Assessment of the influence of levees along Yangtze River on Oncomelania hupensis, the intermediate host of Schistosoma japonicum.

BACKGROUND: Oncomelania hupensis is the exclusive intermediate host of Schistosoma japonicum in China. Snail control is an essential component of schistosomiasis elimination programme. With 70 years of continuous efforts, the range of O. hupensis had reduced significantly, but slowed down in last decades. A large number of levees against flooding were constructed along Yangtze River and its affiliated lakes in the middle and lower reaches, which influenced the hydrology and ecology in the alluvial plains. The purpose of this study was to assess the impact of levees on the distribution of O. hupensis in the middle and lower reaches of the Yangtze River. METHODS: The snail habitats were digitalised by hand-held GPS system. The years for discovery and elimination of snail habitats were extracted from historical records. The accumulated snail-infested range for each habitat was calculated on the basis of annual reports. The current distribution of O. hupensis was determined by systematic and environmental sampling. The geographical distribution of levees was obtained from satellite imagery. To assess the impact of levees, the data pertaining to O. hupensis were divided into two parts: inside and outside the Yangtze River. Joinpoint regression was utilised to divide the study time span and further characterise the regression in each period. The 5-year-period moving averages of eliminated area infested by snails were calculated for the habitats inside and outside Yangtze River. The moving routes of corresponding geographical median centres were simulated in ArcGIS. Hotspot analysis was used to determine the areas with statistical significance clustering of O. hupensis density. RESULTS: Three periods were identified according to Joinpoint regression both inside and outside Yangtze River. The area infested by O. hupensis increased in the first two periods. It decreased rapidly outside Yangtze River year over year after 1970, while that inside the Yangtze River did not change significantly. Furthermore, the latter was significantly higher than the former. It was observed that the present density of O. hupensis inside Yangtze River was lower than outside the Yangtze River. The median centre for eliminated ranges inside Yangtze River wavered between the east (lower reach) and the west (middle reach). In contrast, the median centre for eliminated ranges continuously moved from the east to the west. CONCLUSIONS: Our findings indicated that the levees had a considerable negative impact on the distribution of O. hupensis outside Yangtze River. Some hotspots observed in the irrigation areas need a sluice system at the inlet of branch for snail control. The major distribution of O. hupensis located in Hubei might be caused by severe waterlogging. The intensive surveillance should be implemented there. The biggest two freshwater lakes, the major endemic regions historically, were identified as cold spots. The long-term impact of Three Gorges Dam on the distribution of O. hupensis in the lakes should be monitored and evaluated.

Folate deficiency promotes cervical squamous carcinoma SiHa cells progression by targeting miR-375/FZD4/ß-catenin signaling.

Epidemiological studies suggest an association between folate deficiency (FD) and cervical squamous cell carcinoma (SCC) progression. However, the underlying mechanism is unclear. Our study showed that FD-driven downregulation of miR-375 promoted proliferation of SCC SiHa cells and progression of xenograft tumors developed from SiHa; however, the exact mechanism of this process remained unclear. The current study aimed to elucidate the underlying mechanisms by which FD promotes the progression of SiHa cells by downregulating miR-375 expression. The results showed that miR-375 acted as a suppressor of SCC and inhibited the proliferation, migration, and invasion of SiHa cells. The FZD4 gene was identified as a target gene of miR-375, which can reverse the anti-onco effect of miR-375 and promote the proliferation and migration of SiHa cells. Furthermore, the regulatory effects of miR-375 and FZD4 on SiHa cells may be achieved by activating the ß-catenin signaling pathway. Moreover, FD may regulate the expression of miR-375 by regulating its DNA methylation level in the promoter region. In conclusion, our study reveals that FD regulates the miR-375/FZD4 axis by increasing the methylation of the miR-375 promoter, thereby activating ß-catenin signaling to promote SiHa cells progression. This study may provide new insights into the role of folic acid in the prevention and treatment of SCC.

Efforts to eliminate schistosomiasis in Hubei province, China: 2005-2018.

BACKGROUND: The Hubei province is one of the most schistosomiasis-epidemic-prone provinces in China. A series of strategies were adopted by the government to curb the rebound schistosomiasis endemic status that has prevailed since the early 2000s. This study aimed to elucidate the trends of schistosomiasis transmission and to appraise the effectiveness of the integrated control strategy in lake and marshland areas. METHODS: Surveillance data of schistosomiasis in the Hubei province between 2005 and 2018 were analyzed, including conventional health control measures, integrated strategies, and measures that focused on the infection source. According to the local annual plan for schistosomiasis control in endemic counties, previous measures were human and snail control and surveillance. Residents aged 6-65 years were screened by an immunological detection method called indirect hemagglutination assay (IHA) after the transmission season each year. All residents who tested positive were then asked to provide a fecal sample for examination by the miracidium hatching technique (MHT) to detect the presence of schistosomes. Moreover, systematic snail surveys were conducted as a part of the combined environmental sampling method. The latter included integrated strategies and measures that focused on the infection source. Bovine stool samples were also collected and concurrently assessed using the MHT by the agriculture department, river-hardening slope protection was constructed by the water conservancy department, and forestation promotion was conducted by the forest department. The effectiveness of the integrated control strategy was assessed using two indicators of resident and livestock infection rates and three indicators of snail epidemics across all endemic areas. RESULTS: From 2005 to 2018, a total of 28. 46 million and 2. 05 million residents were assessed by immunological (IHA) and etiological (MHT) detection techniques, respectively. Snail surveys and molluscicide application were performed in 2. 26 hectares and 0. 37 hectares, respectively. Moreover, 2. 60 million bovines were assessed by etiological detection techniques (MHT). The river-hardening slope protection project was implemented in 503 places, and 46 thousand hectares in endemic areas underwent environmental modification. Forestation was implemented at an area of 0. 15 million hectares. Between 2005 and 2018, the epidemic indicators, including resident and livestock infection rates and the infested areas and infection rate of snails, all presented downward trends. The resident infection rate decreased from 3. 78% in 2005 to 0% in 2016, which persisted through 2018. The livestock infection rate decreased from 5. 63% in 2005 to 0% in 2013, which also persisted through 2018. From 2005 to 2018, the snail-inhabited area was slightly reduced, but the area of infected snails decreased to 0 in 2012; this persisted through 2018. All counties met the goal for schistosomiasis infection control, transmission control, and disruption of schistosomiasis activity in 2008, 2013, and 2018 separately. That means the goal has been achieved in each stage. CONCLUSIONS: The decline of the schistosomiasis epidemic rate demonstrates that the Chinese government was successful in meeting its public health goal in Hubei province. In the next decade, precision interventions must be implemented in endemic counties with a relatively low epidemic status to achieve the goals of the Outline of the Healthy China 2030 Plan. A similar strategy can be applied in other countries to eliminate schistosomiasis globally.

[Fetal malnutrition assessment program].

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 (P < 0.05), while there was no significant difference between the combination of BMI+CANS and the combination of PI+BMI+CANS (P > 0.05). 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.

Surveillance-based evidence: elimination of schistosomiasis as a public health problem in the Peoples' Republic of China.

BACKGROUND: A steady progress on schistosomiasis control in the Peoples' Republic of China (P.R. China) was achieved and broadened into the twelve-year medium and long term national plan (MLNP) which marled the implementation of an integrated control strategy across all endemic areas in P.R. China in 2004. To understand the endemic trends of schistosomiasis to assess the effectiveness of an integrated strategy, we conducted an analysis of schistosomiasis surveillance data spanned from 2005 to 2015. METHODS: The schistosomiasis sentinel surveillance data from sentinel sites were collected and analyzed from 2005 to 2015. In these sentinel sites, residents aged 6 years or above were screened annually by indirect hemagglutination assay (IHA), while only antibody positives were followed by stool examination either Kato-katz method (KK) and/or hatching technique (HT). Domestic animals raised in sentinel sites were examined by HT for confirming the infection of schistosomes. Snail investigation was conducted each year through systematic sampling method combined with environmental sampling method. The snails collected from field were tested by microscopic dissection method. The infection rates of schistosomes in residents, domestic animals and snails, as well as the indicators reflecting the snails' distribution were calculated and analyzed. ANOVA analysis was used to examine the changes of the number of eggs per gram feces in population and Chi-square test was used to examine any change in proportions among groups. RESULTS: A total of 148 902 residents from sentinel sites attended this study and 631 676 blood samples were examined by IHA test during the 11 covered years. The annual average antibody positive rates presented a significant decrease trends, from 17.48% (95% CI: 17.20-17.75%) in 2005 to 5.93% (95% CI: 5.71-6.15%) (χ2 = 8890.47, P < 0.001) in 2015. During 2005-2015, the average infection rate of schistosomes in residents declined from 2.07% (95% CI: 1.96-2.17%) to 0.13% (95% CI: 0.09-0.16%), accompanied by significant decrease of infection intensity in population. In 2015, the stool positives were only found in farmers, fishermen and boatmen with infection rate of 0.16% (95% CI: 0.11-0.20%), 0.17% (95% CI: 0-0.50%) respectively. The infection rate of schistosomes in domestic animals dropped from 9.42% (538/5711, 95% CI: 8.66-10.18%) to 0.08% (2/2360, 95% CI: 0-0.20%) from 2005 to 2015. Infections were found in eight species of domestic animals at the beginning of surveillance while only two cattle were infected in 2015. Totally 98 ha of new snail habitats were found, while 94.90% (93/98) distributed in lake and marshland regions. The percentage of frames with snails decreased from 16.96% (56 884/33 5391, 95% CI: 16.83-17.09%) in 2005 to 4.28% (18 121/423 755, 95% CI: 4.22-4.34%) in 2014, with a slightly increase in 2015. Meanwhile, the infection rate of schistosomes in snails was decreased from 0.26% (663/256 531, 95% CI: 0.24-0.28%) to zero during 2005-2015. CONCLUSIONS: The infection rate of schistosomes declined significantly, providing evidence that the goal of the MLNP was achieved. Elimination of schistosomiasis as a public health problem defined as WHO was also reached in P.R. China nationwide. Surveillance-response system should be improved and strengthened to realize the final goal of schistosomiasis elimination.

Corrections to: Molluscicidal effectiveness of Luo-Wei, a novel plant-derived molluscicide, against Oncomelania hupensis, Biomphalaria alexandrina and Bulinus truncatus.

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Molluscicidal effectiveness of Luo-Wei, a novel plant-derived molluscicide, against Oncomelania hupensis, Biomphalaria alexandrina and Bulinus truncatus.

BACKGROUND: Control of snail intermediate hosts has been proved to be a fast and efficient approach for interrupting the transmission of schistosomiasis. Some plant extracts have shown obvious molluscicidal activity, and a new compound Luo-Wei, also named tea-seed distilled saponin (TDS), was developed based on the saponins extracted from Camellia oleifera seeds. We aimed to test the molluscicidal activity of 4% TDS against the intermediate host snails in China and Egypt, and evaluate its environmental safety to non-target organisms. METHODS: In the laboratory, Oncomelania hupensis, Biomphalaria alexandrina and Bulinus truncatus were exposed to 4% TDS, and the median lethal concentration (LC50) was estimated at 24, 48 and 72 h. In the field, snail mortalities were assessed 1, 2, 3 and 7 d post-immersion with 2.5 g/m3 4% TDS and 1, 3, 7 and 15 d post-spraying with 5 g/m2 4% TDS. In addition, the acute toxicity of 4% TDS to Japanese quail (Coturnix japonica), zebrafish (Brachydanio rerio) and freshwater shrimp (Macrobrachium nipponense) was assessed by estimations of LC50 or median lethal dose (LD50). RESULTS: In the laboratory, the LC50 values of 4% TDS for O. hupensis were 0.701, 0.371 and 0.33 mg/L at 24, 48 and 72 h, respectively, and 4% TDS showed a 1.975 mg/L [corrected] 24 h LC50 against B. alexandrina, and a 1.396 mg/L 24 h LC50 against B. truncatus. Across all study regions, the pooled mortalities of O. hupensis were 72, 86, 94 and 98% at 1, 2, 3 and 7 d, following field immersion of 4% TDS at a dose of 2.5 g/m3, and were 69, 77, 85 and 88% at 1, 3, 7 and 15 d, following field spraying at 5 g/m2, respectively. 4% TDS had moderate toxicity to Japanese quail (7 d LD50 > 60 mg/kg) and to shrimp (96 h LC50 = 6.28 mg/L; 95% CI: 3.53-11.2 mg/L), whereas its toxicity to zebrafish was high (96 h LC50 = 0.15 mg/L; 95% CI: 0.14-0.17 mg/L). CONCLUSIONS: 4% TDS is active against O. hupensis, B. alexandrina and B. truncatus under laboratory and field conditions, and it may be a candidate molluscicide of plant origin.

Acute restraint stress triggers progesterone withdrawal and endometrial breakdown and shedding through corticosterone stimulation in mouse menstrual-like model.

Stress impacts the reproductive axis at the level of the hypothalamus and the pituitary gland, which exert an effect on the ovary. Menstruation is regulated by the hypothalamic-pituitary-ovary (HPO) axis. However, the role of stress in menstruation remains unclear. The objective of this study was to explore the role of stress in endometrial breakdown and shedding, using the pseudopregnant mouse menstrual-like model. Female mice were mated with vasectomized males and labeled day 0.5, upon observation of a vaginal seminal plug. On day 3.5, decidualization was induced in pseudopregnant mice using arachis oil. On day 5.5, pseudopregnant mice with artificial decidualization were placed in restraint tubes for 3 h. The findings indicated that acute restraint stress resulted in the disintegration of the endometrium. While corticosterone concentration in the serum increased significantly due to restraint stress, follicle-stimulating hormone (FSH), luteinizing hormone (LH) and progesterone (P4) levels in the serum decreased significantly. An endometrial histology examination indicated that progesterone implants may rescue P4 decline caused by acute stress and block endometrium breakdown and shedding. In addition, mice were treated with metyrapone, an inhibitor of corticosterone synthesis, 1 h prior to being subjected to restraint stress. Interestingly, metyrapone not only inhibited stress-induced endometrium breakdown and shedding, but also prevented stress-induced reduction of P4, LH and FSH. Furthermore, real-time PCR and western blot showed that mRNA and protein expression of CYP11A1 (cytochrome P450, family 11, subfamily A, polypeptide 1) and steroidogenic acute regulatory protein (StAR), the two rate-limiting enzymes for progesterone synthesis in the ovary, decreased following acute stress. But metyrapone prevented the reduction of StAR expression induced by restraint stress. Overall, this study revealed that acute stress results in an increase in corticosterone, which may inhibit LH and FSH release in the serum and CYP11A1 and StAR expression in the ovary, which finally leads to the breakdown and shedding of the endometrium. These experimental findings, based on the mouse model, may enable further understanding of the effects of stress on menstruation regulation and determine the potential factors affecting stress-associated menstrual disorders.

Administrative village-based spatial distribution specificity of Oncomelania hupensis and its relationship with water systems in Hubei Province / 中国血吸虫病防治杂志

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.

Dynamics of spatiotemporal distribution of schistosomiasis in Hubei Province, China.

Schistosomiasis caused by parasitic flatworms of blood flukes, remains a major public health concern in China. The significant progress in controlling schistosomiasis in China over the past decades has resulted in the remarkable reduction in the prevalence and intensity of Schistosoma japonicum infection to an extremely low level. Therefore, the elimination of schistosomiasis has been promoted by the Chinese national government. Hubei Province is the major endemic area, that is, along the middle and low reaches of the Yangtze River in the lake and marshland regions of southern China. Eliminating the transmission of schistosomiasis in Hubei Province is challenging. The current issue is to determine the distributions and clusters of schistosomiasis transmission. In this study, we assessed the spatial distribution of schistosomiasis and the risk at the county level in Hubei Province from 2011 to 2015 to provide guidance on the elimination of schistosomiasis transmission in lake and marshland regions. Spatial database of human S.japonicum infection from 2011 to 2015 at the county level in the study area was built based on the annual schistosomias is surveillance data. Moran's I, the global spatial autocorrelation statistics, was utilized to describe the spatial autocorrelation of human S. japonicum infection. In addition, purely spatial scan statistics combined with space-time scan statistics were used to determine the epidemic clusters. Infection rates of S. japonicum decreased in each endemic county in Hubei from 2011 to 2015. Human S. japonicum infection rate showed statistical significance by global autocorrelation analysis during the study period (Moran's I > 0, P < 0.01). This result suggested that there were spatial clusters present in the distribution of S. japonicum infection for the five years. Purely spatial analysis of human S. japonicum infection showed one most likely cluster and one secondary cluster from 2011 to 2015, which covered four and one counties, respectively. Spatiotemporal clustering analysis determined one most likely cluster and one secondary cluster both in 2011-2012, which appeared in 4 and 5 counties, respectively. However, the number of clustering foci decreased with time, and no cluster was detected after 2013.The clustering foci were both located at the Jianghan Plain, along the middle reaches of the Yangtze River and its connecting branch Hanbei River. Spatial distribution of human S. japonicum infections did not change temporally at the county level in Hubei Province. A declining trend in spatiotemporal clustering was observed between 2011 and 2015. However, effective control strategies and integrated prevention should be continuously performed, especially at the Jianghan Plain area along the Yangtze and Hanbei River Basin. Multivariate statistical analysis was carried out to investigate the risk of missing examinations, missing treatment, and unstandardized treatment events. The results showed that age, education level and Sanitary latrines are risk factors for missing examinations (b > 0, OR >1), and treatment times in past and feeding cattle in village group are protective factors (b < 0, OR <1). We also found that age and education level are risk factors for missing treatment (b > 0, OR >1). Study of the risk for un-standardized treatment revealed that occupation is risk factors (b > 0, OR >1), though, education level is protective factors (b < 0, OR <1). Therefore, precise prevention and control should be mainly targeted at these special populations.

A spatial analysis of human Schistosoma japonicum infections in Hubei, China, during 2009-2014.

BACKGROUND: The province of Hubei is located in the middle of China, near the middle and lower reaches of the River Yangtze, and is an area where schistosomiasis is endemic. It is challenging to control this disease in this environment, and it would be useful to identify clusters of infection and transmission, as well as their distributions during recent years. Therefore, this study aimed to analyze the spatial distribution of schistosomiasis in Hubei, in order to facilitate the effective control and elimination of this disease. METHODS: We collected schistosomiasis surveillance data from all endemic counties in Hubei during 2009-2014. A geographical information system (ArcGIS, version 10.1) was used to link the counties' geographical data with the epidemiological data, and the spatial scanning method (FleXScan v3.1.2) was used to identify spatial clusters of human infections with Schistosoma japonicum. RESULTS: In Hubei, patients who exhibited stool test results that were positive for S. japonicum accounted for > 50 % of all cases in China during 2009-2014. However, each endemic county in Hubei exhibited a declining trend in the number of human S. japonicum infections during the study period. The ArcGIS analyses revealed that the middle reaches of the River Yangtze were highly endemic for S. japonicum infections. Spatial scan analyses revealed the following infection clusters: two clusters in ten counties during 2009, two clusters in nine counties during 2010, three clusters in 12 counties during 2011, two clusters in 12 counties during both 2012 and 2013 and two clusters in ten counties during 2014. Most of the cluster regions were located in the lake and marshland regions along the basins of the River Yangtze. CONCLUSION: We successfully identified schistosomiasis clusters at the county level in Hubei during 2009-2014, and our results revealed that the clusters were typically located in lake and marshland regions. These data may be useful for controlling and eliminating schistosomiasis in other high-risk areas.

[Effect of standardized construction of laboratories of schistosomiasis control institutions in Hubei Province in 2013].

OBJECTIVE: To investigate the effect and current situation of the standardized construction of laboratories of schis- tosomiasis control institutions in Hubei Province, so as to provide the evidence for establishing and improving the quality control system of diagnosis of schistosomiasis after the transmission of schistosomiasis was under control. METHODS: According to the procedures of self-examination, field operation, and laboratory on-site, five laboratories were assessed, and all the results were analyzed comparatively. RESULTS: The average number of staffs were (7.00±1.58) persons, and the staffs of the laboratories of the schistosomiasis control institutions with senior professional titles in the city level were more than that in the county level (t = 5.563, P < 0.05). The average space was (3.20±1.64) rooms, and the average area was (117.00±88.29) m2. The average score of field operation was (96.40±4.49) points. The average score of laboratory on-site assessment was (106.6±6.15) points. The highest and lowest of the laboratory on-site assessment scores were environment and facilities (19.60 ± 0.55) points and management system of laboratory quality control (15.70±2.39) points (F = 2.869, P < 0.05), respectively. CONCLUSION: The cultivation of laboratory staff should be strengthened, and the diagnostic capacity should be maintained and improved. The laboratory quality control system should be paid more attention to, and the construction and management of schistosomiasis laboratories should be standardized.

Spatial analysis of Schistosomiasis in Hubei Province, China: a GIS-based analysis of Schistosomiasis from 2009 to 2013.

BACKGROUND: Schistosomiasis remains a major public health problem in China. The major endemic areas are located in the lake and marshland regions of southern China, particularly in areas along the middle and low reach of the Yangtze River. Spatial analytical techniques are often used in epidemiology to identify spatial clusters in disease regions. This study assesses the spatial distribution of schistosomiasis and explores high-risk regions in Hubei Province, China to provide guidance on schistosomiasis control in marshland regions. METHODS: In this study, spatial autocorrelation methodologies, including global Moran's I and local Getis-Ord statistics, were utilized to describe and map spatial clusters and areas where human Schistosoma japonicum infection is prevalent at the county level in Hubei province. In addition, linear logistic regression model was used to determine the characteristics of spatial autocorrelation with time. RESULTS: The infection rates of S. japonicum decreased from 2009 to 2013. The global autocorrelation analysis results on the infection rate of S. japonicum for five years showed statistical significance (Moran's I > 0, P < 0.01), which suggested that spatial clusters were present in the distribution of S. japonicum infection from 2009 to 2013. Local autocorrelation analysis results showed that the number of highly aggregated areas ranged from eight to eleven within the five-year analysis period. The highly aggregated areas were mainly distributed in eight counties. CONCLUSIONS: The spatial distribution of human S. japonicum infections did not exhibit a temporal change at the county level in Hubei Province. The risk factors that influence human S. japonicum transmission may not have changed after achieving the national criterion of infection control. The findings indicated that spatial-temporal surveillance of S. japonicum transmission plays a significant role on schistosomiasis control. Timely and integrated prevention should be continued, especially in the Yangtze River Basin of Jianghan Plain area.

[Diagnosis and treatment of schistosomiasis japonica-concensuses among ex- perts in Hunan, Hubei and Jiangxi provinces].

In order to further standardize the diagnosis and treatment of schistosomiasis japonica in China, on the basis of evidence-based medicine, the experts on schistosomiasis control from Hunan, Hubei and Jiangxi provinces summarized their consensuses on the disease after the discussion on the current situation and progress of clinical diagnosis and treatment of schistosomiasis in China, with the reference to the Diagnostic Criteria for Schistosomiasis (WS261-2006), which aimed to establish the therapeutic standards or guideline of schistosomiasis in China.

[Assessment of schistosomiasis endemic situation in national surveillance sites in Hubei Province from 2005 to 2010].

OBJECTIVE: To assess the schistosomiasis endemic situation in the national surveillance sites in Hubei Province, so as to provide the evidence for the prevention and control of schistosomiasis. METHODS: According to the national surveillance protocol, a longitudinal surveillance of endemic situation of schistosomiasis was carried out in 16 national surveillance sites from 2005 to 2010. RESULTS: In general, the positive rates of IHA, Kato-Katz technique and infection rates of Schistosoma japonicum decreased from 15.67%, 10.93% and 1.71% in 2005 to 10.48%, 8.54% and 0.90% in 2010, and declined by 33.12%, 22.70% and 47.95%, respectively. The infection rates of S. japonicum of the male were higher than that of the female, and the peak infection rates were in the groups aged above 30 years. The endemic situation of fishermen and farmers were relatively serious. The infection rates of S. japonicum in cattle decreased from 11.69% in 2005 to 1.41% in 2010, and declined by 88.01% (χ2 = 298.79, P < 0.001). The areas with infected Oncomelania hupensis snails, the densities of living snails, the rates of infected snails and the densities of infected snails decreased by 90.88%, 61.66%, 80.00% and 92.00%, respectively. CONCLUSION: The schistosomiasis endemic situation in the national surveillance sites in Hubei Province mitigates in 6 years, but the prevention is still a very daunting task.

[Molluscicidal effect comparison between TDS and MNSC in field].

OBJECTIVE: To compare the molluscicidal effects between "Luo-wei" (TDS), a plant molluscicide in 4 percent, and metaldehyde and niclosamide (MNSC) in the field. METHODS: A natural ecological environment with Oncomelania hupensis was selected as the test area, the test concentrations of TDS and MNSC were 2.5 g/m3 and 2 ml/m3 respectively by the immersion method; the test doses of TDS and MNSC were 3 g/m2 and 2 ml/m2 respectively by the spray method; the doses of WPN in a control group were 2 g/m3 and 2 g/m2 respectively by the two methods above-mentioned. The molluscicidal effects between TDS and MNSC were compared by using the synchronous design method and parallel comparative method. RESULTS: In the TDS group, the death rate of snails was 90.70% by immersion for 24 hours, reached to 81.40% after spraying for 7 days, and there were no significant differences among the observation time points in molluscicidal effects (P > 0.05). One day after the spraying, the death rate of snails was less in the TDS group compared with that in the MSCN group (P < 0.01), but the death rates of snails were similar in both groups 3 days after the spraying (P > 0.05). In the MSCN group, the death rate of snails was 99.17% by immersion for 24 hours, reached to 66.07% by spraying for 1 day. In the WPS group, the death rate of snails was 97.15% by immersion for 24 hours, reached to 71.43% after spraying for 1 day, and there were no significant differences (both P > 0.05). CONCLUSION: TDS has a good molluscicidal activity and stable efficacy, and the molluscicidal effect of TDS is similar to that of MSCN in the filed, but the molluscicidal sensitivity of TDS is lower than that of MSCN.

New integrated strategy emphasizing infection source control to curb Schistosomiasis japonica in a marshland area of Hubei Province, China: findings from an eight-year longitudinal survey.

BACKGROUND: Schistosomiasis remains a major public health problem in China. The major endemic foci are the lake and marshland regions of southern China, particularly the regions along the middle and lower reach of the Yangtze River in four provinces (Hubei, Hunan, Jiangxi, and Anhui). The purpose of our study is to assess the effect of a new integrated strategy emphasizing infection source control to curb schistosomiasis in marshland regions. METHODS: In a longitudinal study, we implemented an integrated control strategy emphasizing infection source control in 16 villages from 2005 through 2012 in marshland regions of Hubei province. The interventions included removing cattle from snail-infested grasslands, providing farmers with mechanized farm equipment, improving sanitation by supplying tap water, building lavatories and latrines, praziquantel chemotherapy, controlling snails, and environmental modification. RESULTS: Following the integrated control strategy designed to reduce the role of bovines and humans as sources of Schistosoma japonicum infection, the prevalence of human S. japonicum infection declined from 1.7% in 2005 to 0.4% in 2012 (P<0.001). Reductions were also observed in both sexes, across all age groups, and among high risk occupations. Moreover, the prevalence of bovine S. japonicum infection decreased from 11.7% in 2005 to 0.6% in 2012 (P<0.001). In addition, all the 16 villages achieved the national criteria of infection control in 2008. CONCLUSION: Our findings indicate that the integrated strategy was likely effective in controlling the transmission of S. japonicum in marshland regions in China.

[Impact of implementation of Three Gorges Project on schistosomiasis endemic situation in Hubei Province].

OBJECTIVE: To understand the change of hydrological regime in the Yangtze River and schistosomiasis endemic situation after the implementation of Three Gorges Project in Hubei Province. METHODS: The data of hydrological regime of the Yangtze River, schistosomiasis epidemic situation, and Oncomelania hupensis snail status were collected and analyzed in Hubei Province from 2002 to 2012. RESULTS: After the implementation of the Three Gorges Project in 2003, the water level of the Yangtze River slightly rose from January to March, the average water level in May and August both reduced compared with that in 2002, and the time of water withdrawal was moved up. The endemic situation of schistosomiasis showed a decline tendency in areas along the Yangtze River in Hubei Province. The positive rate of serological tests in the residents and the Schistosoma ja- ponicum infection rate in bovine decreased by 2.97% and 92.64% respectively. The numbers of human and bovine infected with S. japonicum decreased by 48.35% and 94.48%, respectively. CONCLUSION: After the implementation of the Three Gorges Project, the schistosomiasis endemic situation shows a decline tendency in the areas along the Yangtze River in Hubei Province, but the long-term monitoring still need to be carried out.

[Surveillance of schistosomiasis in Hubei Province in 2013].

OBJECTIVE: To understand the dynamic schistosomiasis situation in Hubei Province so as to provide the evidence for formulating the effective control strategy. METHODS: According to the Scheme of Schistosomiasis Surveillance in Hubei Province (the 2009 edition) , 207 endemic villages were selected and investigated for the schistosome infections of residents and livestock, and the distribution of Oncomelania hupensis snails. RESULTS: The average infection rates of residents and cattle were 0.35% and 0.15% respectively, and the endemic situation of fishermen and farmers were relatively serious (0.44% and 0.42%, respectively). The density of living snails was 0.30 snail/0.1m2, but no infected snails were found. CONCLUSION: The endemic situation of schistosomiasis in Hubei Province was stable in 2013, but the efforts for the infectious source control still should be strengthened.

[Prediction of epidemic tendency of schistosomiasis with time-series model in Hubei Province].

OBJECTIVE: To study the endemic trend of schistosomiasis japonica in Hubei Province, so as to provide the theoretical basis for surveillance and forecasting of schistosomiasis. METHODS: The time-series auto regression integrated moving average (ARIMA) model was applied to fit the infection rate of residents of Hubei Province from 1987 to 2013, and to predict the short-term trend of infection rate. RESULTS: The actual values of infection rate of residents were all in the 95% confidence internals of value predicted by the ARIMA model. The prediction showed that the infection rate of residents of Hubei Province would continue to decrease slowly. CONCLUSION: The time-series ARIMA model has good prediction accuracy, and could be used for the short-term forecasting of schistosomiasis.