The global pandemic caused by the coronavirus disease 2019 not only exposed the fragility of global preparedness and response to public health emergence,but also illustrated the fragmentation and gaps of research and ...The global pandemic caused by the coronavirus disease 2019 not only exposed the fragility of global preparedness and response to public health emergence,but also illustrated the fragmentation and gaps of research and development ecosystem.This emphasizes the need for planned actions against the potentiality of new pandemics and requires research to better understand how viruses bridge the animal/human divide making human-to-human transmission of new diseases possible.Major challenges to response to new epidemics under the current health framework reside in the so called 4-CC approach that focuses on Concept,Communication,Coherence,and Continuity.There is a need to also add a One Health perspective with emphasis on governance,surveillance,capacity building and multi-disciplinary research to achieve a holistic and better integrated system.Using a regulatory framework to equip professionals might facilitate the function of a multi-sector approach that recognizes the value of their mandates and a One Health approach in their work.Collaborative,multisectoral actions under the global regulations and guidance would make evidence-based One Health approaches sustainable and accessible to everyone.展开更多
Background:One Health is an integrated concept of health that aims to optimize the health of humans,animals,plants,and the environment.Identifying research gaps and specific expertise areas is important for understand...Background:One Health is an integrated concept of health that aims to optimize the health of humans,animals,plants,and the environment.Identifying research gaps and specific expertise areas is important for understanding the role of One Health in practice.This information on One Health could be used to promote collaboration and research,inspire innovative ideas,and accelerate the translation of evidence-based practices into policies.Methods:We searched the Scopus database for publications related to One Health between 2012 and 2021 to extract bibliometric information and investigate the possibility of establishing a dedicated expertise database.We matched scholarly information using SciVal to exclude duplicate information and identify scholars’affiliations,countries,and academic profiles.Individual academic contributions to One Health were evaluated according to their citations,publication impact,publication type,and author contributions.Results:A total of 8,313 publications on One Health over a ten-year period were identified,with the number of publications increasing over time.The largest number of publications came from the United States and the United Kingdom.These countries also had the highest number of experts and a high level of international collaboration.We identified 500 scholars from 53 countries and 313 affiliations with a median Hirsch Index of 20 who could be included in a One Health expert database.These scientists had a median of six publications on One Health,with topics mostly focusing on dengue and antimicrobial resistance.Conclusion:A One Health information database could be used as a third-party reference for scholars,a source to track the ongoing academic progress,and support for active scholars in this field of research.展开更多
Following publication of the original article[1],it was found the number of countries with identified One Health publications was incorrectly shown in Table 2,Supplementary data-Multimedia component 3(Table-S2),corres...Following publication of the original article[1],it was found the number of countries with identified One Health publications was incorrectly shown in Table 2,Supplementary data-Multimedia component 3(Table-S2),corresponding text and Fig.3,which should be corrected to 178.The number of countries with 500 One Health experts identified should be corrected to 53 in the abstract.展开更多
Artificial intelligence(AI)is a rapidly evolving field that can impel research in communicable diseases with respect to climate projections,ecological indicators and environmental impact,at the same time revealing new...Artificial intelligence(AI)is a rapidly evolving field that can impel research in communicable diseases with respect to climate projections,ecological indicators and environmental impact,at the same time revealing new,previously overlooked events.A number of zoonotic and vector-borne diseases already show signs of expanding their northern geographical ranges and appropriate risk assessment and decision support are urgently needed.The deployment of AI-enabled monitoring systems tracking animal populations and environmental changes is of immense potential in the study of transmission under different climate scenarios.In addition,AI's capability to identify new treatments should not only accelerate drug and vaccine discovery but also help predicting their effectiveness,while its contribution to genetic pathogen speciation would assist the evaluation of spillover risks with regard to viral infections from animals to human.Close collaboration between AI experts,epidemiologists and other stakeholders is not only crucial for responding to challenges interconnected with a variety of variables effectively,but also necessary to warrant responsible AI use.Despite its wider successful implementation in many fields,AI should be seen as a complement to,rather than a replacement of,traditional public health measures.展开更多
Background Schistosomiasis is a neglected tropical disease,primarily prevalent in tropical and subtropical regions.It imposes a significant health and economic burden in low-and middle-income countries,but a study of ...Background Schistosomiasis is a neglected tropical disease,primarily prevalent in tropical and subtropical regions.It imposes a significant health and economic burden in low-and middle-income countries,but a study of its comprehensive economic impact of the disease at the global level has not been carried out.As this is essential for evidence-based decision-making,this study aims to estimate the macroeconomic burden of schistosomiasis in 25 endemic countries.Methods We used a health-augmented macroeconomic(HAM)model,as well as observed data from 2010 to 2021 and projected data from 2022 to 2050,to model gross domestic product(GDP)under two scenarios:with and without schistosomiasis.The data were obtained from the Global Burden of Disease Study 2021(GBD 2021),the World Bank database,the International Monetary Fund(IMF)database,the International Labour Organization(ILO)database,the United Nations Population Division’s World Population Prospects 2022 database,the Barro-Lee Educational Attainment dataset,the Penn World Table(PWT)database,and relevant literature.The economic burden was quantified as the difference in GDP between these two scenarios.The HAM model considered:(i)the impact of schistosomiasis mortality and morbidity on labor supply;(ii)age and gender differences in education and work experience among schistosomiasis patients;and(iii)the impact of schistosomiasis treatment costs on physical capital accumulation.To be able to compare the purchasing power of different countries,we used international dollars(INT$),a hypothetical currency unit based on purchasing power parity.Results We estimated the macroeconomic burden of schistosomiasis in 25 schistosomiasis endemic countries was INT$49,504 million[uncertainty interval(UI):48,668–50,339]for the study period,using a 3%discount rate in the main analysis.The result implies that the economic burden of schistosomiasis across these 25 countries during study period is equivalent to 0.0174%(UI:0.0171–0.0177)of total GDP.Among all schistosomiasis-endemic countries included,Egypt had the largest absolute economic burden(INT$11,400 million,UI:11,221–11,578),followed by Brazil(INT$9779 million,UI:9717–9841)and South Africa(INT$6744 million,UI:6676–6811).Conclusions The global economic burden of schistosomiasis remains substantial and is inequitably distributed among countries and regions.Our study highlights the need for increased investment and global collaborative efforts to control schistosomiasis and its associated health and economic burdens.By advancing the elimination of schistosomiasis,substantial economic returns can be achieved.展开更多
Background Asian schistosomiasis is projected to be eliminated by 2030 according to World Health Organization road map for neglected tropical diseases 2021-2030.Snail control is an important measure but has not yet be...Background Asian schistosomiasis is projected to be eliminated by 2030 according to World Health Organization road map for neglected tropical diseases 2021-2030.Snail control is an important measure but has not yet been systematically evaluated at a country scale.Here,we report the findings from a nationwide survey to demonstrate the dynamics of Oncomelania and its potential role in transmission interruption of schistisomiasis in the People’s Republic of China(P.R.China).Methods Between March 2016 and December 2017,we conducted a nationwide census on Oncomelania snail habitats in P.R.China.All historically recorded snail habitats were identified and reviewed.Information on habitat attributes,including the infestation of snails,was collected.The shape of habitats was determined using global positioning system and geographical information system technologies.The relationship between snail control and schistosomiasis elimination was established in 378 endemic counties.The comparison of accumulated snail-infested range(ASR)and the median ratio of eliminated ASR between the transmission-interrupted and endemic counties was tested by a non-parametric test(Mann-Whitney)with a significance level of 0.05.Results Overall,15,377.7 million m^(2) of potential snail habitats with a total of 356,550 snail habitats were identified in P.R.China.The ASR amounted to 86.0%of the total area.Most of the ASR(94.9%)and habitats(68.5%)were distributed in the middle and lower reaches of the Yangtze River.Snail habitats were found up to an altitude of 2859 m above the mean sea level.By 2017,85.1%of habitats(73.0%of the ASR)had been eliminated with almost half of them eliminated between 1965 and 1982.The elimination of snail habitats promoted transmission interruption of schistosomiasis,but showed variable patterns in different landscapes.The ratio of eliminated ASR was 99.6 and 91.4%in water network and hilly areas,respectively,while it was only 64.8%in marshland areas,particularly in Hunan and Jiangxi where the two largest freshwater lakes of P.R.China are located.Marshland habitats were seen as the most difficult for transmission interruption,which calls for additional control measures in these settings.Conclusions Our results support recent recommendations by the World Health Organization to implement snail control and demonstrate that schistosomiasis elimination can be achieved.The nationwide,high-resolution map of Oncomelania snail habitats in P.R.China will support further efforts to eliminate schistosomiasis.展开更多
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 implementati...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 148902 residents from sentinel sites attended this study and 631676 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%(56884/335391,95%CI:16.83–17.09%)in 2005 to 4.28%(18121/423755,95%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%(663/256531,95%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.展开更多
Background The control of schistosomiasis is particularly difficult in sub-Saharan Africa,which currently harbours 95%of this disease.The target population for preventive chemotherapy(PC)is expanded to all age group a...Background The control of schistosomiasis is particularly difficult in sub-Saharan Africa,which currently harbours 95%of this disease.The target population for preventive chemotherapy(PC)is expanded to all age group at risk of infection,thus increasing the demands of praziquantel(PZQ)tablets according to the new released guideline by World Health Organization.Due to the gap between available PZQ for PC and requirements,alternative approaches to assess endemicity of schistosomiasis in a community,are urgently needed for more quick and precise methods.We aimed to find out to which degree the infection status of snails can be used to guide chemotherapy against schistosomiasis.Methods We searched literature published from January 1991 to December 2022,that reported on the prevalence rates ofSchistosoma mansoni,S.haematobium in the intermediate snailsBiomphalaria spp.andBulinus spp.,respectively,and in humans.A random effect model for meta-analyses was used to calculate the pooled prevalence estimate(PPE),with heterogeneity assessed using I-squared statistic(I2),with correlation and regression analysis for the exploration of the relationship between humanS.mansoni andS.haematobium infections and that in their specific intermediate hosts.Results Forty-seven publications comprising 59 field investigations were included.The pooled PPE of schistosomiasis,schistosomiasis mansoni and schistosomiasis haematobium in humans were 27.5%[95%confidence interval(CI):24.0-31.1%],25.6%(95%CI:19.9-31.3%),and 28.8%(95%CI:23.4-34.3%),respectively.The snails showed an overall infection rate of 8.6%(95%CI:7.7-9.4%),with 12.1%(95%CI:9.9-14.2%)in theBiomphalaria spp.snails and 6.9%(95%CI:5.7-8.1%)in theBulinus spp.snails.The correlation coefficient was 0.3(95%CI:0.01-0.5%,P<0.05)indicating that the two variables,i.e.all intermediate host snails on the one hand and the human host on the other,were positively correlated.Conclusions The prevalence rate ofS.mansoni andS.haematobium is still high in endemic areas.Given the significant,positive correlation between the prevalence of schistosomes in humans and the intermediate snail hosts,more attention should be paid to programme integration of snail surveillance in future.展开更多
基金supported by the Excellence Action Plan for Science and Technology Journals in China(C-084)。
文摘The global pandemic caused by the coronavirus disease 2019 not only exposed the fragility of global preparedness and response to public health emergence,but also illustrated the fragmentation and gaps of research and development ecosystem.This emphasizes the need for planned actions against the potentiality of new pandemics and requires research to better understand how viruses bridge the animal/human divide making human-to-human transmission of new diseases possible.Major challenges to response to new epidemics under the current health framework reside in the so called 4-CC approach that focuses on Concept,Communication,Coherence,and Continuity.There is a need to also add a One Health perspective with emphasis on governance,surveillance,capacity building and multi-disciplinary research to achieve a holistic and better integrated system.Using a regulatory framework to equip professionals might facilitate the function of a multi-sector approach that recognizes the value of their mandates and a One Health approach in their work.Collaborative,multisectoral actions under the global regulations and guidance would make evidence-based One Health approaches sustainable and accessible to everyone.
基金supported by Bill&Melinda Gates Foundation(No.INV-046218).
文摘Background:One Health is an integrated concept of health that aims to optimize the health of humans,animals,plants,and the environment.Identifying research gaps and specific expertise areas is important for understanding the role of One Health in practice.This information on One Health could be used to promote collaboration and research,inspire innovative ideas,and accelerate the translation of evidence-based practices into policies.Methods:We searched the Scopus database for publications related to One Health between 2012 and 2021 to extract bibliometric information and investigate the possibility of establishing a dedicated expertise database.We matched scholarly information using SciVal to exclude duplicate information and identify scholars’affiliations,countries,and academic profiles.Individual academic contributions to One Health were evaluated according to their citations,publication impact,publication type,and author contributions.Results:A total of 8,313 publications on One Health over a ten-year period were identified,with the number of publications increasing over time.The largest number of publications came from the United States and the United Kingdom.These countries also had the highest number of experts and a high level of international collaboration.We identified 500 scholars from 53 countries and 313 affiliations with a median Hirsch Index of 20 who could be included in a One Health expert database.These scientists had a median of six publications on One Health,with topics mostly focusing on dengue and antimicrobial resistance.Conclusion:A One Health information database could be used as a third-party reference for scholars,a source to track the ongoing academic progress,and support for active scholars in this field of research.
文摘Following publication of the original article[1],it was found the number of countries with identified One Health publications was incorrectly shown in Table 2,Supplementary data-Multimedia component 3(Table-S2),corresponding text and Fig.3,which should be corrected to 178.The number of countries with 500 One Health experts identified should be corrected to 53 in the abstract.
基金National Key Research and Development Program of People's Republic of China(grant no.2021YFC2300800 and 2021YFC2300804)the International Joint Laboratory on Tropical Diseases Control in Greater Mekong Subregion(no.21410750200)from Shanghai Municipality Government。
文摘Artificial intelligence(AI)is a rapidly evolving field that can impel research in communicable diseases with respect to climate projections,ecological indicators and environmental impact,at the same time revealing new,previously overlooked events.A number of zoonotic and vector-borne diseases already show signs of expanding their northern geographical ranges and appropriate risk assessment and decision support are urgently needed.The deployment of AI-enabled monitoring systems tracking animal populations and environmental changes is of immense potential in the study of transmission under different climate scenarios.In addition,AI's capability to identify new treatments should not only accelerate drug and vaccine discovery but also help predicting their effectiveness,while its contribution to genetic pathogen speciation would assist the evaluation of spillover risks with regard to viral infections from animals to human.Close collaboration between AI experts,epidemiologists and other stakeholders is not only crucial for responding to challenges interconnected with a variety of variables effectively,but also necessary to warrant responsible AI use.Despite its wider successful implementation in many fields,AI should be seen as a complement to,rather than a replacement of,traditional public health measures.
基金financially supported by National Key Research and Development Program of China(No.2021YFC2300800,2021YFC2300803).
文摘Background Schistosomiasis is a neglected tropical disease,primarily prevalent in tropical and subtropical regions.It imposes a significant health and economic burden in low-and middle-income countries,but a study of its comprehensive economic impact of the disease at the global level has not been carried out.As this is essential for evidence-based decision-making,this study aims to estimate the macroeconomic burden of schistosomiasis in 25 endemic countries.Methods We used a health-augmented macroeconomic(HAM)model,as well as observed data from 2010 to 2021 and projected data from 2022 to 2050,to model gross domestic product(GDP)under two scenarios:with and without schistosomiasis.The data were obtained from the Global Burden of Disease Study 2021(GBD 2021),the World Bank database,the International Monetary Fund(IMF)database,the International Labour Organization(ILO)database,the United Nations Population Division’s World Population Prospects 2022 database,the Barro-Lee Educational Attainment dataset,the Penn World Table(PWT)database,and relevant literature.The economic burden was quantified as the difference in GDP between these two scenarios.The HAM model considered:(i)the impact of schistosomiasis mortality and morbidity on labor supply;(ii)age and gender differences in education and work experience among schistosomiasis patients;and(iii)the impact of schistosomiasis treatment costs on physical capital accumulation.To be able to compare the purchasing power of different countries,we used international dollars(INT$),a hypothetical currency unit based on purchasing power parity.Results We estimated the macroeconomic burden of schistosomiasis in 25 schistosomiasis endemic countries was INT$49,504 million[uncertainty interval(UI):48,668–50,339]for the study period,using a 3%discount rate in the main analysis.The result implies that the economic burden of schistosomiasis across these 25 countries during study period is equivalent to 0.0174%(UI:0.0171–0.0177)of total GDP.Among all schistosomiasis-endemic countries included,Egypt had the largest absolute economic burden(INT$11,400 million,UI:11,221–11,578),followed by Brazil(INT$9779 million,UI:9717–9841)and South Africa(INT$6744 million,UI:6676–6811).Conclusions The global economic burden of schistosomiasis remains substantial and is inequitably distributed among countries and regions.Our study highlights the need for increased investment and global collaborative efforts to control schistosomiasis and its associated health and economic burdens.By advancing the elimination of schistosomiasis,substantial economic returns can be achieved.
基金supported by National Key Research and Development Program of China(No.2021YFC2300800,2021YFC2300803).
文摘Background Asian schistosomiasis is projected to be eliminated by 2030 according to World Health Organization road map for neglected tropical diseases 2021-2030.Snail control is an important measure but has not yet been systematically evaluated at a country scale.Here,we report the findings from a nationwide survey to demonstrate the dynamics of Oncomelania and its potential role in transmission interruption of schistisomiasis in the People’s Republic of China(P.R.China).Methods Between March 2016 and December 2017,we conducted a nationwide census on Oncomelania snail habitats in P.R.China.All historically recorded snail habitats were identified and reviewed.Information on habitat attributes,including the infestation of snails,was collected.The shape of habitats was determined using global positioning system and geographical information system technologies.The relationship between snail control and schistosomiasis elimination was established in 378 endemic counties.The comparison of accumulated snail-infested range(ASR)and the median ratio of eliminated ASR between the transmission-interrupted and endemic counties was tested by a non-parametric test(Mann-Whitney)with a significance level of 0.05.Results Overall,15,377.7 million m^(2) of potential snail habitats with a total of 356,550 snail habitats were identified in P.R.China.The ASR amounted to 86.0%of the total area.Most of the ASR(94.9%)and habitats(68.5%)were distributed in the middle and lower reaches of the Yangtze River.Snail habitats were found up to an altitude of 2859 m above the mean sea level.By 2017,85.1%of habitats(73.0%of the ASR)had been eliminated with almost half of them eliminated between 1965 and 1982.The elimination of snail habitats promoted transmission interruption of schistosomiasis,but showed variable patterns in different landscapes.The ratio of eliminated ASR was 99.6 and 91.4%in water network and hilly areas,respectively,while it was only 64.8%in marshland areas,particularly in Hunan and Jiangxi where the two largest freshwater lakes of P.R.China are located.Marshland habitats were seen as the most difficult for transmission interruption,which calls for additional control measures in these settings.Conclusions Our results support recent recommendations by the World Health Organization to implement snail control and demonstrate that schistosomiasis elimination can be achieved.The nationwide,high-resolution map of Oncomelania snail habitats in P.R.China will support further efforts to eliminate schistosomiasis.
基金This study was financially supported by the Natural Science Foundation of China(No.30590373)the National Special Science and Technology Project for Major Infectious Diseases of China(No.2012ZX10004–220,2016YFC1202000).
文摘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 148902 residents from sentinel sites attended this study and 631676 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%(56884/335391,95%CI:16.83–17.09%)in 2005 to 4.28%(18121/423755,95%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%(663/256531,95%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.
基金National Science Foundation of China(82073619)National Key Research and Development Program of China(2021YFC2300800,2021YFC2300804)+1 种基金General Programs of Jiangsu Commission of Health(H202309)Schistosomiasis and Parasitic Diseases Project of Jiangsu Province(×202103)。
文摘Background The control of schistosomiasis is particularly difficult in sub-Saharan Africa,which currently harbours 95%of this disease.The target population for preventive chemotherapy(PC)is expanded to all age group at risk of infection,thus increasing the demands of praziquantel(PZQ)tablets according to the new released guideline by World Health Organization.Due to the gap between available PZQ for PC and requirements,alternative approaches to assess endemicity of schistosomiasis in a community,are urgently needed for more quick and precise methods.We aimed to find out to which degree the infection status of snails can be used to guide chemotherapy against schistosomiasis.Methods We searched literature published from January 1991 to December 2022,that reported on the prevalence rates ofSchistosoma mansoni,S.haematobium in the intermediate snailsBiomphalaria spp.andBulinus spp.,respectively,and in humans.A random effect model for meta-analyses was used to calculate the pooled prevalence estimate(PPE),with heterogeneity assessed using I-squared statistic(I2),with correlation and regression analysis for the exploration of the relationship between humanS.mansoni andS.haematobium infections and that in their specific intermediate hosts.Results Forty-seven publications comprising 59 field investigations were included.The pooled PPE of schistosomiasis,schistosomiasis mansoni and schistosomiasis haematobium in humans were 27.5%[95%confidence interval(CI):24.0-31.1%],25.6%(95%CI:19.9-31.3%),and 28.8%(95%CI:23.4-34.3%),respectively.The snails showed an overall infection rate of 8.6%(95%CI:7.7-9.4%),with 12.1%(95%CI:9.9-14.2%)in theBiomphalaria spp.snails and 6.9%(95%CI:5.7-8.1%)in theBulinus spp.snails.The correlation coefficient was 0.3(95%CI:0.01-0.5%,P<0.05)indicating that the two variables,i.e.all intermediate host snails on the one hand and the human host on the other,were positively correlated.Conclusions The prevalence rate ofS.mansoni andS.haematobium is still high in endemic areas.Given the significant,positive correlation between the prevalence of schistosomes in humans and the intermediate snail hosts,more attention should be paid to programme integration of snail surveillance in future.
