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Background: Due to sustained control activities, the prevalence of Schistosoma japonicum infection in humans, livestock and snails has decreased significantly in P. R. China, and the target has shifted from control to elimination according to the Outline of Healthy China 2030 Plan. Applying highly sensitive methods to explore the presence of S. japonicum infection in its intermediate host will benefit to assess the endemicity or verify the transmission interruption of schistosomiasis accurately. The aim of this study was to access the presence of S. japonicum infection by a loop-mediated isothermal amplification (LAMP) method through a 5-year longitudinal study in five lake provinces along the Yangtze River., Methods: Based on previous epidemiological data, about 260 villages with potential transmission risk of schistosomiasis were selected from endemic counties in five lake provinces along the Yangtze River annually from 2015 to 2019. Snail surveys were conducted in selected villages by systematic sampling method and/or environmental sampling method each year. All live snails collected from field were detected by microscopic dissection method, and then about one third of them were detected by LAMP method to assess the presence of S. japonicum infection with a single blind manner. The infection rate and nucleic acid positive rate of schistosomes in snails, as well as the indicators reflecting the snails' distribution were calculated and analyzed. Fisher's exact test was used to examine any change of positive rate of schistosomes in snails over time., Results: The 5-year survey covered 94,241 ha of environment with 33,897 ha of snail habitats detected accumulatively. Totally 145.3 ha new snail habitats and 524.4 ha re-emergent snail habitats were found during 2015-2019. The percentage of frames with snails decreased from 5.93% [45,152/761,492, 95% confidence intervals (CI): 5.88-5.98%] in 2015 to 5.25% (30,947/589,583, 95% CI: 5.19-5.31%) in 2019, while the mean density of living snails fluctuated but presented a downward trend generally from 0.20 snails/frame (155,622/761,492, 95% CI: 0.17-0.37) in 2015 to 0.13 snails/frame (76,144/589,583, 95% CI: 0.11-0.39) in 2019. A total of 555,393 live snails were collected, none of them was positive by dissection method. Totally 17 pooling snail samples were determined as positives by LAMP method among 8716 pooling samples with 174,822 of living snails, distributed in 12 villages of Hubei, Hunan, Jiangxi and Anhui provinces. The annual average positive rate was 0.41% (95% CI: 0.13-0.69%) in 2015, 0% in 2016, 0.36% (95% CI: 0.09-0.63%) in 2017, 0.05% (95% CI: 0-0.16%) in 2018, 0.05% (95% CI: 0-0.15%) in 2019, respectively, presenting a downward trend from 2015 to 2019 with statistical significance (χ 2  = 11.64, P < 0.05)., Conclusions: The results suggest that S. japonicum infection still persisted in nature along the Yangtze River and traditional techniques might underestimate the prevalence of schistosomiasis in its intermediate hosts. Exploring and integrating molecular techniques into national surveillance programme could improve the sensitivity of surveillance system and provide guidance on taking actions against schistosomiasis., (© 2022. The Author(s).)

Dipstick Dye Immunoassay (DDIA) and Indirect Haemagglutination Assay (IHA), are two commercially available kits which have been widely used for screening Schistosoma japonicum in P.R. China. Whether they can be used for screening of Schistosoma haematobium are not clear. In order to evaluate the diagnostic efficiency of DDIA and IHA for screening Schistosoma haematobium, serum samples were collected from pupils in endemic areas in Zambia, Southern Africa, and tested by DDIA and IHA by single-blind manner. Meanwhile, the pupils were microscopically examined by infection with Schistosoma and soil-transmitted helminths, visually observed for parasite eggs. Of the enrolled 148 pupils, 61% tested positive for S. haematobium infection, while 31% and 36% of pupils were infected with hookworm and Ascaris respectively. Regarding the parasitological tests as reference standard, for the diagnosis of S. haematobium infection, IHA performed higher sensitivity (74%, 95% CI: 65%-83%) than that of DDIA (60%, 95%CI: 49%-70%). The sensitivities of IHA and DDIA are significant higher in 10-14 years old students than those of 7-9 years old group. The specificity of DDIA and IHA were 61% (95%CI: 49%-74%) and 72% (95%CI: 60%-84%), respectively. The co-infection with STHs decreased the specificity of DDIA but had no impact on that of IHA. Our study indicated that IHA has more potential as an alternative diagnostic tool for identifying schistosomiasis haematobium but need further improvement., Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: An "integrated control" strategy has been implemented within seven provinces at highest risk for schistosomiasis along Yangtze River in Peoples' Republic of China (P. R. China) since 2004. Since Oncomelania hupensis is the only intermediate host of the blood fluke (Schistosoma japonicum), controlling the distribution of snails is considered an essential and effective way to reduce the risk of schistosomiasis infection. The study aimed to determine the snail area burden and annual trend among provinces with potential risk for schistosomiasis along the Yangtze River, above and below the Three Gorges Dam (TGD)., Methods: This retrospective study utilized data previously collected from the National Parasitic Diseases Control Information Management System (NPDCIMS) on annual snail surveys from 2009 to 2017. Descriptive statistics were performed for analyzing the snail burden by provinces, counties, type of environmental location and year, and mapping was conducted to present the snails distribution., Results: From 2009 to 2017, the total snail infested area decreased by 4.22%, from 372 253 hm 2 to 356 553 hm 2 within the seven high risk provinces. The majority of snails were found in the marshland and lake regions, outside of control embankments. The total snail burden trend remained relatively stable in upstream regions above the TGD from 2010 to 2015, while the trend decreased within downstream regions during this period. In 2016 and 2017, the total snail burden trend increased in both upstream and downstream provinces, however, upstream saw a larger increase. From 2009 to 2017, there were a total of 5990 hm 2 of newly developed snail areas in the seven study provinces and the majority were concentrated in regions below the TGD, accounting for 5610 hm 2 (93.70%)., Conclusions: There has been a decline in total snail counts from 2009 to 2017. Meanwhile, new snail breeding areas were formed mainly within provinces downstream the TGD due to spread of snails, indicated that the oncomelanid snail would be difficult to completely eliminate. We suggest that the national schistosomiasis integrated control strategy, including mollusciding and environmental modification, will need to be enhanced significantly going forward to achieve a greater reduction in snail burden and ultimately to achieve elimination.

Schistosomiasis is closely related to environmental factors, the changes of environmental factors, such as vegetation, temperature, hydrology and soil, could impact the transmission of the disease. The environmental factors associated with schistosomiasis could be extracted by remote sensing technology quickly and precisely, and be applied to monitor the schistosomiasis transmission. The studies on high resolution remote sensing technology applied in the research of schistosomiasis are reviewed in this paper.

Background: Marching towards the elimination of schistosomiasis in China, both the incidence and prevalence have witnessed profound decline over the past decades, with the strategy shifting from morbidity control to transmission control. The current challenge is to find out hotspots of transmission risk for precise targeted control in low-prevalence areas. This study assessed the risk at the village level, using the spatial and temporal characteristics of Schistosomiasis japonica in Anhui province from 2006 to 2012., Method: The comprehensive database was generated from annual surveillance data at village level in Anhui province between 2006 and 2012, comprising schistosomiasis prevalence among humans and cattle, occurrence rate of infected environments and incidence rate of acute schistosomiasis. The database parameters were matched with geographic data of the study area and fine scale spatial-temporal cluster analysis based on retrospective space-time scan statistics was used to assess the clustering pattern of schistosomiasis. The analysis was conducted by using SaTScan 9.1.1 and ArcGIS 10.0. A spatial statistical modelling was carried out to determine the spatial dependency of prevalence of human infection by using Geoda 1.4.3., Result: A pronounced decline was found in the prevalence of human infection, cattle infection, occurrence rate of environment with infected vector snails and incidence rate of acute schistosomiasis from 2006 to 2012 by 48.6%, 71.5%, 91.9% and 96.4%, respectively. Meanwhile, all 4 indicators showed a statistically significant clustering pattern both in time and space, with a total of 16, 6, 8 and 4 corresponding clustering foci found respectively. However, the number of clustering foci declined with time, and none was found after year 2010. All clustering foci were mainly distributed along the Yangtze River and its connecting branches. The result shows that there is a direct spatial relationship between prevalence of human infection and the other indicators., Conclusion: A decreasing trend in space-time clustering of schistosomiasis endemic status was observed between 2006 and 2012 in Anhui province. Nevertheless, giving the complexity in schistosomiasis control, areas within the upper-stream of Yangtze River in Anhui section and its connecting branches should be targeted for effective implementation of control strategies in the future.

The diagnosis of Schistosoma japonicum (Sj) infection in low prevalence areas of the People's Republic of China is challenging due to the sensitivity of the detection methods, leading to an underestimation of the disease burden. We compared the sensitivities of the miracidium hatching test (MHT) with the modified Kato-Katz method (KK) and the combination of the two methods (KK-MHT) to detect Sj infection in low prevalence areas of China. The stool samples of 3,853 residents from 8 villages with a light to moderate prevalence (0-23%) of Sj infection were examined by KK, MHT and KK-MHT. The findings were inconsistent. The KK-MHT conbination gave more positives than either the KK or MHT alone. Using the KK-MHT, we determined the missed rates with the KK (mR(K)) and MHT (mR(H)) to be 30.1% and 10.2%, respectively. At light prevalence sites (infection rate < 10%) the mR(K) was 60.6%, significantly higher than the mR(K) of 22.3% found at moderate prevalence sites (10-23%). However, the mR(H) at the light and moderate prevalence sites were 11.54% and 9.90%, respectively (p > 0.05). The combination KK-MHT had the best sensitivity in low Sj prevalence areas in China and the KK method alone was the least sensitive. Using KK alone as a screening method will result in an underestimation of Sj infection disease burden.

Objective: To monitor water body infestation in schistosomiasis high-risk areas with sentinel mouse technique., Methods: A total of 72 surveillance sites from 47 counties were selected in Hunan, Hubei, Jiangxi, Anhui, Jiangsu, Yunnan, and Sichuan. The water infectivity of Schistosoma japonicum was determined in the surveillance sites by using sentinel mice during June-July and September, 2012., Results: Among the 3,283 sentinel mice which were placed in 72 sites, 3,062 (93.3%) were recovered and dissected. Infected sentinel mice were found in six sites accounting for 8.3% (6/72) of the total surveillance sites, with an occurrence rate of sites with infected mice of 8.3% in June-July and 2.8% in September. 33 infected mice were discovered with a total infection rate of 1.08% (33/3,062). 1,085 adult worms were collected, with a mean worm burden of 32.9 worms per mouse in infected sentinel mice. 4 positive sites were in Hunan and 2 were in Jiangxi. Local acute schistosomiasis or suspected local acute cases which detected elsewhere were reported in 2 positive sites. Some follow-up activities were conducted in the 6 positive sites., Conclusion: Compared with those in 2010, the schistosomiasis risk areas are shrinking in 2012. However, some regions are still the schistosomiasis high-risk areas.

Schistosomiasis is a tropical disease, which could do serious damage to the people's health, and it hinders the development of the social economy but may be neglected. After a positive control, some countries and regions have blocked the spread of schistosomiasis. However, in the past few years, with the development of social economy, due to the global movement of people, schistosomiasis not only poses a threat to control areas, but also may cause new endemic areas. This article reviews the parasitological characteristics, clinical manifestations, epidemiological situation, and control approaches of three major kinds of human schistosomiasis, schistosomiasis japonica, schistosomiasis haematobia, and schistosomiasis mansoni.

Background: China is progressing towards the goal of schistosomiasis elimination, but there are still some problems, such as difficult management of infection source and snail control. This study aimed to develop deep learning models with high-resolution remote sensing images for recognizing and monitoring livestock bovine, which is an intermediate source of Schistosoma japonicum infection, and to evaluate the effectiveness of the models for real-world application. Methods: The dataset of livestock bovine's spatial distribution was collected from the Chinese National Platform for Common Geospatial Information Services. The high-resolution remote sensing images were further divided into training data, test data, and validation data for model development. Two recognition models based on deep learning methods (ENVINet5 and Mask R-CNN) were developed with reference to the training datasets. The performance of the developed models was evaluated by the performance metrics of precision, recall, and F1-score. Results: A total of 50 typical image areas were selected, 1125 bovine objectives were labeled by the ENVINet5 model and 1277 bovine objectives were labeled by the Mask R-CNN model. For the ENVINet5 model, a total of 1598 records of bovine distribution were recognized. The model precision and recall were 81.9% and 80.2%, respectively. The F1 score was 0.81. For the Mask R-CNN mode, 1679 records of bovine objectives were identified. The model precision and recall were 87.3% and 85.2%, respectively. The F1 score was 0.87. When applying the developed models to real-world schistosomiasis-endemic regions, there were 63 bovine objectives in the original image, 53 records were extracted using the ENVINet5 model, and 57 records were extracted using the Mask R-CNN model. The successful recognition ratios were 84.1% and 90.5% for the respectively developed models. Conclusion: The ENVINet5 model is very feasible when the bovine distribution is low in structure with few samples. The Mask R-CNN model has a good framework design and runs highly efficiently. The livestock recognition models developed using deep learning methods with high-resolution remote sensing images accurately recognize the spatial distribution of livestock, which could enable precise control of schistosomiasis. [ABSTRACT FROM AUTHOR]

Background: Flooding is considered to be one of the most important factors contributing to the rebound of Oncomelania hupensis, a small tropical freshwater snail and the only intermediate host of Schistosoma japonicum, in endemic foci. The aim of this study was to assess the risk of intestinal schistosomiasis transmission impacted by flooding in the region around Poyang Lake using multi-source remote sensing images. Methods: Normalized Difference Vegetation Index (NDVI) data collected by the Landsat 8 satellite were used as an ecological and geographical suitability indicator of O. hupensis habitats in the Poyang Lake region. The expansion of the water body due to flooding was estimated using dual-polarized threshold calculations based on dual-polarized synthetic aperture radar (SAR). The image data were captured from the Sentinel-1B satellite in May 2020 before the flood and in July 2020 during the flood. A spatial database of the distribution of snail habitats was created using the 2016 snail survey in Jiangxi Province. The potential spread of O. hupensis snails after the flood was predicted by an overlay analysis of the NDVI maps in the flood-affected areas around Poyang Lake. The risk of schistosomiasis transmission was classified based on O. hupensis snail density data and the related NDVI. Results: The surface area of Poyang Lake was approximately 2207 km2 in May 2020 before the flood and 4403 km2 in July 2020 during the period of peak flooding; this was estimated to be a 99.5% expansion of the water body due to flooding. After the flood, potential snail habitats were predicted to be concentrated in areas neighboring existing habitats in the marshlands of Poyang Lake. The areas with high risk of schistosomiasis transmission were predicted to be mainly distributed in Yongxiu, Xinjian, Yugan and Poyang (District) along the shores of Poyang Lake. By comparing the predictive results and actual snail distribution, we estimated the predictive accuracy of the model to be 87%, which meant the 87% of actual snail distribution was correctly identified as snail habitats in the model predictions. Conclusions: Data on water body expansion due to flooding and environmental factors pertaining to snail breeding may be rapidly extracted from Landsat 8 and Sentinel-1B remote sensing images. Applying multi-source remote sensing data for the timely and effective assessment of potential schistosomiasis transmission risk caused by snail spread during flooding is feasible and will be of great significance for more precision control of schistosomiasis. [ABSTRACT FROM AUTHOR]

Being a zoonotic parasitic disease, schistosomiasis was widely spread in 12 provinces of Southern China in the 1950s, severly harming human health and hindering economic development. The National Institute of Parasitic Diseases at the Chinese Center for Diseases Control and Prevention, and Chinese Center for Tropical Diseases Research (NIPD-CTDR), as the only professional institution focussing on parasitic diseases at the national level, has played an important role in schistosomiasis control in the country. In this article, we look back at the changes of schistosomiasis endemicity and the contribution of NIPD-CTDR to the national schistosomiasis control programme. We review NIPD-CTDR's activities, including field investigations, design of control strategies and measures, development of diagnostics and drugs, surveillance-response of endemic situation, and monitoring & evaluation of the programme. The NIPD-CTDR has mastered the transmission status of schistosomiasis, mapped the snail distribution, and explored strategies and measures suitable for different types of endemic areas in China. With a good understanding of the life cycle of Schistosoma japonicum and transmission patterns of the disease, advanced research carried out in the NIPD-CTDR based on genomics and modern technology has made it possible to explore highly efficient and soft therapeutic drugs and molluscicides, making it possible to develop new diagnostic tools and produce vaccine candidates. In the field, epidemiological studies, updated strategies and targeted intervention measures developed by scientists from the NIPD-CTDR have contributed significantly to the national schistosomiasis control programme. This all adds up to a strong foundation for eliminating schistosomiasis in China in the near future, and recommendations have been put forward how to reach this goal. [ABSTRACT FROM AUTHOR]

World Bank Loan Project (WBLP) for schistosomiasis control conducted from 1992 to 2001, resulted in significant reduction of schistosomiasis morbidity and mortality in People's Republic of China (P.R. China), with implementation of morbidity control. Thereafter, an integrated control strategy, which targeted blocking disease transmission from reservoir hosts to the environment, was initiated in order to conquer schistosomiasis rebound after WBLP completion. Data obtained from the national schistosomiasis control reporting systems was collected and analyzed. The number of confirmed cases and infected cattle decreased significantly from 2002 to 2017, while no infected snails were found by dissection for four consecutive years. However, lake and marshland regions and some parts areas of Yunnan Province require attention for rigorous schistosomiasis control efforts. There is need to strengthen precise interventions and sensitive surveillance to achieve schistosomiasis elimination in P.R. China. [ABSTRACT FROM AUTHOR]

China has made remarkable progress in reducing schistosomiasis caused by Schistosoma japonicum over the past 7 decades but now faces a severe threat from imported schistosomiasis. Results from national surveillance during 2010-2018 indicate integrating active surveillance into current surveillance models for imported cases is urgently needed to achieve schistosomiasis elimination in China. [ABSTRACT FROM AUTHOR]