ABSTRACT
Schistosomiasis is a parasitic disease that seriously hinders socioeconomic developments and threatens public health security. To achieve the global elimination of schistosomiasis as a public health problem by 2030, WHO released the guideline on control and elimination of human schistosomiasis on February, 2022, with aims to provide evidence-based recommendations for schistosomiasis morbidity control, elimination of schistosomiasis as a public health problem, and ultimate interruption of schistosomiasis transmission in disease-endemic countries. Following concerted efforts for decades, great achievements have been obtained for schistosomiasis control in China where the disease was historically highly prevalent, and the country is moving towards schistosomiasis elimination. This article reviews the successful experiences from the national schistosmiasis control program in China, and summarizes their contributions to the formulation and implementation of the WHO guideline on control and elimination of human schistosomiasis. With the progress of the "Belt and Road" initiative, the world is looking forward to more China's solutions on schistosomiasis control.
Subject(s)
Humans , China/epidemiology , Disease Eradication , Public Health , Schistosomiasis/prevention & control , World Health OrganizationABSTRACT
On February 2022, WHO released the evidence-based guideline on control and elimination of human schistosomiasis, with aims to guide the elimination of schistosomiasis as a public health problem in disease-endemic countries by 2030 and promote the interruption of schistosomiasis transmission across the world. Based on the One Health concept, six evidence-based recommendations were proposed in this guideline. This article aims to analyze the feasibility of key aspects of this guideline in Chinese national schistosomiasis control program and illustrate the significance to guide the future actions for Chinese national schistosomiasis control program. Currently, the One Health concept has been embodied in the Chinese national schistosomiasis control program. Based on this new WHO guideline, the following recommendations are proposed for the national schistosomiasis control program of China: (1) improving the systematic framework building, facilitating the agreement of the cross-sectoral consensus, and building a high-level leadership group; (2) optimizing the current human and livestock treatments in the national schistosomiasis control program of China; (3) developing highly sensitive and specific diagnostics and the framework for verifying elimination of schistosomiasis; (4) accelerating the progress towards elimination of schistosomiasis and other parasitic diseases through integrating the national control programs for other parasitic diseases.
Subject(s)
Humans , China/epidemiology , Disease Eradication , Public Health , Schistosomiasis/prevention & control , World Health OrganizationABSTRACT
Objective To establish an indicator system for assessment of schistosomiasis transmission risk after transmission interruption in Hubei Province, so as to provide insights into the precise control of schistosomiasis. Methods The indicator system was preliminarily established based on data collection, literature review, expert interviews. Two rounds of expert consultation were performed. The indicator system was screened based on the importance, operability, sensitivity and comprehensive score of the indicators, and the weights of each indicator were calculated. The credibility of the Delphi method was evaluated by calculating the active coefficient of the experts, degree of expert authority and coordination levels of experts’ opinions. Results An indicator system for assessment of schistosomiasis transmission risk was preliminarily established, including 3 primary indicators, 12 secondary indicators and 44 tertiary indicators. A Delphi consultation was performed among 17 experts participating in schistosomiasis control, management and research. Following two rounds of consultation, a risk assessment indicator system was finally constructed, including 3 primary indicators, 10 secondary indicators and 35 tertiary indicators. Among the primary indicators, the variable with the highest normalized weight was the current status of schistosomiasis (0.420 2), followed by social factors (0.397 3) and natural environments (0.182 5). Among the secondary indicators, those with high combined weights included risk monitoring (0.142 3), current snail status (0.140 1), and current prevalence of human and livestock infections (0.137 8). Among the tertiary indicators, those with high combined weights included the positive rate of wild feces (0.049 8), the prevalence of snail infections (0.047 4), and the area of snail habitats submerged by floods (0.046 8). During the two-round consultation, the active coefficients of the experts were 85.00% and 100.00%, the degree of expert authority was both 0.75 and greater, and the coordination levels of experts’ opinions were 0.405 to 0.521 and 0.592 to 0.695 (all P values < 0.05). Conclusion An indicator system for assessment of schistosomiasis transmission risk is successfully established after transmission interruption in Hubei Province based on the Delphi method, which provides insights into the identification of the schistosomiasis transmission risk and the targets for schistosomiasis control in Hubei Province.
ABSTRACT
Since 2015 when the transmission of schistosomiasis was controlled in China, the country has been moving towards elimination of schistosomiasis, with the surveillance-response as the main interventions for schistosomiasis control. During the period of the 13th Five-Year Plan, the transmission of schistosomiasis had been interrupted in four provinces of Sichuan, Jiangsu, Yunnan and Hubei and the prevalence of schistosomiasis has been at the historically lowest level in China. As a consequence, the goal set in The 13th Five-Year National Schistosomiasis Control Program in China is almost achieved. However, there are multiple challenges during the stage moving towards elimination of schistosomiasis in China, including the widespread distribution of intermediate host snails and complicated snail habitats, many types of sources of Schistosoma japonicum infections and difficulty in management of bovines and sheep, unmet requirements for the current schistosomiasis control program with the currently available tools, and vulnerable control achievements. During the 14th Five-Year period, it is crucial to consolidate the schistosomiasis control achievements and gradually solve the above difficulties, and critical to provide the basis for achieving the ultimate goal of elimination of schistosomiasis in China. Based on the past experiences from the national schistosomiasis control program and the challenges for schistosomiasis elimination in China, an expert consensus has been reached pertaining to the objectives, control strategy and measures for The 14th Five-Year National Schistosomiasis Control Program in China, so as to provide insights in to the development of The 14th Five-Year National Schistosomiasis Control Program in China.
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ObjectiveTo analyze the changing tendency in the endemic situation of schistosomiasis in the national surveillance sites of Hubei Province, so as to provide the scientific evidence for facilitating the progress towards the elimination of schistosomiasis in the province. Methods According to the National Schistosomiasis Surveillance Scheme (2014 version), a total of 65 national schistosomiasis surveillance sites were assigned in Hubei Province, and the Schistosoma japonicum infections in humans, domestic animals, snails and wild feces were monitored in these national surveillance sites from 2015 to 2019. All data pertaining to the surveillance results were descriptively analyzed. Results There were 151 159 person-time local residents and 70 928 person-time mobile populations screened for S. japonicum infections in the 65 national surveillance sites of Hubei Province from 2015 to 2019, and the seroprevalance of S. japonicum infections reduced from 3.45% (1 077/31 197) in 2015 to 1.57% (431/27 371) in 2019 among local residents and from 1.06% (98/9 249) in 2015 to 0.81% (116/14 318) in 2019 among mobile populations. During the period from 2015 through 2019, there were 22 egg-positive local residents and 2 egg-positive mobile populations identified in 2015, with 0.07% and 0.02% prevalence rates of S. japonicum infections, respectively. During the 5-year period, a total of 7 025 herd-time domestic animals examined for S. japonicum infections, with no infections detected, and a total of 2 035 wild feces were tested, with no egg-positives identified in the 65 national surveillance sites of Hubei Province. Snail survey was conducted covering 28 767.35 hm2 during the 5-year period, and the area of snail habitats ranged from 1 609.82 to 2 119.81 hm2. The mean density of living snails and occurrence of frames with snails reduced from 0.360 5 snails/0.1 m2 and 11.26% in 2015 to 0.175 9 snails/0.1 m2 and 8.43% in 2019, respectively, and no S. japonicum infection was found in snails during the 5-year period. In addition, no snails were found in the potential schistosomiasis transmission foci in the two national surveillance sites in the Three Gorges Dam. Conclusions The overall endemic situation of schistosomiasis appears a tendency towards a decline in Hubei Province during the period from 2015 through 2019; however, the schistosomiasis transmission risk remains. Improving the surveillance system of schistosomiasis and increasing the sensitivity and performance of the surveillance system are required to provide insights into the implementation of precision control strategy and interventions in Hubei Province.
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OBJECTIVE@#To study the application of ponderal index (PI), body mass index (BMI), mid-arm circumference/head circumference (MAC/HC), and Clinical Assessment of Nutritional Status (CANS) score in assessing the nutritional status of neonates at birth, and to find a simple and reliable scheme for the assessment of fetal nutritional status.@*METHODS@#PI, BMI, MAC/HC, and CANS were used to assess the nutritional status of full-term infants and preterm infants shortly after birth. The assessment results of these methods were analyzed.@*RESULTS@#Among the 678 full-term infants, 61, 102, 47, and 131 were diagnosed with malnutrition by PI, BMI, MAC/HC, and CANS respectively. Among the 140 preterm infants, 30, 87, 9, and 112 were diagnosed with malnutrition by PI, BMI, MAC/HC, and CANS respectively. The combination of BMI and CANS had a detection rate of 99.3% in full-term infants and 100% in preterm infants. Compared with the single method, the combination significantly improved the detection rate of malnutrition (@*CONCLUSIONS@#The combination of BMI+CANS can reduce the rate of missed diagnosis of fetal malnutrition. It is therefore a simple and reliable method for the assessment of fetal malnutrition.
Subject(s)
Humans , Infant, Newborn , Body Mass Index , Fetal Nutrition Disorders/diagnosis , Infant, Premature , Nutrition Assessment , Nutritional StatusABSTRACT
Objective To investigate the spatial distribution of Oncomelania hupensis snail habitats at the administrative village scale in schistosomiasis-endemic areas of Hubei Province, so as to provide scientific bases for precise control of O. hupensis snails in the province. Methods Data regarding snail distribution at the village level in Hubei Province in 2017 were collected to create a spatial analysis database of snail distribution in Hubei Province. The spatial aggregations of O. hupensis distribution were analyzed using Moran’s I index and Local Moran’s I index. In addition, the distances from schistosomiasis-endemic villages to the Yangtze River were captured using the software ArcGIS 13.0, and their correlations with area of snail habitats were examined with the Spearman correlation method. Results O. hupensis snails were mainly distributed in 5 450 endemic villages from 63 counties of 13 cities in Hubei Province in 2017. The global spatial autocorrelation analysis showed spatial aggregations in the areas of historically accumulated snail habitats, current areas of snail habitats, areas of snail habitats outside the embankment and snail habitats inside the embankment (all Z Scores > 0, all P values < 0.05), and no spatial aggregation was seen in the areas of snail habitats in hilly areas (Z Score > 0, P > 0.05). There were four types of spatial distribution of historically accumulated areas of snail habitats, areas of current snail habitats, areas of snail habitats outside the embankment and snail habitats inside the embankment, including the high-high type (H-H type), high-low type (H-L type), low-high type (L-H type) and random distribution type, and a high percentage of the H-H type was found. There were 340, 125 and 110 endemic villages with the H-H type of areas of historically accumulated snail habitats, current areas of snail habitats and areas of snail habitats outside the embankment, and these villages were mainly concentrated in Wuhan and Jingzhou cities, with almost consistent spatial aggregation locations. There were 319 endemic villages with the H-H type of distribution of snail habitats inside the embankment, which were mainly distributed in Jingzhou, Xiaogan and Huangshi cities. In addition, the areas of historically accumulated snail habitats, current areas of snail habitats and areas of snail habitats outside the embankment negatively correlated with the distance from the endemic villages to the Yangtze River (r = −0.094, P < 0.01; r = −0.225, P < 0.01; r = −0.177, P < 0.01). Conclusion The clustering areas of snail habitats along the Yangtze River Basin, notably the villages near the Yangtze River are key regions for snail monitoring and control in Hubei Province.
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Objective To evaluate the health education effect of schistosomiasis in Hubei Province after implementing of the Outline of National Mid-Long-Term Plan for Schistosomiasis Prevention and Control (2004–2015). Methods Based on questionnaires and datum review, the data of health education for integrated prevention and control of schistosomiasis in Hubei Province from 2004 to 2015 were collected to evaluate the effect of health education. Results A total of 16 662 499 schistosomiasis health education publicity materials were distributed, 28 712 times of media propaganda were conducted, 174 506 warning signs were established, 185 985 promotional slogans were issued, 1 212 810 pieces of personal protective equipment were distributed, 9 248 village officer training courses were organized, and 5 569 school teacher training courses in primary and secondary schools were conducted in 63 counties (cities, districts) of 13 cities in Hubei Province from 2004 to 2015. A total of 4 815 people were surveyed in 3 counties in 2015. The awareness rate of schistosomiasis control knowledge was 91.62%, and the correct rates of beliefs and attitudes were 89.54% and 96.91% respectively. The overall rate of correct behavior of the population was 91.91%. The related indicators, such as schistosomiasis infection rate, acute infection cases, and others, declined year by year over the same period. Conclusions The schistosomiasis health education in Hubei Province has obvious effects on enhancing the knowledge and attitudes of schistosomiasis control in populations and promoting the formation of correct schistosomiasis control behavior among residents. It has played an active role and is an important mean in comprehensive prevention and control of schistosomiasis.
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Objective To evaluate the health education effect of schistosomiasis in Hubei Province after implementing of the Outline of National Mid-Long-Term Plan for Schistosomiasis Prevention and Control (2004–2015). Methods Based on questionnaires and datum review, the data of health education for integrated prevention and control of schistosomiasis in Hubei Province from 2004 to 2015 were collected to evaluate the effect of health education. Results A total of 16 662 499 schistosomiasis health education publicity materials were distributed, 28 712 times of media propaganda were conducted, 174 506 warning signs were established, 185 985 promotional slogans were issued, 1 212 810 pieces of personal protective equipment were distributed, 9 248 village officer training courses were organized, and 5 569 school teacher training courses in primary and secondary schools were conducted in 63 counties (cities, districts) of 13 cities in Hubei Province from 2004 to 2015. A total of 4 815 people were surveyed in 3 counties in 2015. The awareness rate of schistosomiasis control knowledge was 91.62%, and the correct rates of beliefs and attitudes were 89.54% and 96.91% respectively. The overall rate of correct behavior of the population was 91.91%. The related indicators, such as schistosomiasis infection rate, acute infection cases, and others, declined year by year over the same period. Conclusions The schistosomiasis health education in Hubei Province has obvious effects on enhancing the knowledge and attitudes of schistosomiasis control in populations and promoting the formation of correct schistosomiasis control behavior among residents. It has played an active role and is an important mean in comprehensive prevention and control of schistosomiasis.
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To investigate the effects of cordycepin on proliferation and invasion of pancreatic cancer stem cells (Pan CSC) and its mechanisms, MTT assay was used to investigate the effect of cordycepin on proliferation of Pan CSC. Inverted microscope was used to observe the morphologic change of cells. Propidium iodide staining methods was employed to observe the cell apoptosis. Cell scratch method was used to detect the ability of migration of Pan CSC in each group. RT-PCR and Western blot were used to determine the expression of apoptosis gene and epithelial-mesenchymal transitions (EMT) gene. The growth of Pan CSC was inhibited by cordycepin in a dose-and time-dependent manner, with IC50 107.364 and 48.472 μmol·L-1 at 24 and 48 h, respectively. Moreover, the cell migration was inhibited at the same time. RT-PCR and Western blot results showed that cordycepin decreased the expression of Bcl-2 and activated pro-apoptotic gene levels such as Bax,p53, caspase-3. Furthermore, cordycepin reduced the expression of EMT genes by up-regulation of E-cadherin and down-regulation of N-cadherin. Cordycepin has the ability to inhibit Pan CSC proliferation and invasion by activating p53 pathway as well as suppressing the EMT. This study provides a new basis for inhibition of pancreatic cancer stem cells in the treatment of pancreatic cancer.
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<p><b>OBJECTIVE</b>To investigate the influence of cigarette smoking on human sperm DNA integrity.</p><p><b>METHODS</b>Totally, 784 cases of male infertility were selected from our case database and grouped according to whether they were smokers or nonsmokers, how much they smoked (< or = 10, 11-19 and > or = 20 cigarettes/d) and how long they smoked (< or = 5, 6-9 and > or = 10 yr). Sperm DNA integrity was measured using sperm chromatin structure assay (SCSA) and flow cytometry. DNA fragmentation and immature spermatozoa were expressed by the DNA fragmentation index (DFI) and high DNA stainability (HDS) respectively. Conventional sperm parameters and sperm DNA integrity were compared among different groups.</p><p><b>RESULTS</b>The total semen volume and percentage of grade a + b sperm were lower and the sperm morphological abnormality was higher in the > or = 20 cigarettes/d and > or = 10 yr groups than in the others (P < 0.05). DFI and HDS were significantly higher in the smokers than in the nonsmokers (P < 0.05). HDS was negatively correlated with the percentage of grade a + b sperm (r = -0.18, P < 0.05) and both DFI and HDS were positively correlated with the rate of sperm malformation (r = 0.31 and r = 0.39, P < 0.05).</p><p><b>CONCLUSION</b>Smoking more than 20 cigarettes a day or longer than 10 years has deleterious effects on the semen volume, percentage of grade a + b sperm and sperm morphology of the smokers. Cigarette smoking decreases sperm DNA integrity and nuclear maturation.</p>
Subject(s)
Adult , Humans , Male , Middle Aged , Young Adult , DNA Damage , DNA Fragmentation , Infertility, Male , Genetics , Smoking , Sperm Count , Sperm Motility , SpermatozoaABSTRACT
<p><b>OBJECTIVE</b>To understand the risk factors of schistosomiasis transmission in the Three Gorges Reservoir Area (TGRA) and to provide evidence for the development of control strategy.</p><p><b>METHODS</b>Approaches including epidemiology, immunology and field survey were applied to investigate the potential risk factors which would involve the importation of infectious resources live mobile and migrant population, and livestock in the reservoir area. Meanwhile, observation on survival and reproductive status of snail under simulation habitats was also carried out, using ecological methods on snails. Strategy in preventing the spread of snail as infectious resources was also provided.</p><p><b>RESULTS</b>175 mobile people from schistosomaisis endemic area of were tested and one person showed immunology tests positive with indirect hemagglutination test (IHA) and circumoral precipitin test (COPT), with a positive rate of 0.57%. Through the two-year period under observation, data showed that the snails with ribbon/smooth shells could survive and reproduce under habitats of simulation.</p><p><b>CONCLUSIONS</b>Once the infectious resource of schistosomiasis was introduced into the TGRA, the area became a new schistosomiasis epidemic area in TGRA which called for countermeasures to be taken.</p>