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Objective: To compare the efficiency of multiple etiological techniques for detection of Schistosoma japonicum infections in wild mice, so as to provide technical supports to assessment of schistosomiasis transmission risk., Methods: Wild mice were captured with baited traps at night in Oncomelania hupensis snail-infested settings in schistosomiasis-endemic foci of Anhui Province from October to November, 2022. S. japonicum infections were detected in wild mice using microscopy of mouse liver tissues, microscopy of mouse mesenteric tissues, microscopy of mouse liver tissue homogenates, miracidial hatching test of mouse liver tissue homogenates, Kato-Katz technique and miracidial hatching test of mouse stool samples alone and in combinations. Identification of S. japonicum eggs or miracidia by any of these six assays was defined as an infection. The sensitivity of six assays alone or in combinations was compared for detection of S. japonicum infections in wild mice., Results: A total of 1 703 wild mice were captured, with 366 wild mice detected positive for S. japonicum (21.49%). There were significant differences in the prevalence of S. japonicum infections in wild mice by six assays ( Q = 529.33, P < 0.001) and in the sensitivity of six assays for detection of S. japonicum infections in wild mice (χ 2 = 527.78, P < 0.001). In addition, the combination of microscopy of mouse liver tissues and mesenteric tissues, combination of microscopy of mouse liver tissues and liver tissue homogenates and combination of microscopy of mouse liver tissues, microscopy of mesenteric tissues, microscopy of liver tissue homogenates and Kato-Katz technique showed 86.61%, 87.16% and 97.27% sensitivities for detection of S. japonicum infections in wild mice, respectively., Conclusions: Diverse etiological assays show various efficiencies for detection of S. japonicum infections in wild mice. Combination of microscopy of mouse liver tissues and microscopy of mesenteric tissues, and combination of microscopy of mouse liver tissues and microscopy of liver tissue homogenates are potential approaches for field detection of S. japonicum infections in wild mice.

Objective: To construct a schistosomiasis transmission risk assessment system in Wuhan City and preliminary evaluate its application effect, so as to promote the rational allocation of schistosomiasis control resources and accelerate the progress towards schistosomiasis elimination., Methods: The schistosomiasis risk assessment indicators were collected through referring schistosomiasis surveillance data of Wuhan City from 2014 to 2020, literature review and expert interviews. Indicators within each criterion and sub-criterion were screened using the Delphi method, and a hierarchical structure model was created based on analytic hierarchy process. Quantitative assignment of each indicator was conducted according to relative importance, and the weight and combination weight of each criterion were calculated in each analytic hierarchy framework to create a schistosomiasis transmission risk assessment system, which was used for the schistosomiasis transmission risk assessment in 12 national schistosomiasis surveillance sites in Wuhan City., Results: A three-level schistosomiasis transmission risk assessment system was preliminarily constructed, which included a target layer, 5 criterion layers and 21 sub-criterion layers. Of all indicators in the criterion layer, transmission route had the highest weight (0.433), followed by source of Schistosoma japonicum infection (0.294); and among all indicators in the sub-criterion layer, S. japonicum infection in Oncomelania hupensis and sentinel mice had the highest combination weight (0.125), followed by prevalence of S. japonicum infection in humans (0.091) and bovines (0.053), snail control by chemical treatment (0.049), positive rate of inquiry examinations (0.048), allocation of schistosomiasis control professionals (0.045), and areas of submerged snail-infested settings (0.041). Of the 12 national schistosomiasis surveillance sites in Wuhan City, there were 5 sites with weights of > 0.8, 4 sites with weights of 0.6 to 0.8, and 3 sites with weights of < 0.6 in 2020., Conclusions: A schistosomiasis transmission risk assessment system has been constructed based on analytic hierarchy process in Wuhan City, which may provide a evidence-based basis for health resource allocation and decision-making for schistosomiasis control.

This report presented the endemic status of schistosomiasis and analyzed the data collected from the national schistosomiasis prevention and control system and national schistosomiasis surveillance program in the People's Republic of China in 2022. Among the 12 provinces (municipality and autonomous region) endemic for schistosomiasis, Shanghai Municipality, Zhejiang Province, Fujian Province, Guangdong Province and Guangxi Zhuang Autonomous Region continued to maintain the achievements of schistosomiasis elimination, and Sichuan and Jiangsu provinces maintained the criteria of transmission interruption, while Yunnan, Hubei, Anhui, Jiangxi and Hunan provinces maintained the criteria of transmission control by the end of 2022. A total of 452 counties (cites, districts) were found to be endemic for schistosomiasis in China in 2022, with 27 434 endemic villages covering 73 424 400 people at risk of infections. Among the 452 endemic counties (cities, districts), 75.89% (343/452), 23.45% (106/452) and 0.66% (3/452) achieved the criteria of elimination, transmission interruption and transmission control of schistosomiasis, respectively. In 2022, 4 317 356 individuals received serological tests for schistosomiasis, and 62 228 were sero-positive. A total of 208 646 individuals received stool examinations for schistosomiasis, with one positive and another two cases positive for urine microscopy, and these three 3 cases were imported schistosomiasis patients from Africa. There were 28 565 cases with advanced schistosomiasis documented in China by the end of 2022. Oncomelania hupensis snail survey was performed in 18 891 endemic villages in China in 2022 and O. hupensis snails were found in 6 917 villages (36.62% of all surveyed villages), with 8 villages identified with emerging snail habitats. Snail survey was performed at an area of 655 703.01 hm 2 and 183 888.60 hm 2 snail habitats were found, including 110.58 hm 2 emerging snail habitats and 844.35 hm 2 re-emerging snail habitats. There were 477 200 bovines raised in the schistosomiasis endemic areas of China in 2022, and 113 946 bovines received serological examinations for schistosomiasis, with 204 sero-positives detected. Among the 131 715 bovines received stool examinations, no positives were identified. In 2022, there were 19 726 schistosomiasis patients receiving praziquantel chemotherapy, and expanded chemotherapy was performed in 714 465 person-time for humans and 234 737 herd-time for bovines in China. In 2022, snail control with chemical treatment was performed at an area of 119 134.07 hm 2 , and the actual area of chemical treatment was 65 825.27 hm 2 , while environmental improvements were performed at an area of 1 163.96 hm 2 . Data from the national schistosomiasis surveillance program of China showed that the mean prevalence of Schistosoma japonicum infections was both zero in humans and bovines in 2022, and no S. japonicum infection was detected in O. hupensis snails. These data demonstrated that the endemic status of schistosomiasis continued to decline in China in 2022, with 3 confirmed schistosomiasis patients that had a foreign nationality and all imported from Africa, and the areas of snail habitats remained high. Further improvements in the construction of the schistosomaisis surveillance and forecast system, and reinforcement of O. hupensis survey and control are required to prevent the re-emerging schistosomiasis.

Objective: To compare the differences in pathogenicity and gene expression profiles between adult Schistosoma japonicum isolated from hilly and marshland and lake regions of Anhui Province, so as to provide the scientific evidence for formulating the precise schistosomiasis control strategy in different endemic foci., Methods: C57BL/6 mice were infected with cercariae of S. japonicum isolates from Shitai County (hilly regions) and Susong County (marshland and lake regions) of Anhui Province in 2021, and all mice were sacrificed 44 days post-infection and dissected. The worm burdens, number of S. japonicum eggs deposited in the liver, and the area of egg granulomas in the liver were measured to compare the difference in the pathogenicity between the two isolates. In addition, female and male adult S. japonicum worms were collected and subjected to transcriptome sequencing, and the gene expression profiles were compared between Shitai and Susong isolates of S. japonicum. The differentially expressed genes (DEGs) were subjected to Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses., Results: The total worm burdens [(14.50 ± 3.96) worms/mouse vs. (16.10 ± 3.78) worms/mouse; t = 0.877, P = 0.392], number of female and male paired worms [(4.50 ± 0.67) worms/mouse vs. (5.10 ± 1.45) worms/mouse; t = 1.129, P = 0.280], number of unpaired male worms [(5.50 ± 4.01) worms/mouse vs. (5.60 ± 1.69) worms/mouse; t = 0.069, P = 0.946], number of eggs deposited in per gram liver [(12 116.70 ± 6 508.83) eggs vs. (16 696.70 ± 4 571.56) eggs; t = 1.821, P = 0.085], and area of a single egg granuloma in the liver [(74 359.40 ± 11 766.34) µm 2 vs. (74 836.90 ± 13 086.12) µm 2 ; t = 0.081, P = 0.936] were comparable between Shitai and Susong isolates of S. japonicum . Transcriptome sequencing identified 584 DEGs between adult female worms and 1 598 DEGs between adult male worms of Shitai and Susong isolates of S. japonicum . GO enrichment analysis showed that the DEGs between female adults were predominantly enriched in biological processes of stimulus response, cytotoxicity, multiple cell biological processes, metabolic processes, cellular processes and signaling pathways, cellular components of cell, organelles and cell membranes and molecular functions of binding and catalytic ability, and KEGG enrichment analysis showed that these DEGs were significantly enriched in pathways of vascular endothelial growth factor signaling, glutathione metabolism, arginine and proline metabolism. In addition, the DEGs between male adults were predominantly enriched in biological processes of signaling transduction, multiple cell biological processes, regulation of biological processes, metabolic processes, development processes and stimulus responses, cellular components of extracellular matrix and cell junction and molecular functions of binding and catalytic ability, and these DEGs were significantly enriched in pathways of Wnt signaling, Ras signaling, natural killer cells-mediated cytotoxicity, extracellular matrix-receptor interactions and arginine biosynthesis., Conclusions: There is no significant difference in the pathogenicity between S. japonicum isolates from hilly and marshland and lake regions of Anhui Province; however, the gene expression profiles vary significantly between S. japonicum isolates.

Objective: To investigate the changing trends in the prevalence of schistosomiasis in Anhui Province from 2004 to 2020, so as to provide the evidence for formulating the schistosomiasis elimination strategy in the province., Methods: The epidemiological data of schistosomiasis in Anhui Province from 2004 to 2020 were collected, and the trends in the endemic status of schistosomiasis were analyzed using a Joinpoint regression model. The trends in the prevalence of Schistosoma japonicum infections in humans, bovines and Oncomelania hupensis were measured in Anhui Province from 2004 to 2020 using average annual percent change (AAPC), and the correlations among the changing trends in the prevalence of S. japonicum infections in humans, bovines and O. hupensis snail status were evaluated using Pearson correlation analysis., Results: The prevalence of S.japonicum human infections continued to decline in Anhui Province from 2004 to 2020, with an annual mean decline of 14.8% [AAPC = -14.8%, 95% confidential interval ( CI ): (-18.9%, -10.5%), P < 0.01]. The prevalence of S. japonicum infections continued to decline in bovines in Anhui Province from 2004 to 2015 [AAPC = -31.3%, 95% CI : (-35.1%, -27.2%), P < 0.01], and was 0 for 5 successive years from 2016 to 2020. During the period from 2004 to 2020, there was an annual mean decline of 0.7% in areas of snail habitats [AAPC = -0.7%, 95% CI : (-1.2%, 0.3%), P < 0.05] and an annual mean decline of 9.2% in the density of living snails [AAPC = -9.2%, 95% CI : (-18.3%, 1.0%), P = 0.08] in Anhui Province from 2004 to 2020, and an annual mean decline of 35.6% was found in the density of S. japonicum -infected snails [AAPC = -35.6%, 95% CI : (-49.2%, -18.3%), P < 0.01] from 2004 to 2012, with no infected snails detected in Anhui Province from 2013 to 2020. There were significant correlations in the prevalence of S. japonicum infections between humans and bovines ( r = 0.959, P < 0.01), between the prevalence of S. japonicum human infections and the density of S. japonicum -infected snails ( r = 0.823, P < 0.01) and between the prevalence of S. japonicum infections in bovines and the density of S. japonicum -infected snails ( r = 0.902, P < 0.01)., Conclusions: The prevalence of S. japonicum infections appeared a decline in humans, bovines and O. hupensis in Anhui Province from 2004 to 2020, and significant correlations were found among the changing trends in the prevalence of S. japonicum human infections, the prevalence of S. japonicum bovine infections and the density of S. japonicum -infected O. hupensis snails. Because of a minor decline in the area of snail habitats and widespread distribution of O. hupensis , however, there is still a risk of schistosomiasis transmission, and precision control for schistosomiasis remains to be reinforced in Anhui Province.

Objective: To investigate the prevalence of Schistosoma japonicum infection in wild mice in Shitai County, Anhui Province, so as to provide insights into precise control of the source of S. japonicum infections., Methods: Wild mice were captured using the trapping method for three successive nights at snail-infested settings from Jitan Village of Jitan Township, and Shiquan Village and Xibai Village of Dingxiang Township, Shitai County, Anhui Province in June and October, 2018. All trapped wild mice were sacrificed and liver and mesenteric vein specimens were collected for detection of S. japonicum eggs using microscopy, while the fecal samples in mouse intestines were collected for identification of S. japonicum infections using Kato-Katz technique. In addition, the population density of trapped wild mice was estimated and the prevalence of S. japonicum infection was calculated in trapped wild mice., Results: A total of 376 wild mice were trapped from three villages in Shitai County. The population density of trapped wild mice was 9.1% (376/4 124), and the prevalence of S. japonicum infection was 24.2% (91/376) in trapped wild mice. The highest prevalence of S. japonicum infection was detected in Shiquan Village of Dingxiang Township (30.1%), and the lowest prevalence was seen in Xibai Village of Dingxiang Township; however, there was no significant difference in the prevalence of S. japonicum infection in trapped wild mice among three villages (χ 2 = 4.111, P > 0.05). In addition, there was no significant difference in the prevalence of S. japonicum infection in wild mice captured between on June (26.8%, 34/127) and October (22.9%, 57/249) (χ 2 = 0.690, P = 0.406). The trapped wild mice included 6 species, including Rattus norvegicus, Niviventer niviventer, R. losea, Apodemus agrarius, Mus musculus and N. coning, and the two highest prevalence of S. japonicum infection was detected in R. losea (34.9%, 22/63) and R. norvegicus (31.2%, 44/141)., Conclusions: The prevalence of S. japonicum infections is high in wild mice in Shitai County, and there is a natural focus of schistosomiasis transmission in Shitai County.

This report presented the endemic status of schistosomiasis and analyzed the data collected from the national schistosomiasis prevention and control system and national schistosomiasis surveillance sites in the People's Republic of China at a national level in 2021. Among the 12 provinces (municipality and autonomous region) endemic for schistosomiasis in China, Shanghai Municipality, Zhejiang Province, Fujian Province, Guangdong Province and Guangxi Zhuang Autonomous Region continued to consolidate the achievements of schistosomiasis elimination, and Sichuan and Jiangsu provinces maintained the criteria of transmission interruption, while Yunnan, Hubei, Anhui, Jiangxi and Hunan provinces maintained the criteria of transmission control by the end of 2021. A total of 451 counties (cites, districts) were found to be endemic for schistosomiasis in China in 2021, with 27 571 endemic villages covering 73 250 600 people at risk of infections. Among the 451 endemic counties (cities, districts), 75.17% (339/451), 22.17% (100/451) and 2.66% (12/451) achieved the criteria of elimination, transmission interruption and transmission control of schistosomiasis, respectively. By the end of 2021, 29 037 cases with advanced schistosomiasis were documented in China. In 2021, 4 405 056 individuals received serological tests and 72 937 were sero-positive. A total of 220 629 individuals received stool examinations and 3 were positive. In 2021, snail survey was performed in 19 291 endemic villages in China and Oncomelania snails were found in 7 026 villages, accounting for 36.42% of all surveyed villages, with 12 villages identified with emerging snail habitats. Snail survey was performed at an area of 686 574.46 hm 2 and 191 159.91 hm 2 snail habitats were found, including 1 063.08 hm 2 emerging snail habitats and 5 113.87 hm 2 reemerging snail habitats. In 2021, 525 878 bovines were raised in the schistosomiasis endemic areas of China, and 115 437 received serological examinations, with 231 positives detected. Among the 128 719 bovines received stool examinations, no positives were identified. In 2021, there were 19 927 schistosomiasis patients receiving praziquantel chemotherapy, and 729 113 person-time individuals and 256 913 herd-time bovines were given expanded chemotherapy. In 2021, snail control with chemicals was performed in 117 372.74 hm 2 snail habitats, and the actual area of chemical treatment was 65 640.50 hm 2 , while environmental improvements were performed in snail habitats covering an area of 1 244.25 hm 2 . Data from the national schistosomiasis surveillance sites of China showed that the mean prevalence of Schistosoma japonicum infections were both zero in humans and bovines in 2021, and no S. japonicum infection was detected in snails. The results demonstrate that the overall endemic status of schistosomiasis remained at a low level in China in 2021; however, the progress towards schistosomiasis elimination was slowed and the areas of snail habitats rebounded mildly. Strengthening researches on snail diffusion and control, and improving schistosomiasis surveillance and forecast are recommended to prevent reemerging schistosomiasis.

Objective: To evaluate the diagnostic efficacy of indirect haemagglutination assay (IHA) for detection of Schistosoma japonicum infections among boatmen and fishermen in Dongting Lake region, so as to provide insights into improving the schistosomiasis surveillance program among boatmen and fishermen., Methods: The boatmen and fishermen were detected for S. japonicum infections using IHA and Kato-Katz technique or miracidium hatching test nylon gauze simultaneously at schistosomiasis testing sites in the anchor sites for boatmen and fishermen in the Dongting Lake region during the period from 2014 to 2016, and using IHA for serological screening followed by parasitological testing of seropositives during the period from 2017 to 2019. The sensitivity and specificity of IHA were evaluated for detection of S. japonicum infections among boatmen and fishermen, with the 2014-2016 parasitological testing results as a gold standard. In addition, the seroprevalence of S. japonicum infections was compared among boatmen and fishermen with different characteristics and among years., Results: A total of 306 schistosomiasis testing sites were assigned for boatmen and fishermen, and a total of 143 360 person-time boatmen and fishermen were tested for S. japonicum infections in the Dongting Lake region from 2014 to 2019. The sensitivity and specificity of IHA were 69.9%, 97.3% and 96.1% ( χ 2 = 74.6, P < 0.05), and 70.9%, 74.5% and 71.9% for detection of S. japonicum infections from 2014 to 2016 ( χ 2 = 29.4, P < 0.05), respectively. The seroprevalence of S. japonicum infections reduced from 30.3% in 2014 to 1.8% in 2019 among boatmen and fishermen, appearing an overall tendency towards a decline ( Z = 1 552.4, P < 0.05). In addition, male, individuals at ages of 45 to 60 years, full-time boatmen and fishermen were more likely to be seropositive for S. japonicum infections (all P values < 0.05)., Conclusions: The seroprevalence of S. japonicum infections appeared a tendency towards a decline among boatmen and fishermen in the Dongting Lake region year by year from 2014 to 2019. IHA presented a high efficacy for screening of S. japonicum infections among boatmen and fishermen in the Dongting Lake region.

Objective: To analyze the trends of human schistosomiasis prevalence in Hubei Province from 2004 to 2018, so as to provide the evidence for formulating the schistosomiasis elimination strategy in the province., Methods: All data pertaining to human schistosomiasis prevalence in Hubei Province were collected from 2004 to 2018, and the trends for changes in seroprevalence, egg-positive rate and prevalence of human Schistosoma japonicum infection were analyzed using a Joinpoint regression model., Results: Both of the numbers of residents seropositive and egg-positive for S. japonicum infections appeared a tendency towards a decline in Hubei Province from 2004 to 2018, and the prevalence of human S. japonicum infections reduced from 6.85% in 2004 to 0 in 2018. Joinpoint regression analysis showed that the prevalence of human S. japonicum infections appeared an overall tendency towards a reduction in Hubei Province from 2004 to 2018 [average annual percent change (AAPC) = -24.1%, P < 0.01], and the trends for the reduction were both significant during the period from 2004 to 2006 [annual percent change (APC) = -35.1%, P < 0.01] and from 2006 to 2018 (APC = -22.1%, P < 0.01). The prevalence of human S. japonicum infections appeared a tendency towards a decline in islet (AAPC = -25.1%, P < 0.01), inner embankment (AAPC = -26.4%, P < 0.01) and hilly subtypes of schistosomiasis-endemic areas (AAPC = -32.5%, P < 0.01) of Hubei Province from 2004 to 2018, and the prevalence all appeared a tendency towards a decline during the infection control stage (from 2004 to 2008), the transmission control stage (from 2009 to 2013) and the transmission interruption stage (from 2014 to 2018) (AAPC = -28.0%, -24.4% and -63.8%, all P values < 0.01). The seroprevalence of human S. japonicum infections appeared an overall tendency towards a decline in Hubei Province from 2004 to 2018 (AAPC = -14.5%, P < 0.01), and the trends for the reduction were both significant during the period from 2004 to 2012 (APC = -8.4%, P < 0.01) and from 2012 to 2018 (APC = -22.1%, P < 0.01). In addition, the egg-positive rate of human S. japonicum infections appeared an overall tendency towards a decline in Hubei Province from 2004 to 2018 (AAPC = -30.6%, P < 0.05), and the trend for the reduction was significant during the period from 2007 to 2014 (APC = -15.5%, P < 0.01)., Conclusions: The prevalence of human schistosomiasis appeared a tendency towards a decline in Hubei Province from 2004 to 2018, and the islet and inner embankment subtypes of endemic areas are a high priority for schistosomiasis control during the stage moving towards elimination in Hubei Province.

Objective: To analyze the dynamic changes of schistosomiasis in Poyang County of Jiangxi Province from 2004 to 2020, so as to provide insight into the development of the schistosomiasis elimination strategy., Methods: Schistosomiasis control data were captured from Poyang County from 2004 to 2020, and the epidemiological data of schistosomiasis were collected from national schistosomiasis surveillance sites in Poyang County from 2005 to 2020. The endemic status of schistosomiasis was analyzed in Poyang County from 2004 to 2020, and a Joinpoint regression analysis was performed to investigate the trends of schistosomiasis in Poyang County from 2004 to 2020., Results: The sero-prevalence and egg-prevalence of human Schistosoma japonicum infections reduced from 24.39% (24 976/102 397) and 4.53% (259/5 721) in 2004 to 5.37% (2 421/45 100) [annual percent change (APC) = average annual percent change (AAPC) = -8.64%] and 0 (0/3 963) in 2020 (APC = AAPC = -32.07%) in Poyang County, and the trends were both significant (both P < 0.01). The sero-prevalence of S. japonicum infections reduced from 1.21% (294/24 332) in bovines in 2013 to 0.58% (35/5 999) in 2020 in Poyang County, with one turning point (AAPC = -8.20%, P > 0.05). There were no townships or villages with emerging snail habitats in Poyang County from 2004 to 2020, and there were three turning points of trend in the proportion of snail areas detected in total snail areas (AAPC = -2.30%, P > 0.01). The sero-prevalence and adjusted prevalence of S. japonicum infections reduced from 60.82% (742/1 220) and 10.16% (124/1 220) in local residents in 2005 to 5.73% (70/1 221) and 0 in 2020 in national schistosomiasis surveillance sites of Poyang County, and the trends for sero-prevalence (APC = AAPC = 17.47%, P < 0.01) and adjusted prevalence of S. japonicum infections (APC = AAPC = -44.92%, P < 0.01) were both statistically significant. S. japonicum infections were identified in 10 (2005) and 2 local livestock (2007), with prevalence of 10.00% (10/100) and 13.33% (2/15), respectively, and S. japonicum infections were detected in snails in 2008 and 2009; however, no positive samples of mixed O. hupensis were detected by loop-mediated isothermal amplification., Conclusions: The endemic situation of schistosomiasis control had remarkably reduced in Poyang County from 2004 to 2020; however, there are still challenges for consolidating schistosomiasis control achievements and even elimination of schistosomiasis.

Objective: To compare the effectiveness of loop-mediated isothermal amplification (LAMP) assay and microscopic examinations for detection of Schistosoma japonicum infections in Oncomelania hupensis in transmission-interrupted regions, so as to provide insights into the optimization of snail surveillance tools in these regions., Methods: Four hilly schistosomiasis-endemic villages where transmission interruption was achieved were selected in Heqing County of Yunnan Province as the study villages, including Xinzhuang and Gule villages in hilly regions and Lianyi and Yitou villages in dam regions. Snail survey was performed by means of systematic sampling combined with environmental sampling in July 2018. All captured snails were identified for S. japonicum infections using microscopy. In addition, 10 to 20 snails were randomly sampled from each snail habitat following microscopy, numbered according to environments and subjected to LAMP assay. The positive rate of settings with S. japonicum -infected snails was compared among villages., Results: A total of 7 949 living snails were captured from 83 snail habitats in 4 villages, and no S. japonicum infection was detected in snails. There were 226 mixed samples containing 1 786 snails subjected to LAMP assay, and positive LAMP assay was found in 3 mixed samples from 3 snail habitats in 2 dam villages. The positive rates of settings with S. japonicum -infected snails were comparable between Lianyi Village (one setting) and Yitou Village (2 set tings) (5.89% vs. 14.29%, P = 0.344). However, the overall positive rate of settings with S. japonicum -infected snails was significantly higher in dam villages (9.67%, 3/31) than in hilly villages (0) ( P = 0.048)., Conclusions: LAMP assay is more sensitive to detect S. japonicum infections in O. hupensis than conventional microcopy method, which may serve as a supplementary method for detection of S. japonicum infections in O. hupensis in high-risk snail habitats in hilly transmission-interrupted regions.

Objective: To evaluate the effectiveness of the integrated schistosomiasis control measures in Changzhou City from 2015 to 2020, so as to provide insights into the formulation of the strategy used to consolidate the schistosomiasis elimination achievements., Methods: The annual schistosomiasis control working report and integrated schistosomiasis control data were collected in Changzhou City from 2015 to 2020, and the prevalence of Schistosoma japonicum infections in humans and livestock and snail status were analyzed to evaluate the effectiveness of the integrated schistosomiasis control measures., Results: During the period from 2015 to 2020, a total of 112 061 person-time individuals received serological tests for S. japonicum infections in Changzhou City, and the sero-prevalence was 0.15% to 1.09% during the 6-year period, with a significant difference seen among years (χ 2 = 288.11, P < 0.05). From 2015 to 2020, a total of 13 435 person-time individuals received stool examinations, with no egg-positives identified; among 5 840 herd-time livestock receiving schistosomiasis examinations, no positives were detected, while a 100% coverage of fencing livestock was seen each year. During the 6-year period, a total of 38.40 hm 2 snail habitats were found, including 8.97 hm 2 emerging snail habitats, and among the 2 344 snails dissected, no S. japonicum infection was found. Chemical treatment covered an area of 385.71 hm 2 , and environmental improvements covered an area of 200.39 hm 2 . The mean density of living snails was less than 0.1 snails/0.1 m 2 in snail habitats found in Changzhou City each year from 2015 to 2020, and the coverage of harmless toilets was 100% in 2020. During the 6-year period, a total of 3.740 6 million person-time individuals were given schistosomiasis health education in Changzhou City., Conclusions: Changzhou City is now at the post-elimination surveillance stage; however, there are still factors affecting schistosomiasis transmission. The schistosomiasis surveillance system remains to be improved to consolidate the schistosomiasis elimination achievements in Changzhou City.

Objective: To analyze the surveillance data of schistosomiasis in Xiaogan City, Hubei Province from 2016 to 2020, so as to provide the scientific evidence for understanding the epidemiological changes of schistosomiasis and evaluating the schistosomiasis control strategy., Methods: A total of 16 surveillance sites were selected in the schistosomiasis endemic foci of Xiaogan City from 2016 to 2020, where Schistosoma japonicum infections in humans, livestock and Oncomelania snails and the schistosomiasis transmission risk were monitored. The schistosomiasis surveillance results were descriptively analyzed., Results: During the period from 2016 to 2020, there was no schistosomiasis emergency epidemic in Xiaogan City. A total of 660 sero-positive individuals were identified in Xiaogan City during the 5-year period, and the seroprevalence of S. japonicum infections reduced from 2.08% in 2016 to 0.97% in 2020. Higher seroprevalence of S. japonicum infections was detected in men than in women, and in individuals at ages of over 60 years than in those at other age groups; however, no egg-positives were detected in humans or livestock. The mean density of living snails was 0.05 to 0.06 snails/0.1 m 2 during the 5-year period, and the occurrence of frames with snails increased from 2.99% in 2016 to 3.92% in 2020; however, no S. japonicum infection was found in snails., Conclusions: The endemic situation of schistosomiasis remarkably decreases in Xiaogan City during the period from 2016 through 2020. Further improvements of the sensitive and effective schistosomiasis surveillance system are required with an emphasis on the monitoring of the schistosomiasis transmission risk and management of floating populations.

This report presented the endemic status of schistosomiasis in the People's Republic of China at a national level in 2020, and analyzed the data collected from the national schistosomiasis prevention and control system and national schistosomiasis surveillance sites. Among the 12 provinces (municipality and autonomous region) endemic for schistosomiasis in China, Shanghai Municipality, Zhejiang Province, Fujian Province, Guangdong Province and Guangxi Zhuang Autonomous Region continued to consolidate the achievements of schistosomiasis elimination, and Sichuan and Jiangsu provinces maintained the criteria of transmission interruption, while Yunnan, Hubei, Anhui, Jiangxi and Hunan provinces maintained the criteria of transmission control by the end of 2020. A total of 450 counties (cites, districts) were found to be endemic for schistosomiasis in China, with 28 376 endemic villages covering 71 370 400 people at risk of infections. Among the 450 endemic counties (cities, districts), 74.89% (337/450), 21.87% (98/450) and 3.33% (15/450) achieved the criteria of elimination, transmission interruption and transmission control of schistosomiasis, respectively. By the end of 2020, 29 517 cases with advanced schistosomiasis were documented in China. In 2020, 11 117 655 individuals received inquiry examinations and 1 798 580 were positive; 5 263 082 individuals received serological tests and 83 179 were sero-positive. A total of 273 712 individuals received stool examinations and 3 were positive, including one case of acute schistosomiasis. In 2020, snail survey was performed in 19 733 endemic villages in China and Oncomelania snails were found in 7 309 villages, accounting for 37.04% of all surveyed villages, with 15 villages identified with emerging snail habitats. Snail survey covered an area of 736 984.13 hm 2 and 206 125.22 hm 2 snail habitats were found, including 1 174.67 hm 2 emerging snail habitats and 1.96 hm 2 habitats with infected snails. In 2020, 544 424 bovines were raised in the schistosomiasis-endemic areas of China, and 147 887 received serological examinations, with 326 positives detected, while 130 673 bovines received stool examinations, with no positives identified. In 2020, there were 19 214 patients with schistosomiasis receiving praziquantel chemotherapy, and 964 103 person-time individuals and 266 280 herd-time bovines were given expanded chemotherapy. In 2020, molluscicide treatment was performed in 136 141.92 hm 2 snail habitats, and the actual area of chemical treatment was 71 980.22 hm 2 , while environmental improvements were performed in snail habitats covering an area of 1 464.03 hm 2 . Data from the national schistosomiasis surveillance sites of China showed that the mean prevalence of Schistosoma japonicum infections were both zero in humans and bovines in 2020, and no S. japonicum infection was detected in snails. The results demonstrate that the overall endemic status of schistosomiasis remains at a low level in China and the goal of the National Thirteenth Five-Year Plan for Schistosomiasis Control was achieved as scheduled; however, the endemic situation of schistosomiasis rebounded in local areas. Precision schistosomiasis control and intensified monitoring of the endemic situation and transmission risk of schistosomiasis are required to be performed to facilitate the progress towards elimination of schistosomiasis steadily.

Objective: To analyze the endemic situation of schistosomiasis in national surveillance sites of Zhejiang Province, so as to provide the scientific evidence for formulating the new schistosomiasis surveillance program and consolidating schistosomiasis elimination achievements., Methods: A total of 54 to 55 national surveillance sites and 6 risk monitoring sites were assigned in historical endemic regions of Zhejiang Province from 2015 to 2019, where the Schistosoma japonicum infections in humans, livestock, snails and wild feces were monitored. All data pertaining to the surveillance results were descriptively analyzed., Results: There were 34 530 person-time local residents receiving serological screening for S. japonicum infections in national surveillance sites of Zhejiang Province from 2015 to 2019, and the seroprevalance of S. japonicum infections were 0.29% to 0.68%; however, no egg-positives were detected. During the period from 2015 to 2019, there were 62 086 person-time mobile populations receiving serological screening for S. japonicum infections in national surveillance sites of Zhejiang Province, and the seroprevalance of S. japonicum infections were 0.32% to 0.56%; additionally, there were 27 egg-positives identified, including 3 imported cases with schistosomiasis haematobia and one case with acute schistosomiasis japonica, indicating that the adjusted prevalence of Schistosoma infections were 0.01% to 0.07% among mobile populations. A total of 829 livestock were examined for S. japonicum infections, with no positives detected. There were 10.55 hm 2 and 2.89 hm 2 snail habitats found in national surveillance sites and risk monitoring sites of Zhejiang Province during the 5-year period, respectively; however, no S. japonicum infections were identified in snails. Moreover, a total of 305 wild feces were tested for S. japonicum infections, and no egg-positives were identified., Conclusions: The schistosomiasis elimination achievement have been consolidated in Zhejiang Province; however, the risk factors of re-emerging schistosomiasis have not been completely eliminated, such as residual snails and imported schistosomiasis cases. Further surveillance and control activities of snails and the source of S. japonicum infections should be reinforced.

Objective: To investigate the changes in the endemic situation of schistosomiasis in national surveillance sites of Sichuan Province, so as to provide the scientific evidence for formulating the schistosomiasis elimination strategy., Methods: From 2015 to 2019, 63 national schistosomiasis surveillance sites were assigned in Sichuan Province, in which Schistosoma japonicum infections were monitored in humans, livestock, wild feces and snails. The monitoring data were descriptively analyzed., Results: A total of 94 119 person-time local residents were serologically screened for S. japonicum infections in 63 national surveillance sites of Sichuan Province from 2015 to 2019, with sero-prevalence rates ranging from 1.28% to 3.11%, and the sero-positives were predominantly detected in local residents at ages of over 50 years and in farmers. A total of 94 119 person-time mobile populations were serologically screened for S. japonicum infections in the national surveillance sites during the 5-year period, with sero-prevalence of 1.10% to 1.59%. There were no egg-positives identified in either local residents or mobile populations. Among the 6 126 herd-time livestock detected, no egg-positives were identified, and no S. japonicum infection was detected in the 205 wild feces. Snail survey was performed covering an area of 8 484.08 hm 2 , and 724.80 hm 2 snail habitats were identified, including 2.43 hm 2 emerging snail habitats and 63.00 hm 2 re-emerging snail habitats. The mean occurrence of frames with snails was 6.87% to 19.63%, and the mean density of living snails was 0.18 to 0.62 snails/0.1 m 2 in the national surveillance sites of Sichuan Province from 2015 to 2019; however, no S. japonicum infection was detected in snails., Conclusions: The endemic situation of schistosomiasis has reduced to the lowest level in Sichuan Province; however, there is a rise in snail habitats, and there is still a risk of schistosomiasis resurgence. Further improvements of the surveillance system for schistosomiasis are required to achieve the goal of schistosomiasis elimination in Sichuan Province as soon as possible.

Objective: To investigate the prevalence of Schistosoma japonicum infections in Elaphurus davidianus released to Poyang Lake areas and evaluate the impact of the project of " E. davidianus released to wild environments for natural reproduction and growth" "( E. davidianus return home project") on the transmission of schistosomiasis in Poyang Lake areas., Methods: During the period from April 2018 to December 2019, the population distribution, inhabiting activity and natural reproduction of E. davidianus released to Poyang Lake areas were investigated by means of GPS and artificial observations. The S. japonicum infection was identified in animal feces in E. davidianus inhabitats using a hatching test, and snail distribution was surveyed in E. davidianus inhabiting grass islands using a systematic sampling method., Results: A total of 51 E. davidianus were released to the Poyang Lake areas in 2018, which subsequently produced 5 E. davidianus habitats in Yinlong Lake, Longkou, Nanchi Lake, Lianzi Lake and Zhu Lake. E. davidianus was found to predominantly inhibit in grass islands, farmlands and forest lands in hilly regions around the Poyang Lake areas. The natural reproduction rate of E. davidianus was 25% in the habitats in 2019, and the mean density of snails was 0.009 to 0.039 snails/0.1 m 2 in E. davidianus inhabitats; however, no S. japonicum infection was identified in snails. In addition, the mean densities of wild E. davidianus and bovine feces were 4.6 samples/hm 2 and 2.1 samples/hm 2 , Conclusions The E. davidianus released to Poyang Lake areas may get infections with S. japonicum , and cause schistosomiasis transmission through fecal contamination in grass islands. The impact on and the prevalence of S. japonicum infection was 4.35% and 13.16% ( P = 0.236), respectively; however, the intensities of S. japonicum infections were "+++" and "+", respectively., Conclusions: The E. davidianus released to Poyang Lake areas may get infections with S. japonicum , and cause schistosomiasis transmission through fecal contamination in grass islands. The impact on local schistosomiasis transmission and the response strategy requires to be investigated following the release of E. davidianus to lake regions, to ensure the achievement of the goal of schistosomiasis elimination and the successful implementation of the " E. davidianus return home project" in Poyang Lake areas.

Objective: To investigate the prevalence and changing patterns of Schistosoma japonicum infections in goats in Dantu District of Zhenjiang City, so as to provide the scientific data for the management of in livestock., Methods: The S. japonicum infections were detected using a miracidial hatching test (one test for one stool specimen) in goats grazed in settings with snail habitats in Dantu District of Zhenjiang City at spring and autumn of each year from 2004 to 2019, and the prevalence and intensity of S. japonicum infections were estimated., Results: A total of 21 836 goat stool samples were detected from 2004 to 2019, and 86 were positive for S. japonicum (0.39% prevalence). The highest prevalence of S. japonicum infections in goats was seen in 2004 (1.25%) and no infections were detected in goats since 2013. S. japonicum -infected goats were identified in marshland-type endemic areas and plain regions with waterway networks, and there was a significant difference in the prevalence of S. japonicum infections in goats between these two types of endemic areas (0.50% vs. 0.15%; χ 2 = 11.566, P < 0.05). The prevalence of S. japonicum infections was significantly greater in goats at ages of more than 10 months (0.51%) and over 10 months (0.44%) than in other goats ( χ 2 = 13.088, P < 0.05), and higher prevalence was found in autumn than in spring (0.54% vs. 0.27%; χ 2 = 9.597, P < 0.05). In addition, there were 76.74% of S. japonicum -infected goats with intensity of"+++"and"++++"., Conclusions: Although the high prevalence of S. japonicum infections has been effectively controlled in goats in Dantu District, goat remains to be an important source of S. japonicum infections that should be given a high priority for control to consolidate the schistosomiasis control achievements.

Objective: To analyze the endemic situation of schistosomiasis in Hunan Province in 2019, so as to provide insights into the achievement of transmission interruption of schistosomiasis in the province in 2020., Methods: The data pertaining to Schistosoma japonicum infections in humans and livestock and snail status were captured from Hunan Province in 2019 and analyzed., Results: Schistosomiasis was endemic in 281 townships (towns) from 41 counties (districts) of 6 cities in Hunan Province by the end of 2019. A total of 991 900 persons received blood testing in Hunan Province in 2019, and 22 773 were positive for the blood testing, with sero-prevalence of 2.30%. All stool examinations were negative in 22 933 individuals detected. The high sero-prevalence was seen in Nanxian County, Anxiang County and Ziyang District. Currently, there were 5 034 cases with advanced schistosomiasis detected in Hunan Province, and they were predominantly identified in Yuanjiang City, Heshan District and Yueyang County. There were 44 963 bovines fenced in schistosomiasis-endemic villages in Hunan Province in 2019, which were predominantly distributed in Yuanjiang City, Hanshou County and Ziyang District, and no positives were detected in 1 996 bovines receiving blood testing or 20 684 bovines receiving stool examinations. In 2019, there were snail habitats of 1.73 billion m 2 found in Hunan Province, which were mainly found in Yuanjiang City, Hanshou County and Yueyang County., Conclusions: The endemic situation of schistosomiasis further decreases in Hunan Province in 2019; however, there is still a risk of schistosomiasis transmission in local areas of the province.

Objective: To predict the changes in the prevalence of Schistosoma japonicum infections in humans and livestock in Hunan Province using the exponential smoothing model and the ARIMA model., Methods: The data pertaining to S. japonicum infections in humans and livestock in Hunan Province from 1957 to 2015 were collected, and the exponential smoothing model and the ARIMA model were created using the software Eviews and PASW Statistics 18.0. In addition, the effectiveness of these two models for the prediction of S. japonicum infections in humans and livestock in Hunan Province from 2016 to 2018 was evaluated., Results: The exponential smoothing model and the ARIMA model had a high goodness of fit for prediction of S. japonicum infections in humans and livestock in Hunan Province from 1957 to 2015. There was a linear trend in the prevalence of S. japonicum infections in humans and livestock in Hunan Province from 1957 to 2015. The prevalence of S. japonicum infections in humans predicted with the Brown's linear trend and the prevalence of S. japonicum infections in livestock predicted with the Holt's linear trend in Hunan Province from 2016 to 2018 fitted better the actual data than the ARIMA model; however, prediction of the ARIMA model indicated that the endemic situation of schistosomiasis remained at a low level in Hunan Province., Conclusions: At a low epidemic level, development of highly sensitive tools for monitoring schistosomiasis is urgently needed in Hunan Province to fit the current endemic situation, and the schistosomiasis control measures should be intensified to consolidate the control achievements.

Objective: To examine the effect of schistosomiasis on the development of gastric cancer and colorectal cancer., Methods: The clinical data of patients with gastric cancer and colorectal cancer with and without schistosomiasis japonica that were admitted to the Yijishan Hospital Affiliated to Wannan Medical College from January 2014 to December 2018 were collected. All cases were divided into schistosomal gastric cancer group and non - schistosomal gastric cancer group, schistosomal colorectal cancer group and non-schistosomal colorectal cancer group. The risk factors of gastric cancer and colorectal cancer were identified using univariate analysis and multivariate logistic regression analysis, and the effects of schistosomiasis on the development and progression of gastric cancer and colorectal cancer were evaluated. In addition, the survival of 32 patients with schistosomal colorectal cancer and 68 cases with non-schistosomal colorectal were estimated using telephone follow-up, and compared., Results: There were 113 patients with schistosomal gastric cancer and 3 741 cases with non-schistosomal gastric cancer enrolled in this study, and there were significant differences between them in terms of sex ratio, age and prevalence of Helico-bacter pylori infection (all P values < 0.05). Logistic regression analysis revealed that age, H. pylori infection, and schistosomiasis were independent risk factors for gastric cancer (all P values < 0.05). There were 184 patients with schistosomal colorectal cancer and 2 205 cases with non-schistosomal colorectal cancer recruited in this study, and there were significant differences between them in terms of age, sex ratio, rate of history of alcohol consumption and rate of positive fecal occult blood test (all P values < 0.05). The phenotypes of both schistosomal and non-schistosomal colorectal cancer were predominantly ulcerative; however, the proportion of patients with invasive and protruded colorectal cancer was significantly greater than that of patients with non-schistosomal colorectal cancer ( P = 0.003). Logistic regression analysis revealed that age ( P = 0.003), gender ( P = 0.002), phenotype ( P = 0.005) and schistosomiasis ( P = 0.029) were independent risk factors for colorectal cancer. The 5-year survival rate was significantly higher in patients with schistosomal colorectal cancer (68.90%) than in those with non-schistosomal colorectal cancer (46.40%), and the dead patients with schistosomal colorectal cancer had a significantly greater mean age than those with non-schistosomal colorectal cancer [ (66.33 ± 3.08) years vs. (56.29 ± 1.94), P < 0.05]., Conclusions: Schistosomiasis may alter the pathogenesis of colorectal cancer, resulting in the differences in the epidemiology, clinical characteristics and 5-year survival rate between patients with schistosomal and non-schistosomal colorectal cancer. Periodical gastrointestinal endoscopy and other examinations are recommended to exclude the likelihood of gastrointestinal cancers in men with anemia of unknown causes and at ages of 60 years living in schistosomiasis-endemic areas.

Objective: To analyze and investigate the changing trend of the endemic situation of schistosomiasis in national surveillance sites of Jiangsu Province from 2011 to 2018, so as to provide scientific evidence for formulating strategies for schistosomiasis control., Methods: From 2011 to 2014, the national schistosomiasis surveillance sites were set in seven schistosomiasis endemic counties (cities, districts) across Jiangsu Province as according to the National Schistosomiasis Surveillance Scheme (2011 version), and from 2015 to 2018, the national surveillance sites were assigned in all 64 counties (cities, districts) endemic for schistosomiasis in Jiangsu Province according to the National Schistosomiasis Surveillance Scheme (2014 version). Schistosoma japonicum infections in local populations, mobile populations and livestock, and snail status were monitored in the national schistosomiasis surveillance sites of Jiangsu Province from 2011 to 2018, and the monitoring data were statistically analyzed., Results: The sero-prevalence of S. japonicum infections was 1.50% to 4.61% among local populations in the national schistosomiasis surveillance sites of Jiangsu Province from 2011 to 2018, and a higher sero-prevalence was seen in men than in women, with the sero-positives predominantly detected in local populations at ages of over 50 years. The positive rate of stool examinations was 0 to 0.14% among sero-positive local populations in the national schistosomiasis surveillance sites of Jiangsu Province from 2011 to 2018, and no acute case was found in local populations during the study period. The sero-prevalence of S. japonicum infections was 0.46% to 15.97% among mobile populations in the national schistosomiasis surveillance sites of Jiangsu Province from 2011 to 2018, and no egg-positives were identified. A total of 1 453 livestock were tested in the national schistosomiasis surveillance sites of Jiangsu Province from 2011 to 2018, and no S. japonicum infections were detected. During the period from 2011 through 2018, snail survey was conducted in an area of 216 million m 2 in the national schistosomiasis surveillance sites of Jiangsu Province, and 1 291.01 hm 2 snail habitats were identified, with snail densities ranging from 0.01 to 0.47 snails/0.1 m 2 ; however, no S. japonicum infections were identified in snails., Conclusions: The overall endemic situation of schistosomiasis appears a tendency towards a decline in Jiangsu Province, and S. japonicum infection remains at a low level in both humans and livestock. No S. japonicum infection has been identified in local populations in Jiangsu Province since 2012. In the future, monitoring and management of imported sources of S. japonicum infections should be intensified in Jiangsu Province, and the capability building of passive surveillance of schistosomiasis should be improved in sentinel hospitals in national schistosomiasis surveillance sites of Jiangsu Province. In addition, the examination of schistosomiasis should be strengthened in mobile populations in Jiangsu Province, a sensitive and effective surveillance-response system for schistosomiasis is urgently needed.

Objective: To analyze the endemic situation of schistosomiasis in Wuhu City from 2009 to 2018, so as to provide evidence for adjusting and developing the control strategy., Methods: The data regarding the endemic situation were retrospectively collected and analyzed in Wuhu City from 2009 to 2018., Results: The prevalence of human Schistosoma japonicum infections reduced from 0.450% in 2009 to 0.035% in 2018 in Wuhu City, and a reduction rate of 92.22% (χ 2 = 1 6128.307, P < 0.01), and the prevalence of S. japonicum infections decreased from 0.483% in 2009 to 0 in 2018 (χ 2 = 27.570, P < 0.01) in livestock. The area of snail habitats increased from 1 501.07 hm 2 in 2009 to 4 408.62 hm 2 in 2018, with an increase of 193.70%. No infected snails were found in Wuhu City since 2012, and no egg positives were detected in humans and livestock since 2016., Conclusions: Currently, the endemic situation of schistosomiasis is at a low level in Wuhu City; however, there are still factors affecting schistosomiasis transmission. In the future, the integrated strategy with emphasis on the control of infectious source and the surveillance-response system should be intensified to consolidate the achievements of schistosomiasis control.

Objective: To analyze the endemic situation of schistosomiasis in Jiangshan City from 2008 to 2018, so as to provide evidence for formulating the future control strategy., Methods: The data regarding Oncomelania snail survey and control, schistosomiasis examinations and environmental improvements were collected in Jiangshan City from 2008 to 2018. The changes in snail status and morbidity due to Schistosoma japonicum infections were analyzed to assess the effectiveness of comprehensive schistosomiasis control., Results: From 2008 to 2018, a total of 61 220 person-times were examined for S. japonicum infections in Jiangshan City, and the overall seroprevalence of S. japonicum infections was 0.56% (343/61 220); however, no egg-positives were detected. Among 4 231 cattle screened for S. japonicum infections using blood tests in Jiangshan City during the period from 2008 to 2018, 12 were sero-positive, with sero-prevalence of 0.28% (12/4 231), and no egg-positives were identified. There were 422 snail habitats identified in Jiangshan City during the study period, covering an area of 46.915 hm 2 , and among the 31 686 snails dissected, no S. japonicum infections were detected. An area of 3 625.492 hm 2 snail habitats were subjected to repeated snail control and 11 settings were given environmental improvements, covering snail habitats of 17.880 hm 2 and historical snail habitats of 204.380 hm 2 ., Conclusions: Following the implementation of environmental improvements-based comprehensive schistosomiasis control, the endemic situation of schistosomiasis is stable in Jiangshan City; however, there is still a risk of snail importation and re-emerging schistosomiasis. Therefore, the monitoring of snails and morbidity due to S. japonicum infections should be intensified in the city.

Objective: To understand the situation of Schistosoma japonicum infections in wild animals in transmission-controlled schistosomiasis-endemic areas in Jiangxi Province, so as to provide scientific evidence for implementing precision control interventions and achieving the goal of transmission interruption and elimination of schistosomiasis., Methods: Five endemic villages from Ruichang City and Pengze County that were heavily endemic for schistosomiasis in Jiangxi Province, were selected as the study villages. Wild animals like wild mice were captured, and the livers of wild animals were purchased from the snail habitats in the study villages for detection of S. japonicum infections. In the study villages, S. japonicum human infections were screened using indirect hemagglutination assay (IHA) followed by parasitological examinations with miracidial hatching test and Kato-Katz method, and the S. japonicum infection in livestock was tested using a miracidial hatching test with a plastic tube. In addition, snail survey was conducted in the study villages by means of systematic sampling combined with environmental sampling, and the S. japonicum infection in snails was detected using a loop-mediated isothermal amplification (LAMP) assay., Results: A total of 240 liver specimens were sampled or purchased from 5 species of wild animals in the study villages, including wild mice, weasels, pigs, deer and rabbits. A total of 172 wild mice were captured, with a 2.91% rate of S. japonicum infection, and there was no S. japonicum infection detected in other wild animals. The prevalence of Capillaria hepatica infection was 12.21%, 1.96% and 12.50% in wild mice, deer and pigs, respectively. In addition, there was no S. japonicum infection found in either humans or livestock in the study villages, and the mean snail density varied from 0.13 to 0.80 snails/0.1 m 2 in the study villages. LAMP assay detected S. japonicum infection in 2 tubes in a study village., Conclusions: The role of wild animals in schistosomiasis transmission and their potential risks can not be neglected in hilly schistosomiasis-endemic areas of Jiangsu Province after transmission control. Intensified surveillance and targeted control measures should be implemented to consolidate schistosomiasis control achievements.

Objective: To compare the approaches used for the assessment of disability adjust life years (DALYs) for advanced schistosomiasis japonica, so as to provide scientific evidence for accurate assessment of the burden of advanced schistosomiasis japonica., Methods: The patients with advanced schistosomiasis japonica receiving treatment and assistance programs in Hunan Province in 2017 were enrolled, and the years lived with disability (YLD) for the patients with advanced schistosomiasis japonica was calculated using the common global burden of disease (GBD) estimation method, the modified GBD method with addition of common syndromes of advanced schistosomiasis japonica, and the quality of life assessment method., Results: The YLDs of patients with advanced schistosomiasis japonica, the mean YLDs per capita, and the percentages of YLD were 673.94, 728.77 person-years and 1 761.99 person-years; 0.181, 0.196 person-years and 0.474 person-years; and 10.61, 11.48 person-years per 100 thousand persons and 27.75 person-years per 100 thousand persons with the common GBD method, modified GBD method and the quality of life method, respectively. The YLDs of the patients with advanced schistosomiasis japonica in Hunan Province estimated with the modified GBD method and the quality of life method were 8.14% and 2.61 times higher than that with the common GBD method. Of the major symptoms included in the calculation, the 5 symptoms with the greatest contribution to the burden of advanced schistosomiasis japonica included ascites, moderate anemia, severe anemia, diarrhea and hematochezia., Conclusions: The quality of life method may more comprehensively assess the YLDs in patients with advanced schistosomiasis japonica than the common and modified GBD methods.

Objective: To understand the endemic situation and distribution features of schistosomiasis in Xinjian District, Nanchang City, Jiangxi Province from 2009 to 2014, so as to provide a reference for the prevention and control of schistosomiasis in the future., Methods: The endemic data of schistosomiasis in Xinjian District were collected by taking the village as a unit from 2009 to 2014. An endemic database was established, and the SaTScan software was applied to analyze the spatiotemporal aggregation areas of Schistosoma japonicum infection in crowd, Oncomelania hupensis snails and cattle., Results: The S. japonicum infection rate of crowd was decreased from 0.10% in 2009 to 0.000 68% in 2014. The infection rate of O. hupensis snails was greatly fluctuated from 2009 to 2014, the highest was 1.04% in 2012, but it fell to 0 in 2014. The highest infection rate of cattle was 1.98% in 2012, and it fell to 0 in 2014. The spatial temporal clustering detection showed that three areas of crowd infection were mainly concentrated in 20 villages of Changyi Township, Lianyu Township and Songhu Town; two areas of snail infection were mainly concentrated in five villages of Changyi Township and Nanji Township; one area of cattle infection was mainly concentrated in three villages of Changyi Township., Conclusions: The endemic situation of schistosomiasis presents a declining trend in Xinjian District from 2009 to 2014 as a whole. However, the potential risks of the rebound of the disease still exist, and the six clustering areas of infection are still the key areas for the prevention and control of schistosomiasis in the future.

Objective: To understand the situation of Schistosoma japonicum infections in foating population and its epidemiological characteristics in China, so as to provide insights into the development of the surveillance strategy and interventions for schistosomiasis., Methods: According to the protocol of national surveillance project, indirect hemagglutination test (IHA) was employed for serological screening of S. japonicum infections among the floating population in the national schistosomiasis surveillance sites of China from 2005 to 2014, and the sero-positives were subjected to parasitological examinations. In addition, epidemiological analyses were performed to describe the characteristics of schistosomiasis in the floating population., Results: A total of 11 834 floating population were monitored at the national schistosomiasis surveillance sites of China during the study period, and 11 558 persons received serological tests, with 419 sero-positives screened. Then, 370 sero-positive floating populations were detected using parasitological examinations, and 25 stool positives were detected. The prevalence of S. japonicum infections significantly varied in time ( χ 2 = 15.103 7), occupations ( χ 2 = 115.182 7) and regions ( χ 2 = 13.177 5) in the study subjects during the study period (all P < 0.05) . A high adjusted prevalence of S. japonicum infections was seen in the boatmen and fishermen in several provinces., Conclusions: Boatmen and fishermen are at a high risk of S. japonicum infections among the floating population, and should be paid more attention to in future schistosomiasis surveillance and control activities due to their strong mobility and difficulty of monitoring.

Objective To investigate the water infectivity in key water regions, and analyze the transmission risk of schistosomiasis in suspicious and high-risk environments in Hubei Province in 2016. Methods Schistosome-endemic areas of the Yangtze River, the Hanbei River and the Fu River were chosen as the surveillance and forecast sites. The water infectivity was detected by using the sentinel mice during the flood season. The infection status of residents in the villages around the surveillance sites and the activities of human beings and domestic animals were surveyed. The emergency response system was initiated when the water infectivity areas were detected. Results From May to June, among the ten surveillance sites of the first batch, two positive spots with infected mice were found, accounting for 20%. All the recovered mice (totally 200) were dissected: five mice were infected, with a total infection rate of 2.5%. Totally five schistosome adult worms were collected, with mean worm burden of 1 worm per infected mouse. The site with cercariae-infected water body started the emergency response and no epidemic occurred. From August to September, among the eight surveillance sites of the second batch, the recovered mice (totally 160) were dissected, and no infected sentinel mice were found. Conclusion The sentinel mice method plays an important role in analyzing the schistosomiasis transmission risk in Hubei Province.

Objective To explore the spatial-temporal characteristics and changing regularities of Schistosoma japonicum infections among human from 2004 to 2011. Methods The township level spatial databases of schistosomiasis in Hunan Province from 2004 to 2011 were established, and the related spatial analysis was performed by SPSS 17.0, ArcGIS 10.1 and SaTScan 7.03. Results The schistosome infection rate among human in Hunan Province sharply decreased from 3.0% in 2004 to 0.8% in 2011. However, the rate among residents in parts of some townships in 2011 was still hovering at a higher level ( P 90 = 2.12%), and the higher rate was distributed along the Oncomelania hupensis snail ridden areas outside embankment. The autocorrelation analysis showed that the global Moran's I for schistosome infection rate among human was 0.34 to 0.53 from 2004 to 2011, and was higher than the expected value ( Z > 8.71, P < 0.05). The local G statistics indicated that the positive hotspot high-high clustering areas were mainly near the coast of Dongting Lake from 2004 to 2011, and the number of townships with schistosomiasis endemic in the clustering areas reached 30 to 70. The spatial scan analysis showed that the number of townships in the clustering areas ran up to 145 to 183 from 2004 to 2011. Conclusions The schistosome infection rate among human decreased significantly in Hunan Province from 2004 to 2011. However, the rate in parts of some townships still remains at a comparatively high level, and there are positive spatial correlation and spatial agglomerations in the schistosome infection rate among human, suggesting that the prevention and control work on schistosomiasis in these areas should be strengthened in the future.

Objective: To analyze the investigation data of the national schistosomiasis surveillance sites in 2015, so as to provide scientific evidences for schistosomiasis control, elimination and surveillance., Methods: According to National Schistosomiasis Surveillance Programme (version 2014), 457 surveillance sites were selected, and the investigation data in residents, floating population, domestic animals and Oncomelania hupensis snails were collected and analyzed from four types of endemic counties., Results: A total of 4 468 seropositive cases were detected from 133 350 residents, among which 4 457 residents with seropositive results received the etiological tests, and 71 of them were identified with positive results. Most of them were fishermen and farmers in the middle and old-aged group. The schistosomiasis infection rate was 0.05% in local population. Totally 977 seropositive cases were examined from 85 047 migrant individuals, and 16 positive cases were found out from 966 individuals who took etiological tests, which showed the schistosomiasis infection rate was 0.02% in floating population. Imported cases were found among floating people in four provinces, namely Zhejiang, Hunan, Hubei and Anhui provinces. No acute schistosomiasis cases were reported. A total of 13 406 head of cattle received examinations and only 5 were determined as stool positives. The cattle infection rate was 0.04%. The snail survey covered an area of 22 295.13 hm 2 and snails were found in an area of 7 426.63 hm 2 , including 3.47 hm 2 newly detected area with snails. No schistosome-infected snails were found., Conclusions: Based on the collected data from 457 national schistosomiasis surveillance sites of China, the Schistosoma japonicum infection rate is 0.05% in local population which maintains a stably descending trend. In floating population, there are imported schistosome-in-fected persons. Cattle are still a vulnerable species infected with schistosome. Although no infected snails are found, snails are widely distributed in endemic areas. Some provinces detect areas with snails for the first time or the reproduction of snails. The staff in endemic provinces should carry out the surveillance work according to National Schistosomiasis Surveillance Programme (version 2014) to improve the surveillance system, and enhance the sensibility and effectiveness of surveillance work.

Objective: To explore the risk factors of Schistosoma japonicum infection in the residents in Xingzi County, Jiangxi Province., Methods: Six administrative villages from different areas were randomly selected by the cluster sampling method as the study sites in Xingzi Country in 2013, and all the residents aged 5 years or above were investigated epidemiologically, and the schistosome infection was surveyed by Kato-Katz technique. The risk factors of schistosomiasis were analyzed by using the Chi-square test analysis and multivariate Logistic regression model., Results: In 2013, there were 2 050 residents received the stool examination and 146 persons were positive, the schistosome infection rate was 7.1%. The Chi-square test showed that gender, age, occupation and education level were associated with the population infection rate ( χ 2 = 26.485、16.836、25.700、 90.805, all P < 0.05). The multivariate Logistic regression mode showed that the probability of schistosomiasis for the male was 3.041 times as much as that for the female; the probability of schistosomiasis for the illiteracy and primary education level crowd was 8.870 times as much as that for the college degree or above crowed; the probability of schistosomiasis for the junior middle school education level crowd was 5.598 times as much as that for the college degree or above crowed; the probability of schistosomiasis for the high school education level crowd was 2.995 times as much as that for the college degree or above crowed; the probability of infection of fishermen was the highest, which was 3.053 times as much as that for the other professional crowds., Conclusions: The risk factors of schistosome infection mainly include gender, occupation and the education level. We should strengthen the health education of schistosomiasis control, protection against the infested water contact, and so on.

Jiangxi Province is one of serious endemic provinces with schistosomiasis japonica in China. The transmission control of schistosomiais has been achieved in whole province in 2015 after more than 60 years' great efforts. Of them, the surveillance has played an important role in the control of schistosomiasis. Based on the comprehensive analysis of the status of schistosomiasis epidemic, surveillance and challenges, this article exports the priority and development trend of surveillance after the achievement of transmission control of schistosomiasis in Jiangxi Province.

Objective: To comprehensively evaluate the effects of indirect hemagglutination test (IHA) , enzyme-linked immunosorbent assay (ELISA), and dipstick dye method (DDIA) in the diagnosis of schistosomiasis japonica at different prevalence by using Meta-analysis., Methods: Through the literature review according to the inclusion and exclusion criteria, a database was established, and by using Meta-disc and R software, the Meta-analysis was performed including the threshold test, heterogeneity test, weighted by the quantitative effect of merger, SROC curve fitting, etc., Results: A total of 60 papers were included in the final analysis. The sensitivities of IHA were 0.84, 0.76 and 0.94 in heavy, medium and low endemic areas, and specificities were 0.73, 0.64 and 0.73 respectively; the sensitivities of ELISA were 0.88, 0.80 and 0.93 in heavy, medium and low endemic areas, and the specificities were 0.59, 0.59 and 0.62 respectively; the sensitivities of DDIA were 0.93, 0.81 and 0.93 in the heavy, medium and low endemic areas, and specificities were 0.66, 0.69 and 0.59 respectively. The weighted sensitivities of IHA, ELISA and DDIA were 0.83, 0.87 and 0.90 respectively; the weighted specificities were 0.69, 0.60 and 0.62 respectively. The areas under the curve of SROC were 0.89, 0.96 and 0.92 in IHA, ELISA and DDIA respectively., Conclusions: In different prevalence, the effectiveness of different methods for serological diagnosis of schistosomiasis is different. The sensitivity and specificity of all diagnostic methods of schistosomiasis need to further improve.

Objective: To investigate the prevalence and risk factors of helminthic infections including Schistosoma japonicum , Ascaris lumbricoides and Trichuris trichiura and human immunodeficiency virus (HIV), and find out the association among them in a rural community of southwestern China., Methods: A community-based cross sectional study was conducted. One town was selected randomly; the infections of S.japonicum , A.lumbricoides and T.trichiura were detected with the modified Kato-Katz thick smear method and HIV infection with the diagnostic Test Kit among all residents. A questionnaire survey was conducted to investigate the related risk factors., Results: Among the participants, the infection rates of HIV, S.japonicum , A.lumbricoides and T.trichiura were 2.33%, 2.05%, 13.47% and 30.59% respectively; 7.08% (31/438) were infected with both A.lumbricoides and T.trichiura ; 0.23% (1/438) were co-infected with HIV and A.lumbricoides , and the same with HIV and T.trichiura. The multivariate logistic regression analysis showed that sex (male, OR =3.26, 95% CI ：0.97, 10.95) and drug abuse ( OR =72.86, 95% CI ：18.51, 286.76) were significantly associated with HIV infection. Home toilet was negatively related to A.lumbricoides infection ( OR =0.52, 95% CI ：0.27, 0.98) and T.trichiura infection ( OR =0.48, 95% CI ：0.28, 0.80). Compared with the people in Villages Four, the people living in Village One were at a higher risk for A.lumbricoides infection ( OR =3.14, 95% CI ：1.35, 7.27), and compared with the people living in Village Four, the people living in Village Two and Village Three were more likely to be infected with T.trichiura ( OR =3.73, 95% CI ：1.92, 7.26; OR =4.53, 95% CI ：2.12, 9.68). The people aged between 11 and 20 years had a higher T.trichiura infection risk than the people aged more than 50 years ( OR = 3.72, 95% CI ：1.59, 8.67). There was a significant association between A.lumbricoides and T.trichiura infections ( OR = 3.11, 95% CI ：1.63, 5.93). There was no association between S.japonicum infection and related factors above mentioned., Conclusions: The infection rates of HIV, S.japonicum , A.lumbricoides and especially T.trichiura were rather high in this area, and therefore, the prevention and treatment of these diseases should be strengthened. Further studies on the relationship between HIV and the infections of helminths, especially S.japonicum are needed.

Objective: To explore and integrate the key techniques used in the surveillance and forecast of schistosomiasis in the water regions along the Yangtze River, so as to provide technical support for identifying rapidly the risk of schistosomiasis transmission and implementing control measures targeting the risk., Methods: According to the distribution of water systems and water regions along the Yangtze River in Jiangsu Province, the demonstration sites for surveillance and forecast of schistosomiasis were set across the province, where the integration and demonstration of the techniques regarding monitoring of Schistosoma japonicum infection in sentinel mice, human and animal activities, release of forecast information, and emergency treatment of water regions at risk of infection were performed. The pattern of human and animal activities was compared with the S. japonicum infection in sentinel mice in the demonstration sites, and the operability of the release of information and emergency treatment of the risk of S. japonicum infection was evaluated., Results: A total of 50 demonstration sites for surveillance and forecast of schistosomiasis were set in fixed anchor points, opening of the navigation lock to the Yangtze River, freight terminal, agritainment places, ferry, large construction places, and places for guaranteeing the Youth Olympic Games in 23 counties (districts) of 5 cities, Jiangsu Province. During the period between May. and September, 2014, the infectivity of water body was monitored by using 5 batches of sentinel mice, with a 99.06% (4,954/5,001) gross recovery rate of mice. S. japonicum infection was detected in a demonstration site, and an infected mouse was found, with a 0.02% (1/4,933) gross positive rate of sentinel mice. The field survey showed 2 088 person-times contacting water, including 91.95% (1,920/2,088) contacting water due to the production such as capturing fish, harvesting and cultivating crops, and repairing and building boats, and 8.05% (168/2 088) contacting water due to the life activity, such as fishing, washing vegetables and playing with water. The people contacted water predominantly in August and September (49.57%). A total of 859 boats containing 1,877 boatmen were observed, 68.22% (586/859) of which were fishing boats containing 1,306 fishermen (69.58%). There were 32 sheep found in 4 demonstration sites, and 3 sheep were seen in the demonstration site with infected sentinel mouse. Four blue forecasts (emergence of water contact) and one orange forecast (S. japonicum-infected sentinel mouse detected) were released across the province, with one forecast map released which showed 5 sites with fishing and one site with sheep grazing, one emergency response system initiated, mollusciciding implemented in 10 hm2 high-risk regions, 120 sheep grazed in fence, and 35 fishermen given health-education materials, schistosomiasis examination and preventive therapy. In addition, no acute schistosomiasis occurred in the demonstration site with S. japonicum-infected sentinel mice., Conclusions: The integration and demonstration of the techniques regarding monitoring of S. japonicum infection in sentinel mice, human and animal activities, release of forecast information, and emergency treatment of water regions at risk of infection provides an effective approach for the large-scale surveillance and forecast of schistosomiasis.

This report presented the endemic status of schistosomiasis in the People's Republic of China at national level in 2013. By the end of 2013, there are 184 943 schistosomiasis japonica cases. Meanwhile, nine acute cases were reported, and 4 cases reduced compared with that of 2012. A total of 29 796 advanced cases were reported; while 911 cases were determined as advanced cases and 1 700 cases were dead in 2013. Nationally, there were around 365 467.99 hm2 Oncomelania snail infested areas in total and 9.25 hm2 of them habituated infected snails in 2013. There were 287.28 hm2 of snail infested areas found in non-endemic areas historically. Moreover, 962 065 cattle were estimated to be raised in endemic regions and 633 cattle were determined as positive by stool examinations. The data showed that the endemicity of schistosomiasis in China decreased further. However, challenges exist to reach the aims of the medium and long-term national program. Further control and effective surveillance need to be strengthened as the endemicity of schistosomiasis is unstable in the areas after schistosomiasis transmission under control or interruption.

Objective: To study the endemic trend of schistosomiasis japonica in Hubei Province, so as to provide the theoretical basis for surveillance and forecasting of schistosomiasis., Methods: The time-series auto regression integrated moving average (ARIMA) model was applied to fit the infection rate of residents of Hubei Province from 1987 to 2013, and to predict the short-term trend of infection rate., Results: The actual values of infection rate of residents were all in the 95% confidence internals of value predicted by the ARIMA model. The prediction showed that the infection rate of residents of Hubei Province would continue to decrease slowly., Conclusion: The time-series ARIMA model has good prediction accuracy, and could be used for the short-term forecasting of schistosomiasis.

Objective: To assess the schistosomiasis endemic situation in the national surveillance sites in Hubei Province, so as to provide the evidence for the prevention and control of schistosomiasis., Methods: According to the national surveillance protocol, a longitudinal surveillance of endemic situation of schistosomiasis was carried out in 16 national surveillance sites from 2005 to 2010., Results: In general, the positive rates of IHA, Kato-Katz technique and infection rates of Schistosoma japonicum decreased from 15.67%, 10.93% and 1.71% in 2005 to 10.48%, 8.54% and 0.90% in 2010, and declined by 33.12%, 22.70% and 47.95%, respectively. The infection rates of S. japonicum of the male were higher than that of the female, and the peak infection rates were in the groups aged above 30 years. The endemic situation of fishermen and farmers were relatively serious. The infection rates of S. japonicum in cattle decreased from 11.69% in 2005 to 1.41% in 2010, and declined by 88.01% (χ2 = 298.79, P < 0.001). The areas with infected Oncomelania hupensis snails, the densities of living snails, the rates of infected snails and the densities of infected snails decreased by 90.88%, 61.66%, 80.00% and 92.00%, respectively., Conclusion: The schistosomiasis endemic situation in the national surveillance sites in Hubei Province mitigates in 6 years, but the prevention is still a very daunting task.

Objective: To investigate the schistosomiasis japonica infection and preventive knowledge of immigration population in Jinshan District, Shanghai so as to provide the evidence for improving the control work., Methods: The immigration population from schistosomiasis endemic provinces and local people were screened by serum IHA screening for schistosome infection, and the positives were further examined by Kato-Katz technique and the miracidium hatching method. The schistosomiasis preventive knowledge and behaviors were investigated by questionnaires., Results: A total of 579 were investigated with 348 immigration people and 231 local people, and among them, the male accounted for 72.0% and female accounted for 28.0%. In the immigration population, the main age group was 20-29 (56.0%), and 56.6% of the immigration had an education level at senior middle school or higher. The most proportion of immigration was from Anhui Province (36.2%). There were 4 IHA positive persons (1.15%) in the immigration, and 1 was positive in the stool test, and the schistosome infection rate was 0.29%. There were no positives in the local people. The schistosomiasis preventive knowledge of the immigration was generally poor, and some people' s behaviors of see doctor and medication were incorrect., Conclusion: There are schistosome infected persons among the immigration population from schistosomiasis endemic provinces, and their schistosomiasis prevention knowledge was poor, thus there is a schistosomiasis transmission risk.

Objective: To explore the potential key risk factors of schistosomiasis transmission in potential endemic areas so as to provide the evidence for setting up the prediction and surveillance systems of schistosomiasis outbreak epidemic., Methods: From 2008 to 2012, fixed and mobile surveillance sites in potential endemic areas of 2 counties in Hubei Province were selected. The immunological assays and stool examinations were carried out to investigate the schistosome infection situation of local people, mobile population and livestock. The distribution of Oncomelania hupensis snails was investigated in risk areas and suspicious areas, and spreading patterns of snails were observed in the rivers that directly connected with the Yangtze River., Results: A total of 6 052 local people aged 6-65 years were screened by IHA immunological tests, and the positive rate of antibody was 1.19% (72/6 052). Totally 72 antibody positives were examined by Kato-Katz technique and there were no positives. A total of 5 004 mobile persons were tested by IHA immunological tests and the positive rate was 1.36% (68/5 004). Totally 68 antibody positives were examined by Kato-Katz technique and there were no positives. Totally 287.07 hm2 potential endemic areas were investigated for Oncomelania snail detection, and no snails were found. The investigation on snail spreading patterns and the surveillance on suspicious circumstances were carried out, with no snails found., Conclusions: In the schistosomiasis potential endemic areas, some positives of IHA immunological tests are found. Therefore, monitoring is still needed to be strengthened.

Objective: To understand the dynamics of human infection and reinfection of Schistosoma japonicum after chemotherapy in marshland and lake endemic regions so as to provide the evidence for developing a cost-effective control strategy., Methods: From 2007 to 2011, the schistosome infection, intensities and reinfection of population were investigated and the results were analyzed dynamically in Caohui Village, a national schistosomiasis surveillance site in Changyi Township, Xinjian County, Jiangxi Province, China., Results: The schistosome infection rate was 3.55% and the mean intensity was 1.56 in 2007, and the schistosome infection rate was 1.52% and the mean intensity was 1.60 in 2011. The reinfection rates were 2.70%, 9.09% and 2.47% in 2009, 2010, and 2011, respectively., Conclusion: The schistosomiasis endemic situation shows a downtrend in the village. However, the reinfection is still serious; therefore, we should strengthen the research of risk factors of reinfection and control them.

Objective: To understand the ability of pathogenic diagnosis for schistosomiasis japonica in the national surveillance sites and evaluate the effect of stool hatching method in the field, so as to provide the evidence for establishing a quality control system of pathogenic diagnosis of schistosomiasis in the surveillance sites., Methods: The data pertaining to the parasitological diagnosis of the residents with positive serological tests were collected in 81 national surveillance sites of 12 provinces in 2011, and the effects of the Kato-Katz technique and stool hatching method were evaluated and compared. The incubation quality control samples made by the national schistosomiasis diagnosis reference laboratory were detected by both Kato-Katz technique and stool hatching method using the single-blind method, and the results were analyzed and compared for the coincidence rate, misdiagnosis rate and missing diagnosis rate in all the county laboratories in 2012., Results: A total of 3 780 sero-positive residents were tested by using the Kato-Katz technique and stool hatching method in the 81 national surveillance sites in 2011, 127 persons were double egg-positive, 3 513 persons were double egg-negative, and the total coincidence rate was 96.30%. Totally 173 infected people were diagnosed by using the Kato-Katz technique and the positive detection rate was 4.58%; 221 infected people were diagnosed by using the stool hatching method and the positive detection rate was 5.85%. A total of 267 positive people were diagnosed by the Kato-Katz technique or the stool hatching method or both and the total positive detection rate was 7.06%, which was higher by 54.15% than that by using the single Kato-Katz technique (chi2 = 21.32, P < 0.01). In 2012, of 240 standard incubation quality control samples (160 positives, 80 negatives) detected by the technicians from the 80 surveillance sites, 105 samples were positive and 67 samples were negative, with a total coincidence rate of 71.67% (172/240) and a total missing diagnosis rate of 34.38% (55/160). Among them, the missing rate of the strong positive samples was 32.50% (26/80), the missing rate of the weakly positive samples was 36.25% (29/80), and the misdiagnosis rate of the negative samples was 16.25% (13/80). The detection rates of the incubation quality control samples were 61.11%, 80.00%, 77.08%, 90.48%, 58.33% and 59.26% in the surveillance sites of six provinces, including Anhui, Hubei, Hunan, Jiangsu, Jiangxi and Sichuan provinces, respectively, and a significant difference was found (chi2 = 14.27, P < 0.05)., Conclusions: The detection efficiency of the stool hatching method is superior to that of the Kato-Katz technique in the field. However, the levels of the technical personnel for the stool hatching method are relatively low in most of the surveillance sites. Therefore, the technical training should be strengthened.

Objective: To understand the endemic situation dynamics of schistosomiasis in domestic animals (mainly bovine) in mountainous endemic regions, so as to provide the reference for evaluating the control effect and improving control strategy., Methods: Two representative pilots (Renmei and Dacang) in mountainous schistosomiasis endemic regions were selected for survey. The schistosome infection status of bovine was investigated by the miracidium hatching method, the pasture of bovine were investigated by home visiting, and the distributions of wild feces and Oncomelania snails, and the snail schistosome infection status were also investigated in April and September every year., Results: The schistosome infection rates of bovine reduced by 98.4% and 93.8% in two pilots in 2007 compared with those in 1993, and the infection intensities also showed a decline trend. The infection rate of wild faces was 0 in Renmei pilot since 1995, while in Dacang pilot, the infection rate of wild feces fluctuated in 2007, and the intensities of living snails and infected snails showed a declined trend., Conclusions: Due to the special natural environment of mountainous endemic regions, there is a dot-like or band-like distribution of endemic areas. The strengthening of schistosomiasis examination and chemotherapy will rapidly reduce endemic situation. However, to completely interrupt the transmission of schistosomiasis, we should emphasize environmental modification and domestic animal management.

This report overviewed the national endemic status of schistosomiasis in People's Republic of China in 2011. By the end of 2011, a total of 286 836 cases of schistosomiasis japonica were estimated with a decrease rate of 11.97% compared with the number in 2010. A total of 3 acute cases were reported, decreased by 93.02% compared to the number in 2010. A total of 22 519 advanced cases were treated in 2010, increased by 10.34% compared to that in 2010. About 372 664.10 hm2 of areas infested with Oncomelania snail were found in 2011, and about 1 163.87 hm2 newly detected areas were reported. There were 1 410 936 cattle raised in schistosomiasis transmission regions in 2011. The infection rate of cattle was 0.68% in 2011, with a reduction rate of 34.62% comparing to that in 2010 (1.04%).

Objective: To understand the endemic situation of national surveillance sites in Jiangsu Province from 2005 to 2010, so as to provide the evidence for the prevention and control of schistosomiasis., Methods: According to the national surveillance protocol, a longitudinal surveillance on endemic situation of schistosomiasis was carried out in 8 national surveillance sites from 2005 to 2010., Results: In general, the positive rates of blood tests and infection rates of Schistosoma japonicum decreased from 9.04% and 0.22% in 2005 to 4.34% and 0.02% in 2010, and the rates of decline were 51.99% and 90.91%, respectively. The endemic situation of farmers, fishermen and business men were relatively serious, and the infection degree of the low-aged group of students was relatively serious. No local acute schistosomiasis case was detected. A total of 7 466.46 hm2 of environmental sites were investigated, and the areas with living Oncomelania hupensis snails and infected snails were 2 213.98 and 247.91 hm2, respectively, the densities of living snails and infected snails decreased gradually, and no infected snail was found in 2010. However, the total areas with living snails and infected snails still keep a relative high level, and the density of infected snails rebounded in special sites., Conclusion: The endemic situation of the national surveillance sites is under control, and the infection rate of human keeps at a low level in Jiangsu Province. The surveillance and control of snails and infection source should still be strengthened.

Objective: To understand the characterization and levels of antibody isotype responses to soluble egg antigen (SEA) and adult worm antigen (AWA) of Schistosoma japonicum in schistosomiasis patients in Poyang Lake region., Methods: Antibody isotype IgG, IgG1, IgG2, IgG3, IgG4, IgE, IgM and IgA responses to SEA and AWA in the sera of individuals from endemic and non-endemic areas were determined by indirect ELISA., Results: The levels of antigen-specific antibody isotypes in the sera of patients with egg positive were significantly higher than those of people with egg negative and normal control population from non-endemic area (P < 0.001), and except for anti-SEA IgG2 and anti-AWA IgG4 and IgE antibodies, the levels of antibody isotypes in the sera of people with egg negative in endemic area were significantly higher than those of normal control population from non-endemic area (P < 0.05). In the population with egg positive, children had higher levels of anti-SEA IgM and IgG1 and anti-AWA IgM antibody, and lower AWA specific IgG than adults. There was no significant difference between the male and female except for the male had higher levels of IgG (F = 4.677, P = 0.032) and IgG1 (F = 5.55, P = 0.020)against AWA. Three months post-treatment, the levels of IgG1, IgG3, IgG4 antibody responses to SEA deceased significantly (P < 0.001, P = 0.029, P = 0.044), and almost all the antibody levels decreased significantly (P < 0.05) twelve months post-treatment, except for SEA specific IgE and IgM and AWA specific IgG4 and IgM antibodies., Conclusions: The levels of antigen-specific antibody isotypes in the sera of patients with egg positive are significantly higher than those of people with egg negative and normal control population from non-endemic area. Almost all of antibody levels decrease significantly twelve months post-treatment. The levels of antibody isotypes in the sera of people with egg negative in endemic area are significantly higher than those of population from non-endemic area, giving a clue that the selection of negative control of schistosomiasis diagnostic kit should be noticed.

Objective: To compare the sensitivities of different isolates of Schistosoma japonicum in marshland and lake regions of Chinese Mainland to praziquantel, so as to provide experimental evidence for establishing the techniques of detecting and monitoring praziquantel sensitivity., Methods: Mice were infected with cercariae released from the S. japonicum-infected snails collected from the marshland and lake endemic regions of Hunan, Hubei, Jiangxi, Anhui and Jiangsu provinces, grouped, and treated with praziquantel at single oral doses of 37.5, 75, 150, 300 mg/kg and 600 mg/kg, while mice infected but treated with 2.5% Cremophor EL served as controls. The worm burden reductions caused by praziquantel treatment were observed, and the 50% effective dose (ED50 value) was calculated., Results: The administration with praziquantel at single oral doses of 37.5, 75, 150, 300 mg/kg and 600 mg/kg achieved worm burden reductions of 10.37%-19.81%, 23.22%-33.09%, 39.25%-49.61%, 62.87%-74.44% and 91.26%-98.09%, respectively, and no significant differences in worm burden reductions of different isolates of S. japonicum were detected following treatment with different doses of praziquantel (P > 0.05). The praziquantel ED50 values against different isolates of S. japonicum ranged from 134.1 to 186.7 mg/kg, and no significant differences of praziquantel ED50 values were found among different isolates (P > 0.05)., Conclusions: There were no significant differences of praziquantel sensitivities of different isolates of S. japonicum in marshland and lake regions of Chinese Mainland. Praziquantel ED50 value against schistosomes, as a quantitative index, can truly reflect the sensitivity of schistosome populations to praziquantel, which can be used to assess the risk of emergence of praziquantel resistance in schistosomes.

This article describes the main approach of ecological civilization construction and great changes and achievements in the original schistosomiasis endemic areas, Yujiang County, Jiangxi Province. Ecological civilization is an important part of schistosomiasis control work.

From 2005 to 2010, the infection rates of schistosomiasis among residents (above 6 years old) were 13.34%, 9.59%, 4.81%, 3.03%, 2.35% and 2.19%, respectively. The positive rates of schistosomiasis among domestic animals fluctuated from 2.50% to 25.92%. Oncomelania snails were not found inside embankment since 1980, yet a high density of infected snails was found at low and uneven areas outside embankment. The cattle were the main infectious source and we should strengthen the administration and control of cattle.