Center for Occupational and Environmental Health, School of Public Health, University of California, Berkeley, CA 94720-7360, USA.
J R Soc Interface. 2012 Feb 7;9(67):272-82. doi: 10.1098/rsif.2011.0285. Epub 2011 Jul 13.
Currently schistosomiasis transmission has been suppressed to low levels in many historically endemic areas of China by widespread use of praziquantel in human and bovine populations and application of niclosamide for snail control. However, re-emergent transmission has signalled the need for sustainable interventions beyond these repeated chemical interventions. To take advantage of ongoing investment in rural infrastructure, an index of schistosomiasis transmission potential is needed to identify villages where environmental modifications would be particularly effective. Based on a retrospective analysis of data from 10 villages in Sichuan Province, an index linked to the basic reproductive number is shown to have promise in meeting this need. However, a lack of methods for estimating the spatial components of the proposed metric and for estimating the import of cercariae and miracidia from neighbouring villages leads to significant uncertainty in its estimation. These findings suggest a priority effort to develop methods for measuring the free-swimming forms of the parasite in surface waters. This need is underscored by the high cost and limited sensitivity of current methods for diagnosing human infection and mounting evidence of the inadequacy of snail surveys to identify environments supporting low levels of transmission.
目前，在中国许多历史流行区，由于广泛应用吡喹酮对人群和牛群进行治疗，以及使用氯硝柳胺进行钉螺控制，血吸虫病传播已被抑制到较低水平。然而，重新出现的传播表明需要采取可持续的干预措施，以弥补这些反复的化学干预措施。为了利用农村基础设施方面正在进行的投资，需要有一种血吸虫病传播潜力指数，以确定在哪些村庄进行环境改造将特别有效。基于对四川省 10 个村庄数据的回顾性分析，与基本繁殖数相关的指数显示出有希望满足这一需求。然而，缺乏估计拟议指标的空间分量的方法，以及估计从邻近村庄输入尾蚴和毛蚴的方法，导致其估计存在很大的不确定性。这些发现表明，需要优先努力开发测量地表水自由游动寄生虫形式的方法。目前诊断人体感染的方法成本高、灵敏度有限，以及钉螺调查不足以确定支持低传播水平的环境的证据，都突显了这一需求。
