Department of Epidemiology and Statistics, School of Public Health, Soochow University, Suzhou, China.
BMC Infect Dis. 2022 Mar 8;22(1):236. doi: 10.1186/s12879-022-07241-5.
Schistosoma japonicum was once one of the most severe parasitic diseases in China. After 70 years of national schistosomiasis control programmes, the prevalence and associated morbidity of the infection have been reduced to a much lower level. However, due to the low sensitivity of the current detection approaches, many minor infections in humans could not be identified and ultimately develop chronic injuries with liver abnormalities, a specific 'network' echogenic pattern under ultrasonography. Therefore, as more people take part in physical examinations, we performed this meta-analysis to estimate the overall prevalence of schistosomiasis-associated liver abnormalities in China.
The publications were searched systematically across five electronic databases. All eligible studies were assessed with quality evaluation forms. Heterogeneity of studies was determined using the I and Q tests. A random effects or fixed effects model was employed based on heterogeneity results. The pooled prevalence and its 95% confidence intervals were calculated with the Freeman-Tukey double arcsine transformation. All analyses were conducted using R with the "meta" package. The protocol registration number was CRD42021232982.
A total of 19 relevant articles, including 21 studies, were included. The average score of study quality was 6.4 (total score 7), indicating high quality of all included studies. A total of 268, 247 persons were included, and 43, 917 persons were diagnosed with schistosomiasis liver abnormalities by ultrasonography. High degrees of heterogeneity existed among all studies or within subgroups. The overall pooled prevalence was 18.64% (95% CI: 11.88-26.50%). The estimate significantly increased over time and varied among provinces, with the highest in Shanghai and the lowest in Sichuan. The estimate in people aged 60 years or older was significantly higher than that in people of all ages. No significant difference was seen when based on study areas (urban or rural areas) or gender.
The long-term burden of schistosomiasis in China remains large, as nearly one-fifth of the examined persons were diagnosed with schistosomiasis liver abnormalities. The pooled prevalence was associated with regions or age groups. Such may have a high reference value in the exact calculation of the disease burden and can be helpful for policy makers in prioritizing public health.
日本血吸虫病曾是中国最严重的寄生虫病之一。经过 70 年的全国血吸虫病防治规划，感染的流行率和相关发病率已降低到较低水平。然而，由于目前检测方法的灵敏度较低，许多人类的轻度感染无法被识别，最终会发展为慢性损伤，伴有肝脏异常，超声检查下呈现特定的“网络”样强回声。因此，随着越来越多的人参加体检，我们进行了这项荟萃分析，以估计中国血吸虫病相关肝异常的总体流行率。
系统地在五个电子数据库中检索文献。使用质量评估表评估所有合格的研究。使用 I 和 Q 检验确定研究之间的异质性。根据异质性结果，使用随机效应或固定效应模型。使用 Freeman-Tukey 双反正弦变换计算合并患病率及其 95%置信区间。所有分析均使用 R 语言中的“meta”包进行。方案注册号为 CRD42021232982。
共纳入 19 篇相关文献，包括 21 项研究。研究质量平均得分为 6.4 分（总分 7 分），表明所有纳入研究的质量均较高。共纳入 268247 人，超声诊断为血吸虫病肝异常者 43917 人。所有研究或亚组之间均存在高度异质性。总体合并患病率为 18.64%（95%CI：11.88-26.50%）。估计值随时间显著增加，并在各省之间存在差异，上海最高，四川最低。60 岁及以上人群的估计值明显高于所有年龄人群。基于研究区域（城市或农村）或性别，未见显著差异。
中国血吸虫病的长期负担仍然很大，近五分之一的受检者被诊断为血吸虫病肝异常。合并患病率与地区或年龄组有关。这可能对准确计算疾病负担具有很高的参考价值，并有助于决策者确定优先公共卫生事项。
