Search

Objective: Precision interventions have been proposed in transmission-interrupted areas to further reduce the potential transmission risk of schistosomiasis. This study aimed to evaluate the effects of different interventions modes for potential transmission risk control. Methods: Three groups of schistosomiasis-endemic villages were selected in Jiangling county, Hubei province. After baseline surveys in 2020, three intervention models were employed in 2021 and 2022. In Model 1, Oncomelania hupensis snail control in key settings and an integrated strategy with an emphasis on the infectious sources managing was employed. In Model 2, an integrated health education-led strategy with an emphasis on infectious source management was employed. In Model 3, only the integrated strategy with an emphasis on infectious source management was employed. The effects of the different intervention models were examined with multiple indicators after 2 years of intervention using the entropy-weighted technique for order of preference by similarity to ideal solution (TOPSIS), rank-sum ratio (RSR) and fuzzy combination model of entropy-weighted TOPSIS and RSR. Results: Entropy-weighted TOPSIS modeling showed that the Ci values of Model 2 were 0.4434, 0.2759, and 0.3069 in the three pilot villages, Ci values were larger, with top comprehensive ranking. The results of the RSR method showed that the RSR values of Model 2 were 0.75, 0.708, and 0.736 in the three pilot villages, with top comprehensive ranking. The results from the fuzzy combination model of entropy-weighted TOPSIS and RSR showed that implementation of Model 2 resulted in the highest comprehensive ranking among the three models in the three pilot villages under Ci: RSR = 0.1: 0.9, Ci: RSR = 0.5: 0.5 and Ci: RSR = 0.9: 0.1. Conclusion: The integrated health education-led strategy with an emphasis on infectious source management was the optimal model to manage the risk of transmission of schistosomiasis during the post-transmission interruption phase. Author summary: Currently, schistosomiasis control has moved into the transmission interruption phase in China. During the transition from the transmission interruption to elimination stages, the national schistosomiasis control program shifts from morbidity control to interventions of schistosomiasis transmission. Following the implementation of intervention models with adaptations to current epidemiological features of schistosomiasis, the shift from conventional comprehensive control to more scientific and precise modern control is an important issue for schistosomiasis control strategies. Therefore, this study selected Jiangling County of Hubei Province, where schistosomiasis was historically hyperendemic and there is a high risk of schistosomiasis transmission, to carry out field empirical research on different transmission risk intervention modes. Results from the RSR, TOPSIS and fuzzy combination model all revealed that the effectiveness of the integrated health education-led strategy with an emphasis on infectious source management was superior to the other two intervention models. Results from this field interventional study showed that the integrated health education-led strategy with an emphasis on infectious source management was the optimal model to manage the risk of transmission of schistosomiasis during the post-transmission interruption phase. [ABSTRACT FROM AUTHOR]

Objective: This study aims to explore the spatiotemporal distribution of schistosomiasis in Jiangling County, and provide insights into the precise schistosomiasis control. Methods: The descriptive epidemiological method and Joinpoint regression model were used to analyze the changes in infection rates of humans, livestock, snails, average density of living snails and occurrence rate of frames with snails in Jiangling County from 2005 to 2021. Spatial epidemiology methods were used to detect the spatiotemporal clustering of schistosomiasis transmission risk in Jiangling county. Results: The infection rates in humans, livestock, snails, average density of living snails and occurrence rate of frames with snails in Jiangling County decreased from 2005 to 2021 with statistically significant. The average density of living snails in Jiangling County was spatially clustered in each year, and the Moran's I varied from 0.10 to 0.26. The hot spots were mainly concentrated in some villages of Xionghe Town, Baimasi Town and Shagang Town. The mean center of the distribution of average density of living snails in Jiangling County first moved from northwest to southeast, and then returned from southeast to northwest after 2014. SDE azimuth fluctuated in the range of 111.68°-124.42°. Kernal density analysis showed that the high and medium-high risk areas of Jiangling County from 2005 to 2021 were mainly concentrated in the central and eastern of Jiangling County, and the medium-low and low risk areas were mainly distributed in the periphery of Jiangling County. Conclusions: The epidemic situation of schistosomiasis decreased significantly in Jiangling County from 2005 to 2021, but the schistosomiasis transmission risk still had spatial clustering in some areas. After transmission interruption, targeted transmission risk intervention strategies can be adopted according to different types of schistosomiasis risk areas. Author summary: Schistosoma (S.) japonicum was once hyper-endemic in southern China. Jiangling County is one of the key endemic areas of schistosomiasis in Hubei Province, P.R. China. Although the prevalence of schistosomiasis in Jiangling County has decreased significantly, the geographical location of Jiangling County is suitable for snails breeding due to the crisscrossed ditches, so the risk of schistosomiasis transmission is still widespread. This study analyzed the schistosomiasis transmission risk in different regions in Jiangling County from 2005 to 2021, and targeted transmission risk intervention strategies can be adopted in different endemic areas after schistosomiasis transmission interruption. The areas with high risk of schistosomiasis transmission in Jiangling County were mainly distributed in the central part of Jiangling County near the west main ditch and the eastern part of Jiangling County. It is suggested strengthen schistosomiasis risk monitoring in Jiangling County, especially snails monitoring and snails elimination. In addition, health education intervention should be strengthened in key areas to prevent the spread of transmission risk to surrounding areas, in order to achieve the goal of eliminating schistosomiasis as soon as possible. [ABSTRACT FROM AUTHOR]