Department of Epidemiology, School of Public Health, Fudan University, 138 Yixueyuan Road, Shanghai 200032, People's Republic of China.
Parasitology. 2010 Jun;137(7):1099-107. doi: 10.1017/S003118200999206X. Epub 2010 Feb 4.
The epidemiology of schistosomiasis japonicum over small areas remains poorly understood, and this is particularly true in China. We aimed to identify high-risk areas for schistosomiasis and associated risk factors in the Poyang Lake region, China. A cross-sectional study was conducted and 60 of 920 persons (6.5%) were found to be infected with Schistosoma japonicum. Locations of households and snail habitats were determined using a hand-held global positioning system. We mapped the data in a geographical information system and used spatial scan statistics to explore clustering of infection, logistic regression and Bayesian geostatistical models to identify risk factors for each individual's infection status and multinomial logistic regression to identify risk factors for living in a cluster area. The risk of schistosomiasis was spatially clustered and higher in fishermen and males, not in persons who lived in close proximity to snail habitats and infected water sources. This study has demonstrated significant spatial variation in the prevalence of schistosomiasis at a small spatial scale. The results suggest that demographic factors (gender, occupation) rather than the distance to infected water are driving human transmission at small-scale spatial levels. Such information can be used to plan locally targeted interventions based on anthelminthic drug administration, snail control and sanitation improvement.
日本血吸虫病的小范围流行病学仍了解甚少，中国尤其如此。本研究旨在确定中国鄱阳湖区日本血吸虫病的高风险地区和相关危险因素。采用横断面研究，在 920 人中发现 60 人（6.5%）感染日本血吸虫。使用手持全球定位系统确定家庭和螺栖息地的位置。我们将数据映射到地理信息系统中，并使用空间扫描统计来探索感染的聚类，逻辑回归和贝叶斯地质统计模型来确定每个个体感染状况的危险因素，以及多项逻辑回归来确定生活在聚类区域的危险因素。血吸虫病的风险具有空间聚集性，渔民和男性的风险更高，而与螺栖息地和受感染水源的距离较近的人则风险较低。这项研究在小尺度上证明了血吸虫病的流行存在显著的空间变异性。结果表明，人口统计学因素（性别，职业）而不是与受感染水的距离，在小尺度空间水平上驱动人类传播。此类信息可用于根据驱虫药物管理、钉螺控制和改善卫生条件，规划有针对性的局部干预措施。
