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      Risk mapping of clonorchiasis in the People’s Republic of China: A systematic review and Bayesian geostatistical analysis

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Clonorchiasis, one of the most important food-borne trematodiases, affects more than 12 million people in the People’s Republic of China (P.R. China). Spatially explicit risk estimates of Clonorchis sinensis infection are needed in order to target control interventions.

          Methodology

          Georeferenced survey data pertaining to infection prevalence of C. sinensis in P.R. China from 2000 onwards were obtained via a systematic review in PubMed, ISI Web of Science, Chinese National Knowledge Internet, and Wanfang Data from January 1, 2000 until January 10, 2016, with no restriction of language or study design. Additional disease data were provided by the National Institute of Parasitic Diseases, Chinese Center for Diseases Control and Prevention in Shanghai. Environmental and socioeconomic proxies were extracted from remote-sensing and other data sources. Bayesian variable selection was carried out to identify the most important predictors of C. sinensis risk. Geostatistical models were applied to quantify the association between infection risk and the predictors of the disease, and to predict the risk of infection across P.R. China at high spatial resolution (over a grid with grid cell size of 5×5 km).

          Principal findings

          We obtained clonorchiasis survey data at 633 unique locations in P.R. China. We observed that the risk of C. sinensis infection increased over time, particularly from 2005 onwards. We estimate that around 14.8 million (95% Bayesian credible interval 13.8–15.8 million) people in P.R. China were infected with C. sinensis in 2010. Highly endemic areas (≥ 20%) were concentrated in southern and northeastern parts of the country. The provinces with the highest risk of infection and the largest number of infected people were Guangdong, Guangxi, and Heilongjiang.

          Conclusions/Significance

          Our results provide spatially relevant information for guiding clonorchiasis control interventions in P.R. China. The trend toward higher risk of C. sinensis infection in the recent past urges the Chinese government to pay more attention to the public health importance of clonorchiasis and to target interventions to high-risk areas.

          Author summary

          Clonorchiasis is an important food-borne trematodiases and it has been estimated that more than 12 million people in China are affected. Precise information on where the disease occurs can help to identify priority areas for where control interventions should be implemented. We collected data from recent surveys on clonorchiasis and applied Bayesian geostatistical models to produce model-based, high-resolution risk maps for clonorchiasis in China. We found an increasing trend of infection risk from 2005 onwards. We estimated that approximately 14.8 million people in China were infected with Clonorchis sinensis in 2010. Areas where the high prevalence of C. sinensis was predicted were concentrated in the provinces of Guangdong, Guangxi, and Heilongjiang. Our results suggest that the Chinese government should pay more attention on the public health importance of clonorchiasis and that specific control efforts should be implemented in high-risk areas.

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          Most cited references 38

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          A review of human carcinogens--Part B: biological agents.

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            The BUGS project: Evolution, critique and future directions.

            BUGS is a software package for Bayesian inference using Gibbs sampling. The software has been instrumental in raising awareness of Bayesian modelling among both academic and commercial communities internationally, and has enjoyed considerable success over its 20-year life span. Despite this, the software has a number of shortcomings and a principal aim of this paper is to provide a balanced critical appraisal, in particular highlighting how various ideas have led to unprecedented flexibility while at the same time producing negative side effects. We also present a historical overview of the BUGS project and some future perspectives.
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              Food-borne trematodiases.

              An estimated 750 million people are at risk of infections with food-borne trematodes, which comprise liver flukes (Clonorchis sinensis, Fasciola gigantica, Fasciola hepatica, Opisthorchis felineus, and Opisthorchis viverrini), lung flukes (Paragonimus spp.), and intestinal flukes (e.g., Echinostoma spp., Fasciolopsis buski, and the heterophyids). Food-borne trematodiases pose a significant public health and economic problem, yet these diseases are often neglected. In this review, we summarize the taxonomy, morphology, and life cycle of food-borne trematodes. Estimates of the at-risk population and number of infections, geographic distribution, history, and ecological features of the major food-borne trematodes are reviewed. We summarize clinical manifestations, patterns of infection, and current means of diagnosis, treatment, and other control options. The changing epidemiological pattern and the rapid growth of aquaculture and food distribution networks are highlighted, as these developments might be associated with an elevated risk of transmission of food-borne trematodiases. Current research needs are emphasized.
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                Author and article information

                Affiliations
                [1 ]Swiss Tropical and Public Health Institute, Basel, Switzerland
                [2 ]University of Basel, Basel, Switzerland
                [3 ]National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People’s Republic of China
                [4 ]WHO Collaborating Centre for Tropical Diseases, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People’s Republic of China
                [5 ]Tianjin Modern Vocational Technology College, Tianjin, People’s Republic of China
                Australian National University, AUSTRALIA
                Author notes

                The authors have declared that no competing interests exist.

                • Conceived and designed the experiments: YSL PV.

                • Performed the experiments: YSL.

                • Analyzed the data: YSL PV.

                • Contributed reagents/materials/analysis tools: XNZ ZHP.

                • Wrote the paper: YSL JU PV.

                • Conceptualized the project: YSL XNZ JU PV.

                • Provided important intellectual content: XNZ JU PV.

                Contributors
                Role: Editor
                Journal
                PLoS Negl Trop Dis
                PLoS Negl Trop Dis
                plos
                plosntds
                PLoS Neglected Tropical Diseases
                Public Library of Science (San Francisco, CA USA )
                1935-2727
                1935-2735
                2 March 2017
                March 2017
                : 11
                : 3
                28253272 5416880 10.1371/journal.pntd.0005239 PNTD-D-16-00531
                © 2017 Lai et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                Counts
                Figures: 2, Tables: 4, Pages: 16
                Product
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100000781, European Research Council;
                Award ID: 323180
                Funded by: funder-id http://dx.doi.org/10.13039/501100004543, China Scholarship Council;
                Award Recipient :
                Funded by: the UBS Optimus Foundation
                Award ID: 5879
                YSL received financial support of the China Scholarship Council (CSC, http://www.csc.edu.cn). This study received financial support from the UBS Optimus Foundation (project no. 5879, https://www.ubs.com/global/de/wealth_management/optimusfoundation.html) and from the European Research Council (Advanced Grant no.323180, https://erc.europa.eu/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Medicine and Health Sciences
                Parasitic Diseases
                Helminth Infections
                Foodborne Trematodiases
                Clonorchiasis
                Medicine and Health Sciences
                Tropical Diseases
                Neglected Tropical Diseases
                Foodborne Trematodiases
                Clonorchiasis
                Medicine and Health Sciences
                Parasitic Diseases
                Helminth Infections
                Clonorchiasis
                People and Places
                Geographical Locations
                Asia
                China
                Medicine and Health Sciences
                Infectious Diseases
                Infectious Disease Control
                Biology and Life Sciences
                Organisms
                Animals
                Invertebrates
                Helminths
                Trematodes
                Clonorchis
                Clonorchis Sinensis
                Biology and Life Sciences
                Organisms
                Animals
                Invertebrates
                Flatworms
                Trematodes
                Clonorchis
                Clonorchis Sinensis
                Biology and Life Sciences
                Organisms
                Animals
                Vertebrates
                Fishes
                Freshwater Fish
                Research and Analysis Methods
                Research Assessment
                Systematic Reviews
                Physical Sciences
                Mathematics
                Probability Theory
                Probability Distribution
                Research and Analysis Methods
                Simulation and Modeling
                Custom metadata
                The disease data is not fully available without restriction. They are publicly available in the open-access Global Neglected Tropical Diseases (GNTDs) database ( http://www.gntd.org). Researchers need to register and login to fully access the data. Once researchers have logged into the database, please use Country="China" and Disease="Food-borne trematodiasis" as search criteria to access the whole dataset. The rest of the relevant data are within the paper or in publicly accessible data sources listed in Table 1 of the paper.

                Infectious disease & Microbiology

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