A multi-component integrated approach for the elimination of schistosomiasis in the People's Republic of China: design and baseline results of a 4-year cluster-randomised intervention trial
A multi-component integrated approach for the elimination of schistosomiasis in the People's Republic of China: design and baseline results of a 4-year cluster-randomised intervention trial
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DOI：
10.1016/j.ijpara.2014.05.005
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发表时间：
2014-08-01
影响因子：
4
通讯作者：
McManus, Donald P.
中科院分区：
文献类型：
--
作者：
Gray, Darren J.;Li, Yue-Sheng;McManus, Donald P.
尽管过去 50 年来在控制方面取得了重大成功，但日本血吸虫病仍然是中华人民共和国的一个公共卫生问题。从历史上看，主要的地方病疫源地发生在长江沿岸的湖泊和沼泽地，这些地区的传播被证明是困难的。目前的疫情形势可能会因三峡大坝的关闭而发生改变。预计相当大的环境和生态变化可能会导致日本血吸虫（Sj）的钉螺类中间宿主蜗牛产生新的栖息地，从而增加传播风险。中国目前的国家控制计划涉及多方面的综合战略，但尽管针对多种传播途径，但仍然存在某些挑战。随着中国政府推动消除病毒，需要额外的工具，例如疫苗接种，以进行长期预防。尽管日本血吸虫病的人畜共患性质增加了控制的复杂性，但它提供了一个独特的机会来开发针对牛的传播阻断疫苗，以协助预防人类感染和疾病。数学模型表明，针对日本血吸虫病的各种传播途径并结合牛疫苗接种、大规模人类化疗和杀灭软体动物的控制方案可能会导致其从中国消除。在这里，我们介绍了我们在湖南省血吸虫病流行地区洞庭湖周围进行的一项为期四年的整群随机干预试验的研究设计和基线结果，旨在确定多成分综合控制策略对血吸虫传播的影响，包括使用基于先前测试的 SjCTPI 疫苗的异源“初免-加强”传递平台进行牛疫苗接种。 (C) 2014 年澳大利亚寄生虫学协会。由 Elsevier Ltd 出版。保留所有权利。
Despite major successes in its control over the past 50 years, schistosomiasis japonica continues to be a public health problem in the People's Republic of China (P.R. China). Historically, the major endemic foci occur in the lakes and marshlands along the Yangtze River, areas where transmission interruption has proven difficult. The current endemic situation may alter due to the closure of the Three Gorges Dam. Considerable environmental and ecological changes are anticipated that may result in new habitats for the oncomelanid intermediate snail host of Schistosoma japonicum (Sj), thereby increasing the risk of transmission. The current national control program for P.R. China involves a multi-component integrated strategy but, despite targeting multiple transmission pathways, certain challenges remain. As the Chinese government pushes towards elimination, there is a requirement for additional tools, such as vaccination, for long-term prevention. Whereas the zoonotic nature of schistosomiasis japonica adds to the complexity of control, it provides a unique opportunity to develop a transmission blocking vaccine targeting bovines to assist in the prevention of human infection and disease. Mathematical modelling has shown that control options targeting the various transmission pathways of schistosomiasis japonica and incorporating bovine vaccination, mass human chemotherapy and mollusciciding could lead to its elimination from P.R. China. Here we present the study design and baseline results of a four-year cluster randomised intervention trial we are undertaking around the schistosomiasis-endemic Dongting Lake in Hunan Province aimed at determining the impact on schistosome transmission of the multi-component integrated control strategy, including bovine vaccination using a heterologous "prime-boost" delivery platform based on the previously tested SjCTPI vaccine. (C) 2014 Australian Society for Parasitology Inc. Published by Elsevier Ltd. All rights reserved.