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Prevalence, intensity and associated morbidity of Schistosoma japonicum infection in the Dongting Lake region, China Translated title: Prévalence, intensité et morbidité associée de l’infection à Schistosoma Japonicum dans la région du lac de Dongting, en Chine Translated title: Prevalencia e intensidad de la infección por Schistosoma japonicum y morbilidad asociada en la región del lago Dongting, China

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      Abstract

      OBJECTIVE: To determine the prevalence and intensity of Schistosoma japonicum infection and associated morbidity, and to estimate the infected human and buffalo populations in the Dongting Lake region, Hunan province, China. METHODS: We used data from the third national schistosomiasis periodic epidemiological survey (PES) of 2004. These included 47 144 human serological and 7205 stool examinations, 3893 clinical examinations and questionnaire surveys, and 874 buffalo stool examinations, carried out in 47 villages in Hunan province. Serological examinations were performed using the enzyme linked immunosorbent assay technique and human stool samples were examined by the Kato-Katz method. Stools from buffaloes and other domestic animals were examined for schistosome infection by the miracidial hatching test. FINDINGS: Sero-prevalence was 11.9% (range: 1.3-34.9% at the village level), and the rate of egg-positive stools was estimated at 1.9% (0-10.9%) for the same population. The prevalence of infection among buffaloes was 9.5% (0-66.7%). Extrapolating to the entire population of the Dongting Lake region, an estimated 73 225 people and 13 973 buffaloes were infected. Most frequently reported symptoms were abdominal pain (6.2%) and bloody stools (2.7%). More than half of the clinically examined people reported having had at least one prior antischistosomal treatment. CONCLUSION: There was a significant reduction in the number of humans infected with S. japonicum since the previous national PES carried out in 1995, partially explained by large-scale chemotherapy campaigns. However, a near-stable number of buffalo infections suggest continuing human re-infection, which may lead to future increases in human prevalence.

      Translated abstract

      OBJECTIF: Déterminer la prévalence et l’intensité de l’infection à Schistosoma Japonicum et la morbidité associée. Estimer l’importance des populations d’êtres humains et de buffles contaminés dans la région du lac de Dongting, dans la province du Hunan, en Chine. MÉTHODES: Nous avons utilisé des données provenant de la troisième enquête épidémiologique périodique sur la schistosomiase (PES) de 2004. Ces données étaient les résultats de 47 144 examens sérologiques, de 7205 examens de selles et de 3893 examens cliniques et enquêtes par questionnaire pratiqués chez des êtres humains, ainsi que de 874 examens d’excréments de buffles, effectués dans 47 villages du Hunan. Les examens sérologiques ont été réalisés par la méthode immuno-enzymatique en phase solide et les examens de selles humaines par la technique de Kato-Katz. On a recherché la présence d’une infection à schistosomes sur des selles de buffles et d’autres animaux domestiques par le test d’éclosion des miracidia. RÉSULTATS: La séroprévalence était de 11,9 % (plage : 1,3 - 34,9 % au niveau du village) et la proportion de selles positives pour le test d’éclosion a été estimée à 1,9 % (0 - 10,9 %) dans la même population. La prévalence de l’infection parmi les buffles était de 9,5 % (0 - 66,7 %). En extrapolant ces résultat à l’ensemble de la population de la région du Lac Dongting, on a estimé que 73 225 personnes et 13 973 buffles étaient contaminés. Les symptômes les plus fréquemment rapportés étaient des douleurs abdominales (6,2 %) et des selles sanglantes (2,7 %). Plus de la moitié des participants ayant subi un examen clinique ont signalé au moins un traitement antischistosomique antérieur. CONCLUSION: L’étude a permis de constater une réduction notable du nombre d’êtres humains contaminés par S. japonicum depuis la précédente enquête PES de 1995, réduction partiellement explicable par les campagnes de chimiothérapie à grande échelle. Cependant, le nombre relativement stable de buffles contaminés laisse prévoir une recontamination permanente des humains, susceptible de conduire à une recrudescence de la prévalence de la schistosomiase chez l’homme.

      Translated abstract

      OBJETIVO: Determinar la prevalencia e intensidad de la infección por Schistosoma japonicum y la morbilidad a ella asociada, y estimar las poblaciones humanas y de búfalos infectadas en la región del lago Dongting, en la provincia china de Hunan. MÉTODOS: Usamos datos del tercer estudio epidemiológico nacional periódico sobre la esquistosomiasis de 2004. Como parte del mismo se hicieron 47 144 pruebas serológicas y 7205 análisis de heces en personas, 3893 exploraciones clínicas y encuestas a base de cuestionarios, y 874 análisis de heces en búfalos, en un total de 47 aldeas de la provincia de Hunan. Los análisis serológicos se realizaron mediante una técnica de inmunosorción enzimática, y las muestras de heces humanas fueron examinadas mediante el método de Kato-Katz. La presencia de infección por esquistosoma en las heces de búfalos y otros animales domésticos se analizó mediante la prueba de incubación de miracidia. RESULTADOS: La seroprevalencia fue del 11,9% (intervalo: 1,3%-34,9% a nivel de aldea), y la tasa de resultados positivos para la presencia de huevos en las heces fue del 1,9% (0%-10,9%) para la misma población. La prevalencia de infección entre los búfalos fue del 9,5% (0%-66,7%). Extrapolando a la totalidad de la población de la región del lago Dongting, se estimó que estaban infectadas unas 73 225 personas y 13 973 búfalos. Los síntomas notificados con más frecuencia fueron el dolor abdominal (6,2%) y las heces sanguinolentas (2,7%). Más de la mitad de los participantes explorados clínicamente declararon haber sido sometidos antes a tratamiento antiesquistosómico por lo menos una vez. CONCLUSIÓN: Se observó una reducción importante del número de personas infectadas por S. japonicum desde el estudio nacional realizado en 1995, lo que puede atribuirse en parte a las campañas de antibioticoterapia emprendidas a gran escala. Sin embargo, el número prácticamente inalterado de infecciones detectadas en la población de búfalos lleva a pensar que persisten las reinfecciones humanas, y ello podría traducirse en un futuro aumento de la prevalencia en el hombre.

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      Most cited references 64

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      Incorporating a Rapid-Impact Package for Neglected Tropical Diseases with Programs for HIV/AIDS, Tuberculosis, and Malaria

      Hotez et al. argue that achieving success in the global fight against HIV/AIDS, tuberculosis, and malaria may well require a concurrent attack on the neglected tropical diseases.
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        Schistosomiasis in the People's Republic of China: prospects and challenges for the 21st century.

        Schistosomiasis japonica is a serious communicable disease and a major disease risk for more than 30 million people living in the tropical and subtropical zones of China. Infection remains a major public health concern despite 45 years of intensive control efforts. It is estimated that 865,000 people and 100,250 bovines are today infected in the provinces where the disease is endemic, and its transmission continues. Unlike the other schistosome species known to infect humans, the oriental schistosome, Schistosoma japonicum, is a true zoonotic organism, with a range of mammalian reservoirs, making control efforts extremely difficult. Clinical features of schistosomiasis range from fever, headache, and lethargy to severe fibro-obstructive pathology leading to portal hypertension, ascites, and hepatosplenomegaly, which can cause premature death. Infected children are stunted and have cognitive defects impairing memory and learning ability. Current control programs are heavily based on community chemotherapy with a single dose of the drug praziquantel, but vaccines (for use in bovines and humans) in combination with other control strategies are needed to make elimination of the disease possible. In this article, we provide an overview of the biology, epidemiology, clinical features, and prospects for control of oriental schistosomiasis in the People's Republic of China.
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          Immunodiagnosis and its role in schistosomiasis control in China: a review.

           Yin-Chang Zhu (2015)
          Parasitological techniques (stool examination and/or urine filtration) are still the diagnosis of choice in national schistosomiasis control programmes the world over. However, the success of current control efforts, mainly due to the large-scale administration of praziquantel, emphasises the need for a more sensitive approach. In addition, microscopy is labour-intensive and time-consuming, while declining compliance rates after repeated chemotherapy make good coverage for the long-term increasingly problematic. China's success in the control of schistosomiasis is contributing to an enhanced understanding of the need for better and more sensitive screening methods. Immunodiagnostic techniques have a high sensitivity, are easy to perform and are an excellent epidemiological tool for the screening of target populations in schistosome-endemic areas. These assays are also useful for the surveillance of cure after chemotherapy, and for periodic control of transmission of the infection after it has been eliminated in an area. A succinct historical background of using immunodiagnosis for schistosomiasis japonica in China is given, together with a review and evaluation of the relative efficacy of the main techniques applied, i.e. the intradermal test, the circumoval precipitation test, the indirect hemagglutination assay, the dye dipstick immunoassay and different kinds of enzyme-linked immunosorbent assay applications. The important role of immunodiagnosis in the screening for schistosomiasis in China is discussed.
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            Author and article information

            Affiliations
            [1 ] Queensland Institute of Medical Research Australia
            [2 ] University of Queensland Australia
            [3 ] Hunan Institute of Parasitic Diseases Peoples R China
            [4 ] Central South University Peoples R China
            [5 ] Swiss Tropical Institute Switzerland
            Contributors
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            Journal
            bwho
            Bulletin of the World Health Organization
            Bull World Health Organ
            World Health Organization (Genebra )
            0042-9686
            July 2007
            : 85
            : 7
            : 519-526
            S0042-96862007000700009

            http://creativecommons.org/licenses/by/4.0/

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            Product Information: SciELO Public Health
            Categories
            Health Policy & Services

            Public health

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