National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre for Tropical Diseases, Chinese Center for Tropical Disease Research, Shanghai, 200025, People's Republic of China.
Infect Dis Poverty. 2020 Oct 1;9(1):136. doi: 10.1186/s40249-020-00758-4.
The People's Republic of China (P. R. China) has made significant progress on schistosomiasis control. Among the 12 provincial-level administrative divisions (PLADs) with schistosomiasis endemic in P. R. China, Guangdong, Shanghai, Fujian, Guangxi and Zhejiang PLADs (following as five PLADs) had successively eliminated schistosomiasis during 1985-1995. However, consolidation of the schistosomiasis elimination in these five PLADs remains challenging. In the current study, we sought to understand the epidemic situation in these post-elimination areas and their surveillance capabilities on schistosomiasis.
Annual data reflecting the interventions and surveillance on human beings, cattle and snails based on county level from 2005 to 2016 were collected through the national schistosomiasis reporting system and the data were analyzed to understand the epidemic status of schistosomiasis in the five PLADs. A standardized score sheet was designed to assess the surveillance capacity for schistosomiasis of selected disease control agencies in five PLADs and ten counties. Assessment on surveillance capacity including schistosomiasis diagnostic skills, identification of snails' living and infection status and knowledge about schistosomiasis and its control were made. Descriptive analysis was used to analyze the epidemic status and evaluation results on surveillance capacities.
The assessments showed that no local cases in humans and cattle or infected snail were found in these five PLADs since 2005. However, from 2005 to 2016, a total of 221 imported cases were detected in Zhejiang, Shanghai and Fujian, and 11.98 hm of new snail habitats were found in Zhejiang, Shanghai and Guangxi. In addition, snail infestation reoccurred in 247.55 hm of former snail habitats since 2011. For the surveillance capacity assessment, the accuracy rate of IHA and MHT were 100 and 89.3%, respectively. All participants could judge the living status of snails accurately and 98.1% on the infection status of snails. The accuracy rate of the questionnaire survey was 98.0%.
Elimination of schistosomiasis was consolidated successfully in five PLADs of P. R. China due to effective and strong post-elimination surveillance. Comprehensive consolidation strategies should be focused on the elimination of residual snails and the prevention of imported infection sources to consolidate the achievements of schistosomiasis control.
中华人民共和国（中国）在血吸虫病防治方面取得了重大进展。在中国 12 个存在血吸虫病流行的省级行政区（省级行政区）中，广东、上海、福建、广西和浙江省级行政区（以下简称五个省级行政区）已于 1985-1995 年相继消除了血吸虫病。然而，这些五个省级行政区血吸虫病消除后的巩固工作仍然具有挑战性。在目前的研究中，我们试图了解这些消除地区的疫情情况及其对血吸虫病的监测能力。
通过国家血吸虫病报告系统收集了 2005 年至 2016 年县级层面反映人类、牛和钉螺干预和监测的年度数据，并对数据进行了分析，以了解五个省级行政区的血吸虫病疫情状况。设计了一份标准化评分表，以评估五个省级行政区和十个县选定疾病控制机构的血吸虫病监测能力。评估包括血吸虫病诊断技能、钉螺生活和感染状况的识别以及对血吸虫病及其控制的了解。采用描述性分析对疫情状况和监测能力评估结果进行分析。
评估结果表明，自 2005 年以来，这五个省级行政区未发现当地人类和牛感染病例或感染钉螺。然而，2005 年至 2016 年期间，在浙江、上海和福建共发现 221 例输入性病例，在浙江、上海和广西发现 11.98 公顷新的钉螺栖息地。此外，自 2011 年以来，原钉螺栖息地有 247.55 公顷再次发生钉螺滋生。对于监测能力评估，间接血凝试验（IHA）和酶联免疫吸附试验（MHT）的准确率分别为 100%和 89.3%。所有参与者均能准确判断钉螺的生存状况，98.1%能准确判断钉螺的感染状况。问卷调查的准确率为 98.0%。
由于有效的、强有力的消除后监测，中国五个省级行政区成功地巩固了血吸虫病的消除。综合巩固策略应侧重于消除残留钉螺和预防输入性感染源，以巩固血吸虫病防治成果。
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