Schistosomiasis japonica intervention study on Poyang Lake, China: The snail's tale
Schistosomiasis japonica intervention study on Poyang Lake, China: The snail's tale
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DOI：
10.4002/1543-8120-49.1.79
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发表时间：
2006-01-01
期刊：
影响因子：
1.3
通讯作者：
Guo, Jia-Gang
中科院分区：
文献类型：
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作者：
Davis, George M.;Wu, Wei Ping;Guo, Jia-Gang
美国国立卫生研究院资助的一项研究于 1998 年启动，于 2002 年结束，目的是检验牛（尤其是水牛）对居住在中国江西省鄱阳湖及其周边地区的人群中血吸虫病的持续存在负有责任的假设。实验的吉山村和对照的河西村这两个村是本文的重点。确定了人类和水牛的感染流行率和强度。然后，所有村庄的所有居民都接受了吡喹酮治疗，而只有实验（干预）村的水牛接受了治疗。治疗后，每年监测两个村庄和实验村水牛的再感染率，以及对照村水牛的持续感染流行情况。在洪水前后共九个季节对钉螺进行定量采集，以确定钉螺密度、感染钉螺密度和感染钉螺流行率。收集品来自不同生态的村庄区域以及区域内持续性蜗牛感染的热点地区。假设实验村的治疗措施可以将蜗牛感染率降低到比试验前水平低 80% 或更多。本文证明，干预措施并未实现将全村的蜗牛感染减少 50% 或更多。讨论了失败的可能原因。 这项纵向研究的重要发现有几个：（1）首先，干预措施没有达到显着减少稷山县钉螺感染的目标。 (2) 为了了解日本血吸虫在河西行政村和稷山行政村等大范围内的传播动态，重要的是将该地区划分为明确的生态区。 (3) 我们发现最大的感染风险是在我们称为热点的区域内的非常小的区域。 （4）感染风险最重要的指标是感染钉螺的密度，而不是患病率。 (5) 热点地区单位面积受感染的蜗牛数量明显多于非热点地区。 (6)感染钉螺密度与钉螺总体密度不相关。 (7) 区域、正方形和正方形内 20 4 m(2) 个单元的随机选择的采样策略使得能够对具有强负二项分布的蜗牛种群进行稳健的统计分析。每年至少采样 8 或 9 个季节两次（洪水前和洪水后），提供了一个时间序列，可以对实验村和对照村的趋势进行可靠评估。密切关注影响结果的环境因素至关重要。
A U.S. National Institutes of Health-sponsored study was initiated in 1998, ending in 2002, to examine the hypothesis that bovines, buffaloes in particular, were responsible for the persistence of schistosomiasis in human populations living in and around Poyang Lake, Jiangxi Province, P. R. China. The two villages are the focus of this paper, the experimental Jishan Village and the control Hexi Village. The prevalence and intensity of infection of humans and buffaloes were determined. Then, all inhabitants of all the villages were treated with praziquantel, while only the buffaloes of the experimental (intervention) village were treated. Following treatment, rates of re-infection of people in the two villages and buffaloes in the experimental village, as well as the ongoing prevalence of infections in the buffaloes of the control village were monitored annually.Quantitative collections of snails were made pre- and post-flood for a total of nine seasons to determine the density of snails, density of infected snails, and prevalence of infected snails. Collections were made from ecologically different village zones and from hot spots for persistent snail infections within zones. The hypothesis was that treatments in the experimental village would drive down snail infections to 80% or more below pre-trial levels. This paper makes the case that the intervention did not achieve reducing snail infections village-wide by even 50% or more. The probable reasons for this failure are discussed.The significant findings of this longitudinal study are several: (1) Foremost, the intervention did not achieve the goal of significantly reducing snail infections in Jishan. (2) To understand the dynamics of Schistosoma japonicum transmission throughout large areas, such as the administrative villages of Hexi and Jishan, it is important to partition the area into clearly definable ecological zones. (3) We have found that the greatest risk of infection is in very small areas within zones that we call hot spots. (4) The most important indicator for risk of infection is the density of infected snails, not the prevalence. (5) There are very significantly more infected snails per area in hot spots than in non-hot spots. (6) Density of infected snails is not correlated with density of snails overall. (7) The sampling strategy of zones, squares, and random selection of 20 4 m(2) cells within squares has enabled robust statistical analyses of snail populations that have a strong negative binomial distribution. Sampling twice a year (before the floods and after the floods) for at least 8 or 9 seasons has provided a time series enabling a robust assessment of trends in the experimental and control villages. Paying close attention to environmental factors as they impact results is critical.