Gray Darren J, Li Yue-Sheng, Williams Gail M, Zhao Zheng-Yuan, Harn Donald A, Li Sheng-Ming, Ren Mao-Yuan, Feng Zeng, Guo Feng-Ying, Guo Jia-Gang, Zhou Jie, Dong Yu-Lan, Li Yuan, Ross Allen G, McManus Donald P
Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, Australia; School of Population Health, University of Queensland, Brisbane, Australia; Research School of Population Health, Australian National University, Canberra, Australia.
Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, Australia; Hunan Institute of Parasitic Diseases, World Health Organisation Collaborating Centre for Research and Control of Schistosomiasis in Lake Region, Yueyang, Hunan Province, People's Republic of China.
Int J Parasitol. 2014 Aug;44(9):659-68. doi: 10.1016/j.ijpara.2014.05.005. Epub 2014 Jun 11.
Despite major successes in its control over the past 50years, schistosomiasis japonica continues to be a public health problem in the People's Republic of China (P.R. China). Historically, the major endemic foci occur in the lakes and marshlands along the Yangtze River, areas where transmission interruption has proven difficult. The current endemic situation may alter due to the closure of the Three Gorges Dam. Considerable environmental and ecological changes are anticipated that may result in new habitats for the oncomelanid intermediate snail host of Schistosoma japonicum (Sj), thereby increasing the risk of transmission. The current national control program for P.R. China involves a multi-component integrated strategy but, despite targeting multiple transmission pathways, certain challenges remain. As the Chinese government pushes towards elimination, there is a requirement for additional tools, such as vaccination, for long-term prevention. Whereas the zoonotic nature of schistosomiasis japonica adds to the complexity of control, it provides a unique opportunity to develop a transmission blocking vaccine targeting bovines to assist in the prevention of human infection and disease. Mathematical modelling has shown that control options targeting the various transmission pathways of schistosomiasis japonica and incorporating bovine vaccination, mass human chemotherapy and mollusciciding could lead to its elimination from P.R. China. Here we present the study design and baseline results of a four-year cluster randomised intervention trial we are undertaking around the schistosomiasis-endemic Dongting Lake in Hunan Province aimed at determining the impact on schistosome transmission of the multi-component integrated control strategy, including bovine vaccination using a heterologous "prime-boost" delivery platform based on the previously tested SjCTPI vaccine.
尽管在过去50年里日本血吸虫病的防控取得了重大成功，但在中国仍是一个公共卫生问题。历史上，主要流行区集中在长江沿岸的湖泊和沼泽地带，这些地区的传播阻断工作一直颇具难度。由于三峡大坝的建成，当前的流行状况可能会发生改变。预计会出现显著的环境和生态变化，这可能为日本血吸虫的钉螺中间宿主创造新的栖息地，从而增加传播风险。中国目前的国家防控计划采用多组分综合策略，尽管针对多种传播途径，但仍面临一些挑战。随着中国政府努力实现消除目标，需要更多工具，如疫苗接种，以进行长期预防。日本血吸虫病的人畜共患特性增加了防控的复杂性，但也为开发针对牛的传播阻断疫苗提供了独特机会，以帮助预防人类感染和疾病。数学模型表明，针对日本血吸虫病各种传播途径并结合牛疫苗接种、大规模人群化疗和灭螺的防控措施，有望在中国消除该病。在此，我们介绍一项为期四年的整群随机干预试验的研究设计和基线结果，该试验正在湖南省血吸虫病流行区洞庭湖周边开展，旨在确定多组分综合防控策略对血吸虫传播的影响，包括使用基于先前测试的SjCTPI疫苗的异源“初免 - 加强”接种平台对牛进行疫苗接种。
