控制蜗牛是消除血吸虫病的重要途径:来自中华人民共和国的证据。

IF 5.5 1区 医学
Shan Lv, Jing Xu, Yin-Long Li, Zi-Ping Bao, Li-Juan Zhang, Kun Yang, Dan-Dan Lin, Jian-Bing Liu, Tian-Ping Wang, Guang-Hui Ren, Bo Zhong, Yi Dong, Li Cai, Li-Yong Wen, Zhi-Hua Jiang, Zhuo-Hui Deng, Han-Guo Xie, Shi-Zhu Li, Robert Bergquist, Jürg Utzinger, Xiao-Nong Zhou
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引用次数: 0

摘要

背景:根据世界卫生组织2021-2030年被忽视热带病路线图,预计到2030年将消除亚洲血吸虫病。灭螺是一项重要措施,但尚未在全国范围内进行系统评价。在此,我们报告了一项全国性调查的结果,以证明钉螺的动态及其在中华人民共和国(中华人民共和国)血吸虫病传播中断中的潜在作用。方法:2016年3月至2017年12月,在全国范围内开展钉螺生境普查。对所有历史记录的蜗牛栖息地进行了鉴定和回顾。收集了包括蜗牛侵扰在内的生境属性信息。利用全球定位系统和地理信息系统技术确定了生境的形状。在378个血吸虫病流行县建立了防治钉螺与消灭血吸虫病的关系。传播中断县与流行县之间的累计蜗牛感染范围(ASR)和消除蜗牛感染的中位数比值比较,采用非参数检验(Mann-Whitney),显著性水平为0.05。结果:全国共发现钉螺潜在生境153.777亿m2,共有钉螺生境356550个;ASR占总面积的86.0%。主要的ASR(94.9%)和生境(68.5%)分布在长江中下游。在平均海平面以上2859 m处发现了蜗牛栖息地。到2017年,85.1%的栖息地(占ASR的73.0%)已经消失,其中近一半是在1965年至1982年之间消失的。钉螺栖息地的消失促进了血吸虫病传播的中断,但在不同的景观中表现出不同的模式。水网区和丘陵区ASR消除率分别为99.6%和91.4%,而沼泽区ASR消除率仅为64.8%,特别是在中国最大的两个淡水湖所在的湖南和江西。沼泽生境被认为是最难阻断传播的,因此需要在这些环境中采取额外的控制措施。结论:我们的研究结果支持了世界卫生组织最近关于实施蜗牛控制的建议,并证明消除血吸虫病是可以实现的。中国全国高分辨率钉螺分布图将支持进一步消除血吸虫病的工作。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Snail control as a crucial approach to schistosomiasis elimination: evidence from the People's Republic of China.

Background: Asian schistosomiasis is projected to be eliminated by 2030 according to World Health Organization road map for neglected tropical diseases 2021-2030. Snail control is an important measure but has not yet been systematically evaluated at a country scale. Here, we report the findings from a nationwide survey to demonstrate the dynamics of Oncomelania and its potential role in transmission interruption of schistisomiasis in the People's Republic of China (P.R. China).

Methods: Between March 2016 and December 2017, we conducted a nationwide census on Oncomelania snail habitats in P.R. China. All historically recorded snail habitats were identified and reviewed. Information on habitat attributes, including the infestation of snails, was collected. The shape of habitats was determined using global positioning system and geographical information system technologies. The relationship between snail control and schistosomiasis elimination was established in 378 endemic counties. The comparison of accumulated snail-infested range (ASR) and the median ratio of eliminated ASR between the transmission-interrupted and endemic counties was tested by a non-parametric test (Mann-Whitney) with a significance level of 0.05.

Results: Overall, 15,377.7 million m2 of potential snail habitats with a total of 356,550 snail habitats were identified in P.R. China. The ASR amounted to 86.0% of the total area. Most of the ASR (94.9%) and habitats (68.5%) were distributed in the middle and lower reaches of the Yangtze River. Snail habitats were found up to an altitude of 2859 m above the mean sea level. By 2017, 85.1% of habitats (73.0% of the ASR) had been eliminated with almost half of them eliminated between 1965 and 1982. The elimination of snail habitats promoted transmission interruption of schistosomiasis, but showed variable patterns in different landscapes. The ratio of eliminated ASR was 99.6 and 91.4% in water network and hilly areas, respectively, while it was only 64.8% in marshland areas, particularly in Hunan and Jiangxi where the two largest freshwater lakes of P.R. China are located. Marshland habitats were seen as the most difficult for transmission interruption, which calls for additional control measures in these settings.

Conclusions: Our results support recent recommendations by the World Health Organization to implement snail control and demonstrate that schistosomiasis elimination can be achieved. The nationwide, high-resolution map of Oncomelania snail habitats in P.R. China will support further efforts to eliminate schistosomiasis.

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来源期刊
Infectious Diseases of Poverty
Infectious Diseases of Poverty INFECTIOUS DISEASES-
自引率
1.20%
发文量
368
期刊介绍: Infectious Diseases of Poverty is an open access, peer-reviewed journal that focuses on addressing essential public health questions related to infectious diseases of poverty. The journal covers a wide range of topics including the biology of pathogens and vectors, diagnosis and detection, treatment and case management, epidemiology and modeling, zoonotic hosts and animal reservoirs, control strategies and implementation, new technologies and application. It also considers the transdisciplinary or multisectoral effects on health systems, ecohealth, environmental management, and innovative technology. The journal aims to identify and assess research and information gaps that hinder progress towards new interventions for public health problems in the developing world. Additionally, it provides a platform for discussing these issues to advance research and evidence building for improved public health interventions in poor settings.
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