Wang Xiaoli, Wang Wei, Wang Peng
Jingzhou Hospital of Traditional Chinese Medicine, Jingzhou City, Hubei, 434000, China.
Key Laboratory of National Health and Family Planning Commission on Parasitic Disease Control and Prevention, Wuxi City, Jiangsu Province, 214064, China.
Parasitol Res. 2017 Feb;116(2):521-528. doi: 10.1007/s00436-016-5315-8. Epub 2016 Nov 3.
Schistosomiasis is a neglected tropical parasitic disease of great public health significance worldwide. Currently, mass drug administration with praziquantel remains the major strategy for global schistosomiasis control programs. Since 2005, an integrated strategy with emphasis on infectious source control was implemented for the control of schistosomiasis japonica, a major public health concern in China, and pilot studies have demonstrated that such a strategy is effective to reduce the prevalence of Schistosoma japonicum infection in both humans and bovines. However, there is little knowledge on the long-term effectiveness of this integrated strategy for controlling schistosomiasis japonica. The aim of this study was to evaluate the long-term effectiveness of the integrated strategy for schistosomiasis control following the 10-year implementation, based on the data from the national schistosomiasis control program released by the Ministry of Health, People's Republic of China. In 2014, there were 5 counties in which the transmission of schistosomiasis japonica had not been interrupted, which reduced by 95.2% as compared to that in 2005 (105 counties). The number of schistosomiasis patients and acute cases reduced by 85.5 and 99.7% in 2014 (115,614 cases and 2 cases) as compared to that in 2005 (798,762 cases and 564 cases), and the number of bovines and S. japonicum-infected bovines reduced by 47.9 and 98% in 2014 (919,579 bovines and 666 infected bovines) as compared to that in 2005 (1,764,472 bovines and 33,736 infected bovines), respectively. During the 10-year implementation of the integrated strategy, however, there was a minor fluctuation in the area of Oncomelania hupensis snail habitats, and there was only a 5.6% reduction in the area of snail habitats in 2014 relative to in 2005. The results of the current study demonstrate that the 10-year implementation of the integrated strategy with emphasis on infectious source has greatly reduced schistosomiasis-related morbidity in humans and bovines. It is concluded that the new integrated strategy has remarkable long-term effectiveness on the transmission of schistosomiasis japonica in China, which facilitates the shift of the national schistosomiasis control program from transmission control to transmission interruption and elimination. However, such a strategy seems to have little effect on the shrinking of areas of snail habitats.
血吸虫病是一种被忽视的热带寄生虫病，在全球范围内具有重大的公共卫生意义。目前，吡喹酮大规模药物治疗仍是全球血吸虫病控制项目的主要策略。自2005年以来，中国实施了一项以传染源控制为重点的综合策略来控制日本血吸虫病，这是中国主要的公共卫生问题，试点研究表明，该策略对于降低人和牛的日本血吸虫感染率是有效的。然而，对于这种控制日本血吸虫病综合策略的长期有效性知之甚少。本研究旨在根据中华人民共和国卫生部发布的全国血吸虫病控制项目数据，评估实施10年后该综合策略控制血吸虫病的长期有效性。2014年，有5个县的日本血吸虫病传播尚未被阻断，与2005年（105个县）相比减少了95.2%。2014年血吸虫病患者和急性病例数分别为115,614例和2例，与2005年（798,762例和564例）相比分别减少了85.5%和99.7%，牛和感染日本血吸虫的牛的数量在2014年分别为919,579头和666头，与2005年（1,764,472头和33,736头）相比分别减少了47.9%和98%。然而，在综合策略实施的10年期间，钉螺孳生地面积有轻微波动，2014年钉螺孳生地面积相对于2005年仅减少了5.6%。本研究结果表明，实施10年的以传染源为重点的综合策略极大地降低了人和牛与血吸虫病相关的发病率。得出的结论是，新的综合策略对中国日本血吸虫病的传播具有显著的长期有效性，这有助于国家血吸虫病控制项目从传播控制向传播阻断和消除转变。然而，这种策略似乎对钉螺孳生地面积的缩小作用不大。
