Five-year longitudinal assessment of the downstream impact on schistosomiasis transmission following closure of the Three Gorges Dam.
Five-year longitudinal assessment of the downstream impact on schistosomiasis transmission following closure of the Three Gorges Dam.
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DOI：
10.1371/journal.pntd.0001588
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发表时间：
2012
影响因子：
3.8
通讯作者：
McManus DP
中科院分区：
文献类型：
--
作者：
Gray DJ;Thrift AP;Williams GM;Zheng F;Li YS;Guo J;Chen H;Wang T;Xu XJ;Zhu R;Zhu H;Cao CL;Lin DD;Zhao ZY;Li RS;Davis GM;McManus DP
日本血吸虫是中华人民共和国的一个主要公共卫生问题，约有80万人受到感染，另有5000万人生活在有感染风险的地区。基于生态、环境、群体遗传和分子因素，中国血吸虫病传播可分为4个离散的生态系统或传播模式。预测从长期来看，三峡大坝对中国血吸虫病的传播将产生影响，四种传播方式的影响程度不同。我们于2002 - 2006年在湖南、江西、湖北和安徽四省的三种传播模式下的哨点村进行了纵向监测，以确定TGD是否对血吸虫病传播有任何直接影响。选择了8个哨点村来代表省和传播模式。测量的主要终点是人类发病率。在此，我们介绍了这项为期五年的纵向队列研究的结果。结果表明，在研究过程中，在个别村庄和总体模式中，人类日本血吸虫感染的发病率明显下降。这也反映在感染风险的年度优势比（调整后）中，在随访期间，所有模式的感染风险都呈显著（P<0.01）下降趋势。本研究在所有传播模式中观察到的人类日本血吸虫发病率的下降可能归因于每年人类和牛的PZQ化疗。如果由于TGD而增加了血吸虫传播，那么与这里所见的治疗引起的下降相比，它的大小可以忽略不计。因此，三峡大坝实际上并没有对大坝下游的血吸虫病传播产生直接影响。血吸虫病是由日本血吸虫引起的一种严重的寄生虫病和公共卫生问题。寄生虫在那里的传播方式可以分为四种不同的模式（模式I-IV），据预测，最近建成的三峡大坝将影响血吸虫病在这些模式中的传播方式。我们对横跨四省（湖南、江西、湖北和安徽）的八个村庄进行了为期5年（2002-2006年）的传播监测，以确定大坝是否对血吸虫病传播有任何直接影响。人血吸虫病发病率在个别村庄和每种模式内显著下降，在随访期间，感染风险的年度优势比（调整后）在所有三种模式中均显示显著下降趋势。在I-III传播模式中记录的人类日本血吸虫发病率下降可能是由于人类和牛每年使用吡喹酮药物治疗所致。如果由于大坝而增加了血吸虫传播，与这种治疗引起的下降相比，它的规模可以忽略不计。因此，在5年的监测期内，三峡工程对大坝下游血吸虫病传播几乎没有直接影响。
Schistosoma japonicum is a major public health concern in the Peoples' Republic of China (PRC), with about 800,000 people infected and another 50 million living in areas at risk of infection. Based on ecological, environmental, population genetic and molecular factors, schistosomiasis transmission in PRC can be categorised into four discrete ecosystems or transmission modes. It is predicted that, long-term, the Three Gorges Dam (TGD) will impact upon the transmission of schistosomiasis in the PRC, with varying degree across the four transmission modes. We undertook longitudinal surveillance from 2002 to 2006 in sentinel villages of the three transmission modes below the TGD across four provinces (Hunan, Jiangxi, Hubei and Anhui) to determine whether there was any immediate impact of the TGD on schistosomiasis transmission. Eight sentinel villages were selected to represent both province and transmission mode. The primary end point measured was human incidence. Here we present the results of this five-year longitudinal cohort study. Results showed that the incidence of human S. japonicum infection declined considerably within individual villages and overall mode over the course of the study. This is also reflected in the yearly odds ratios (adjusted) for infection risk that showed significant (P<0.01) downward trends in all modes over the follow-up period. The decrease in human S. japonicum incidence observed across all transmission modes in this study can probably be attributed to the annual human and bovine PZQ chemotherapy. If an increase in schistosome transmission had occurred as a result of the TGD, it would be of negligible size compared to the treatment induced decline seen here. It appears therefore that there has been virtually no immediate impact of the TGD on schistosomiasis transmission downstream of the dam. Schistosomiasis, caused by Schistosoma japonicum, is a significant parasitic disease and public health problem in China. How the parasite is transmitted there can be categorized into four distinct modes (modes I–IV) and it is predicted that the Three Gorges Dam, recently completed, will affect the way schistosomiasis is spread in these modes. We monitored transmission for a 5-year period (2002–2006) in eight villages, representative of the three modes (I–III) below the dam across four provinces (Hunan, Jiangxi, Hubei and Anhui) to determine whether there was any immediate impact of the dam on schistosomiasis spread. Human schistosomiasis incidence declined considerably within individual villages and each mode, and the yearly odds ratios (adjusted) for infection risk showed significant downward trends in all three modes over the follow-up period. The decreased human S. japonicum incidence recorded across transmission modes I–III was probably attributable to annual human and bovine praziquantel drug treatment. If an increase in schistosome transmission had occurred as a result of the dam, it would be of negligible size compared with this treatment-induced decline. There had thus been virtually no immediate impact of the TGD on schistosomiasis transmission downstream of the dam over the 5-year surveillance period.
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影响因子：
2.5
作者：
Seto, Edmund Y. W.;Wu, Weiping;Davis, George M.
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Davis, George M.
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通讯作者：
McManus, DP