Niño , China/epidemiología , Humanos , Lagos , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Ríos , Factores de Tiempo , Adulto JovenRESUMEN
OBJECTIVE: To investigate the effect and current situation of the standardized construction of laboratories of schis- tosomiasis control institutions in Hubei Province, so as to provide the evidence for establishing and improving the quality control system of diagnosis of schistosomiasis after the transmission of schistosomiasis was under control. METHODS: According to the procedures of self-examination, field operation, and laboratory on-site, five laboratories were assessed, and all the results were analyzed comparatively. RESULTS: The average number of staffs were (7.00±1.58) persons, and the staffs of the laboratories of the schistosomiasis control institutions with senior professional titles in the city level were more than that in the county level (t = 5.563, P < 0.05). The average space was (3.20±1.64) rooms, and the average area was (117.00±88.29) m2. The average score of field operation was (96.40±4.49) points. The average score of laboratory on-site assessment was (106.6±6.15) points. The highest and lowest of the laboratory on-site assessment scores were environment and facilities (19.60 ± 0.55) points and management system of laboratory quality control (15.70±2.39) points (F = 2.869, P < 0.05), respectively. CONCLUSION: The cultivation of laboratory staff should be strengthened, and the diagnostic capacity should be maintained and improved. The laboratory quality control system should be paid more attention to, and the construction and management of schistosomiasis laboratories should be standardized.
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Control de Enfermedades Transmisibles/normas , Laboratorios/normas , Esquistosomiasis/prevención & control , Adolescente , Adulto , Anciano , Animales , Bovinos , Niño , China/epidemiología , Ciudades , Control de Enfermedades Transmisibles/instrumentación , Control de Enfermedades Transmisibles/métodos , Reservorios de Enfermedades/parasitología , Ambiente , Femenino , Humanos , Masculino , Persona de Mediana Edad , Schistosoma/fisiología , Esquistosomiasis/epidemiología , Esquistosomiasis/parasitología , Caracoles/crecimiento & desarrollo , Caracoles/parasitología , Recursos Humanos , Adulto JovenRESUMEN
OBJECTIVE: To assess the schistosomiasis endemic situation in the national surveillance sites in Hubei Province, so as to provide the evidence for the prevention and control of schistosomiasis. METHODS: According to the national surveillance protocol, a longitudinal surveillance of endemic situation of schistosomiasis was carried out in 16 national surveillance sites from 2005 to 2010. RESULTS: In general, the positive rates of IHA, Kato-Katz technique and infection rates of Schistosoma japonicum decreased from 15.67%, 10.93% and 1.71% in 2005 to 10.48%, 8.54% and 0.90% in 2010, and declined by 33.12%, 22.70% and 47.95%, respectively. The infection rates of S. japonicum of the male were higher than that of the female, and the peak infection rates were in the groups aged above 30 years. The endemic situation of fishermen and farmers were relatively serious. The infection rates of S. japonicum in cattle decreased from 11.69% in 2005 to 1.41% in 2010, and declined by 88.01% (χ2 = 298.79, P < 0.001). The areas with infected Oncomelania hupensis snails, the densities of living snails, the rates of infected snails and the densities of infected snails decreased by 90.88%, 61.66%, 80.00% and 92.00%, respectively. CONCLUSION: The schistosomiasis endemic situation in the national surveillance sites in Hubei Province mitigates in 6 years, but the prevention is still a very daunting task.
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Monitoreo Epidemiológico , Schistosoma japonicum/fisiología , Esquistosomiasis Japónica/epidemiología , Adolescente , Adulto , Animales , Bovinos , Niño , China/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Esquistosomiasis Japónica/veterinaria , Adulto JovenRESUMEN
OBJECTIVE: To explore the potential key risk factors of schistosomiasis transmission in potential endemic areas so as to provide the evidence for setting up the prediction and surveillance systems of schistosomiasis outbreak epidemic. METHODS: From 2008 to 2012, fixed and mobile surveillance sites in potential endemic areas of 2 counties in Hubei Province were selected. The immunological assays and stool examinations were carried out to investigate the schistosome infection situation of local people, mobile population and livestock. The distribution of Oncomelania hupensis snails was investigated in risk areas and suspicious areas, and spreading patterns of snails were observed in the rivers that directly connected with the Yangtze River. RESULTS: A total of 6 052 local people aged 6-65 years were screened by IHA immunological tests, and the positive rate of antibody was 1.19% (72/6 052). Totally 72 antibody positives were examined by Kato-Katz technique and there were no positives. A total of 5 004 mobile persons were tested by IHA immunological tests and the positive rate was 1.36% (68/5 004). Totally 68 antibody positives were examined by Kato-Katz technique and there were no positives. Totally 287.07 hm2 potential endemic areas were investigated for Oncomelania snail detection, and no snails were found. The investigation on snail spreading patterns and the surveillance on suspicious circumstances were carried out, with no snails found. CONCLUSIONS: In the schistosomiasis potential endemic areas, some positives of IHA immunological tests are found. Therefore, monitoring is still needed to be strengthened.
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Enfermedades Endémicas , Esquistosomiasis Japónica/epidemiología , Adolescente , Adulto , Anciano , Animales , Anticuerpos Antihelmínticos/sangre , Niño , China/epidemiología , Humanos , Persona de Mediana Edad , Caracoles , Factores de TiempoRESUMEN
BACKGROUND: Schistosomiasis remains a major public health problem in China. The major endemic foci are the lake and marshland regions of southern China, particularly the regions along the middle and lower reach of the Yangtze River in four provinces (Hubei, Hunan, Jiangxi, and Anhui). The purpose of our study is to assess the effect of a new integrated strategy emphasizing infection source control to curb schistosomiasis in marshland regions. METHODS: In a longitudinal study, we implemented an integrated control strategy emphasizing infection source control in 16 villages from 2005 through 2012 in marshland regions of Hubei province. The interventions included removing cattle from snail-infested grasslands, providing farmers with mechanized farm equipment, improving sanitation by supplying tap water, building lavatories and latrines, praziquantel chemotherapy, controlling snails, and environmental modification. RESULTS: Following the integrated control strategy designed to reduce the role of bovines and humans as sources of Schistosoma japonicum infection, the prevalence of human S. japonicum infection declined from 1.7% in 2005 to 0.4% in 2012 (P<0.001). Reductions were also observed in both sexes, across all age groups, and among high risk occupations. Moreover, the prevalence of bovine S. japonicum infection decreased from 11.7% in 2005 to 0.6% in 2012 (P<0.001). In addition, all the 16 villages achieved the national criteria of infection control in 2008. CONCLUSION: Our findings indicate that the integrated strategy was likely effective in controlling the transmission of S. japonicum in marshland regions in China.
Asunto(s)
Schistosoma japonicum/patogenicidad , Esquistosomiasis Japónica/epidemiología , Animales , Bovinos , China/epidemiología , Humanos , Estudios LongitudinalesRESUMEN
BACKGROUND: The transmission of schistosomiasis japonica in a local setting is still poorly understood in the lake regions of the People's Republic of China (P. R. China), and its transmission patterns are closely related to human, social and economic factors. METHODOLOGY/PRINCIPAL FINDINGS: We aimed to apply the integrated approach of artificial neural network (ANN) and logistic regression model in assessment of transmission risks of Schistosoma japonicum with epidemiological data collected from 2339 villagers from 1247 households in six villages of Jiangling County, P.R. China. By using the back-propagation (BP) of the ANN model, 16 factors out of 27 factors were screened, and the top five factors ranked by the absolute value of mean impact value (MIV) were mainly related to human behavior, i.e. integration of water contact history and infection history, family with past infection, history of water contact, infection history, and infection times. The top five factors screened by the logistic regression model were mainly related to the social economics, i.e. village level, economic conditions of family, age group, education level, and infection times. The risk of human infection with S. japonicum is higher in the population who are at age 15 or younger, or with lower education, or with the higher infection rate of the village, or with poor family, and in the population with more than one time to be infected. CONCLUSION/SIGNIFICANCE: Both BP artificial neural network and logistic regression model established in a small scale suggested that individual behavior and socioeconomic status are the most important risk factors in the transmission of schistosomiasis japonica. It was reviewed that the young population (≤15) in higher-risk areas was the main target to be intervened for the disease transmission control.
Asunto(s)
Métodos Epidemiológicos , Modelos Logísticos , Redes Neurales de la Computación , Schistosoma japonicum/aislamiento & purificación , Esquistosomiasis Japónica/epidemiología , Esquistosomiasis Japónica/transmisión , Adolescente , Adulto , Factores de Edad , Animales , Conducta , Niño , China/epidemiología , Educación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Medición de Riesgo , Población Rural , Factores Socioeconómicos , Adulto JovenRESUMEN
OBJECTIVE: To establish the measures of schistosomiasis field survey and evaluate the efficacy of their application according to the content of indexes of rapid assessment system to high transmission risks in schistosomiasis endemic areas of lake regions. METHODS: In 2012, based on the analysis of Oncomelania hupensis snail situation, and schistosomiasis epidemic data of human and cattle from 2008-2010, 60 villages from Hunan, Hubei, Jiangxi and Anhui provinces were selected and investigated, and the content of the investigation included the field feces, snail status, and epidemic situation of human and cattle. The systemic sampling was applied for snail investigation; the feces collected from snail investigation field were examined by the hatching test (3 bottles for 1 sample). A cluster random sampling was carried out with more than 300 people in each village. By using the hatching test (3 bottles for 1 sample) , the human stool examination was carried out for the identification of the infected persons who were positive in the immunity test screening. The hatching test was applied for cattle of all the villages (3 bottles for 1 sample). RESULTS: A total of 65 field feces spots were surveyed in 60 villages, field feces were found in 78.46% (51/65) of spots, and the positive rate of field feces was 1.07% (9/842). There were 73.33% (44,160)of villages with cattle, and the largest amount cattle with 329 was found in Wufeng Village, Jiangxi Province. The cattle infection rate was 1.5 1% (4,913,242) in 3242 investigated cattle. The highest cattle infection rate was 4% in Tongxin Village, Jiangxi Province. The population of 47 099 was surveyed, the infection rate was 0.77% (364/47 099), and the highest was 4.37% in Xumuchang Village, Hunan Province. The infection rate was 0 in 43.33% (26/60) of villages. No acute schistosomiasis cases were reported in all the villages in 2011 and 2012. Totally, 77 snail spots in 60 villages were investigated, and 51 spots were marshland and 26 spots were ditches. The schistosome-infected snails were detected in 5.88% (3/51 )of the marshland spots and the living snails were found in 80.39%(41/51) of the spots. The highest density of living snails was 3.20/0.1 m2 in Xumuchang Village, Hunan Province. The average density of infected snails was 0.00045/0.1 m2 (4/8942). The infected snail spots were distributed in Liujiadi Village and Liuhe Village of Hubei Province, and Jiangkou Village of Anhui Province. No infected snails were detected in 26 ditches spots. The living snails were detected in 53.85% (14/26) of the ditches spots. The highest average density of living snails was 3.76/0.1 m2 in Huakou Village, Hubei Province. CONCLUSIONS: The measures of field survey for rapid assessment system of high transmission risks in schistosomiasis endemic areas of lake regions are established and applied with scientific, impersonal and rapid characteristics.
Asunto(s)
Esquistosomiasis/transmisión , Animales , Bovinos , China/epidemiología , Ambiente , Humanos , Lagos , Densidad de Población , Riesgo , Caracoles , HumedalesRESUMEN
OBJECTIVE: To evaluate the performance of small Oncomelania snail control projects in Hubei Province in 2009 and 2010, so as to explore the best snail control project in different areas. METHODS: The expense-effect, expense-efficiency and cost-utility analyses were carried out to analyze the small snail control projects with reference to the relevant schistosomiasis japonica prevention and control index system. RESULTS: The coverage rate of snail control was 40.15%, the decrease rate of the snail areas was 32.86%, the unit cost for the snail control was 0.39 Yuan/m2, the cost of reducing 1% of the snail area was 67.34 ten thousand Yuan, the total benefit was 15 554.14 ten thousand Yuan, the ratio of cost to benefit was 7.03, the net benefit was 13 341.44 ten thousand Yuan, and the ratio of cost to net benefit was 6.03, and the investment ratio was 1 : 2.11 in the 183 small snail control projects. CONCLUSION: There is an obvious and respectable short-period effect of the small snail control projects.