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Objective To establish a surveillance and early warning index system for schistosomiasis transmission risk along the middle and lower reaches of the Yangtze River basin, so as to provide insights into creation of a sensitive and highly efficient surveillance and early warning system for schistosomiasis. Methods National and international publications, documents, laws and regulations pertaining to schistosomiasis control were retrieved with keywords including schistosomiasis, surveillance, early warning and control interventions from 2008 to 2022, and a thematic panel discussion was held to preliminarily construct surveillance and early warning index system for schistosomiasis transmission risk along the middle and lower reaches of the Yangtze River basin. The index system was then comprehensively scored and screened using the Delphi method, and the weight of each index was determined using analytic hierarchy process and the modified proportional allocation method. In addition, the credibility of the Delphi method was evaluated using positive coefficient, authority coefficient, degree of concentration and degree of coordination of experts. Results Following two rounds of expert consultation, a surveillance and early warning index system for schistosomiasis transmission risk in endemic areas along the middle and lower reaches of the Yangtze River basin was preliminarily constructed, including 3 primary indicators, 9 secondary indicators and 41 tertiary indicators. The normalized weights of primary indicators epidemics, natural and social factors and comprehensive control were 0.639 8, 0.145 6 and 0.214 6, respectively, and among all secondary indicators, snail status (0.321 3) and schistosomiasis prevalence (0.318 5) had the highest combined weights, while social factors had the lowest combined weight (0.030 4). Of all tertiary indicators, human egg-positive rate (0.041 9), number of acute schistosomiasis cases (0.041 5), number of stool-positive bovine and sheep (0.041 1), and prevalence of Schistosoma japonicum in free-ranging livestock (0.041 1) had the highest combined weights. During two rounds of consultation, the positive coefficient of experts was both 100%, and the authority coefficient was both 0.9 and greater, while the coordination coefficients were 0.338 to 0.441 and 0.426 to 0.565 (χ2 = 22.875 to 216.524, both P values < 0.05). Conclusions The established surveillance and early warning index system for schistosomiasis transmission risk along the middle and lower reaches of the Yangtze River basin is of great scientific values and authority, which may provide insights into construction of the sensitive and highly efficient surveillance and early warning system for schistosomiasis in the context of low prevalence and low intensity of infection in China.
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Objective To evaluate the impact of the flood disaster on schistosomiasis transmission along the Yangtze River basin in 2020, so as to provide insights into schistosomiasis prevention and control in flood-affected areas. Methods The data pertaining to the endemic situation of schistosomiasis were collected from 5 provinces of Hunan, Hubei, Jiangxi, Anhui and Jiangsu from 2013 to 2019, including Schistosoma japonicum infections in humans and livestock and snail distribution, and the warning water levels and actual water status were collected in water regions locating in these 5 provinces. The cumulative numbers of S. japonicum egg-positive individuals and bovines during the period from 2013 to 2019, the area of snail habitats in 2019 and the water level on July 12, 2020 were estimated at a county level and employed as parameters for classification of schistosomiasis transmission risk. Then, the cumulative value of each risk index was calculated to assess the risk of schistosomiasis transmission risk. Results After the flood disaster along the Yangtze River basin in 2020, there were 10, 5 and 9 counties (districts) at high risk of schistosomiasis transmission in 5 provinces of Hunan, Hubei, Jiangxi, Anhui and Jiangsu based on number of egg-positive individuals, number of egg-positive bovines and snail distribution, respectively. Based on comprehensive risk indices, there were 10 (8 in Dongting Lake regions of Hunan Province and 2 in Poyang Lake regions of Jiangxi Province) and 15 counties (districts) (4 in Hubei Province, 7 in Hunan Province and 4 in Jiangxi Province) identified at grades 5 and 4 risk of schistosomiasis transmission. Conclusions Dongting Lake regions and Poyang Lake regions are the most severely flood-affected schistosomiasis-endemic foci of China in 2020, and the flood disaster may facilitate the transmission of schistosomiasis in affected areas. Therefore, schistosomiasis control requires to be intensified after the flood disaster to prevent the rebound of the disease.
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Objective To investigate the spatio-temporal characteristics of Oncomelania hupensis snails along the Jiangsu section of the Yangtze River, so as to provide evidence for eliminating schistosomiasis and formulating precision control measures in Jiangsu Province. Methods A total of 75 marshlands were randomly sampled from Nanjing, Zhenjiang and Yangzhou cities along the Jiangsu section of the Yangtze River basin, and the spatio-temporal distribution and changing patterns of O. hupensis snails were investigated using the spatial autocorrelation analysis, kernel density analysis and hotspot analysis during the period from 2015 through 2017. Results There was a spatial autocorrelation in the mean snail density along the Jiangsu section of the Yangtze River basin during the period from 2015 through 2017. The number of living snails and the density of living snails showed an overall decline in Yangzhou City; however, both showed a slight increase in 2016. Kernel density analysis and hotspot analysis showed that the hotspots of living snails were located in the regions neighboring the marshlands at the Yangzhou-Zhenjiang boundary areas along the Jiangsu section of the Yangtze River basin. Conclusion There is a spatial autocorrelation in the snail distribution with hotspots along the Jiangsu section of the Yangtze River basin, and the surveillance of snails should not be neglected in the marshlands in Jiangsu Province.
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Objective To investigate the spatio-temporal characteristics of Oncomelania hupensis snails along the Jiangsu section of the Yangtze River, so as to provide evidence for eliminating schistosomiasis and formulating precision control measures in Jiangsu Province. Methods A total of 75 marshlands were randomly sampled from Nanjing, Zhenjiang and Yangzhou cities along the Jiangsu section of the Yangtze River basin, and the spatio-temporal distribution and changing patterns of O. hupensis snails were investigated using the spatial autocorrelation analysis, kernel density analysis and hotspot analysis during the period from 2015 through 2017. Results There was a spatial autocorrelation in the mean snail density along the Jiangsu section of the Yangtze River basin during the period from 2015 through 2017. The number of living snails and the density of living snails showed an overall decline in Yangzhou City; however, both showed a slight increase in 2016. Kernel density analysis and hotspot analysis showed that the hotspots of living snails were located in the regions neighboring the marshlands at the Yangzhou-Zhenjiang boundary areas along the Jiangsu section of the Yangtze River basin. Conclusion There is a spatial autocorrelation in the snail distribution with hotspots along the Jiangsu section of the Yangtze River basin, and the surveillance of snails should not be neglected in the marshlands in Jiangsu Province.
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This paper reviewed the prevention and control of schistosomiasis in the Yangtze River Basin in three stages, centered on the measures and achievements. It pointed out the key work of prevention and control which are infectious source control and effective surveillance at present stage. It will be beneficial to schistosomiasis control in China.
ABSTRACT
This paper reviewed the prevention and control of schistosomiasis in the Yangtze River Basin in three stages, centered on the measures and achievements. It pointed out the key work of prevention and control which are infectious source control and effective surveillance at present stage. It will be beneficial to schistosomiasis control in China.
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OBJECTIVE:To provide reference for clinical rational drug use. METHODS:The drug sales amount,DDDs, DDC and major pharmaceutical enterprises in 273 sample hospitals of Yangtze River basin in 2014 were statistically analyzed. RE-SULTS:The growth of consumption sum slowed down gradually. The anti-infective drugs,cardiovascular drugs and nervous sys-tem drugs occupied the medical mainstream market. Top 3 drugs in the list of consumption sum in consecutive 4 quarters were monosialotetrahexosylganglioside,thymic peptide and lansoprazole. Nearly half of top 15 drugs were auxiliary drugs;Chinese pat-ent medicines grew increasingly and appeared in the list. The sales enterprises were mainly domestic enterprises,which concentrat-ed in Sichuan,Chongqing,Jiangsu province,and other places. CONCLUSIONS:The structure of drug use in sample hospitals is basically consistent with the spectrum of disease in China. However,there is deviation between auxiliary drug use and international guide,and the rationality of clinical drug use needs to be improved.
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OBJECTIVE:To probe into the drug use of 20 hospitals in Chongqing in order to provide reference for drug administration,clinical medication,drug manufacturer and medicine enterprise. METHODS:Retrospective analysis was applied to sequencing 14 categories of drugs in the top level of lists for total consumption sum,growth rate of drug category and manufacturer. RESULTS&CONCLUSION:In recent 3 years,the total consumption sum of drugs increased year by year. The growth rate of anti-cancer drugs was 98.11%. The growth rate of consumption sum of Chongqing LUMMY Pharmaceuticals was the highest among pharmaceutical enterprises in Chongqing,accounting for 106.46%. It is expected that the consumption sum of drugs can continue to increase in the future. Reorganizations of pharmaceutical enterprises in Chongqing have been completed basically,which will be developed with great effort in the next.