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Background: Flooding is considered to be one of the most important factors contributing to the rebound of Oncomelania hupensis, a small tropical freshwater snail and the only intermediate host of Schistosoma japonicum, in endemic foci. The aim of this study was to assess the risk of intestinal schistosomiasis transmission impacted by flooding in the region around Poyang Lake using multi-source remote sensing images., Methods: Normalized Difference Vegetation Index (NDVI) data collected by the Landsat 8 satellite were used as an ecological and geographical suitability indicator of O. hupensis habitats in the Poyang Lake region. The expansion of the water body due to flooding was estimated using dual-polarized threshold calculations based on dual-polarized synthetic aperture radar (SAR). The image data were captured from the Sentinel-1B satellite in May 2020 before the flood and in July 2020 during the flood. A spatial database of the distribution of snail habitats was created using the 2016 snail survey in Jiangxi Province. The potential spread of O. hupensis snails after the flood was predicted by an overlay analysis of the NDVI maps in the flood-affected areas around Poyang Lake. The risk of schistosomiasis transmission was classified based on O. hupensis snail density data and the related NDVI., Results: The surface area of Poyang Lake was approximately 2207 km 2 in May 2020 before the flood and 4403 km 2 in July 2020 during the period of peak flooding; this was estimated to be a 99.5% expansion of the water body due to flooding. After the flood, potential snail habitats were predicted to be concentrated in areas neighboring existing habitats in the marshlands of Poyang Lake. The areas with high risk of schistosomiasis transmission were predicted to be mainly distributed in Yongxiu, Xinjian, Yugan and Poyang (District) along the shores of Poyang Lake. By comparing the predictive results and actual snail distribution, we estimated the predictive accuracy of the model to be 87%, which meant the 87% of actual snail distribution was correctly identified as snail habitats in the model predictions., Conclusions: Data on water body expansion due to flooding and environmental factors pertaining to snail breeding may be rapidly extracted from Landsat 8 and Sentinel-1B remote sensing images. Applying multi-source remote sensing data for the timely and effective assessment of potential schistosomiasis transmission risk caused by snail spread during flooding is feasible and will be of great significance for more precision control of schistosomiasis.

Background: The People's Republic of China (P. R. China) has made significant progress on schistosomiasis control. Among the 12 provincial-level administrative divisions (PLADs) with schistosomiasis endemic in P. R. China, Guangdong, Shanghai, Fujian, Guangxi and Zhejiang PLADs (following as five PLADs) had successively eliminated schistosomiasis during 1985-1995. However, consolidation of the schistosomiasis elimination in these five PLADs remains challenging. In the current study, we sought to understand the epidemic situation in these post-elimination areas and their surveillance capabilities on schistosomiasis., Methods: Annual data reflecting the interventions and surveillance on human beings, cattle and snails based on county level from 2005 to 2016 were collected through the national schistosomiasis reporting system and the data were analyzed to understand the epidemic status of schistosomiasis in the five PLADs. A standardized score sheet was designed to assess the surveillance capacity for schistosomiasis of selected disease control agencies in five PLADs and ten counties. Assessment on surveillance capacity including schistosomiasis diagnostic skills, identification of snails' living and infection status and knowledge about schistosomiasis and its control were made. Descriptive analysis was used to analyze the epidemic status and evaluation results on surveillance capacities., Results: The assessments showed that no local cases in humans and cattle or infected snail were found in these five PLADs since 2005. However, from 2005 to 2016, a total of 221 imported cases were detected in Zhejiang, Shanghai and Fujian, and 11.98 hm 2 of new snail habitats were found in Zhejiang, Shanghai and Guangxi. In addition, snail infestation reoccurred in 247.55 hm 2 of former snail habitats since 2011. For the surveillance capacity assessment, the accuracy rate of IHA and MHT were 100 and 89.3%, respectively. All participants could judge the living status of snails accurately and 98.1% on the infection status of snails. The accuracy rate of the questionnaire survey was 98.0%., Conclusions: Elimination of schistosomiasis was consolidated successfully in five PLADs of P. R. China due to effective and strong post-elimination surveillance. Comprehensive consolidation strategies should be focused on the elimination of residual snails and the prevention of imported infection sources to consolidate the achievements of schistosomiasis control.

The geographical distribution of snail (i.e., the intermediate host of schistosomiasis) is consistent with that of endemic areas. The suitable snail habitus requires necessary environmental conditions for snail population. The high-resolution remote sensing provides an important tool for the spatio-temporal analysis of disease monitoring and prediction. This study conducted a typical schistosomiasis epidemic area in the marshland and lake regions along the Yangtze River, Yueyang City, Hunan Province of China. And three types of environmental factors, i.e., NDVI, soil moisture, and shortest distance to water body, associated with the geographical distribution of snail population, were extracted from the high-resolution remoting sensing data. The predicted distribution of snail habitus from the high-resolution environmental factors were compared with the data of annual program of snail survey. The results have shown that the application of high-resolution remote sensing can improve the accuracy of the modeled and predicted the potential risk areas of schistosomiasis, and may become an important tool for the ongoing national schistosomiasis control program., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: An "integrated control" strategy has been implemented within seven provinces at highest risk for schistosomiasis along Yangtze River in Peoples' Republic of China (P. R. China) since 2004. Since Oncomelania hupensis is the only intermediate host of the blood fluke (Schistosoma japonicum), controlling the distribution of snails is considered an essential and effective way to reduce the risk of schistosomiasis infection. The study aimed to determine the snail area burden and annual trend among provinces with potential risk for schistosomiasis along the Yangtze River, above and below the Three Gorges Dam (TGD)., Methods: This retrospective study utilized data previously collected from the National Parasitic Diseases Control Information Management System (NPDCIMS) on annual snail surveys from 2009 to 2017. Descriptive statistics were performed for analyzing the snail burden by provinces, counties, type of environmental location and year, and mapping was conducted to present the snails distribution., Results: From 2009 to 2017, the total snail infested area decreased by 4.22%, from 372 253 hm 2 to 356 553 hm 2 within the seven high risk provinces. The majority of snails were found in the marshland and lake regions, outside of control embankments. The total snail burden trend remained relatively stable in upstream regions above the TGD from 2010 to 2015, while the trend decreased within downstream regions during this period. In 2016 and 2017, the total snail burden trend increased in both upstream and downstream provinces, however, upstream saw a larger increase. From 2009 to 2017, there were a total of 5990 hm 2 of newly developed snail areas in the seven study provinces and the majority were concentrated in regions below the TGD, accounting for 5610 hm 2 (93.70%)., Conclusions: There has been a decline in total snail counts from 2009 to 2017. Meanwhile, new snail breeding areas were formed mainly within provinces downstream the TGD due to spread of snails, indicated that the oncomelanid snail would be difficult to completely eliminate. We suggest that the national schistosomiasis integrated control strategy, including mollusciding and environmental modification, will need to be enhanced significantly going forward to achieve a greater reduction in snail burden and ultimately to achieve elimination.

Schistosomiasis japonica was endemic in 12 provinces (including municipalities and autonomous regions) in the People's Republic of China (PR China). Despite the tremendous decrease of schistosomiasis incidence after almost 60 years of control, the distribution of snail-breeding sites has not been reduced significantly. In order to verify current transmission risks and identify the potential establishment of new foci of schistosomiasis driven by environmental changes, we conducted surveillance in selected risk areas of three provinces: Jiangsu, Anhui and Shandong from 2008 to 2010 in addition to routine snail surveillance. We investigated populations and possible reservoirs in sentinel sites and report that the total number of new acute cases did not diminish further in spite of ongoing control activities. In Anhui Province the local count compared to the national count was 43% (19/44) in 2008, 33% (25/75) in 2009 and 40% (17/42) in 2010. In all, 31.58 km(2) areas of snail breeding sites were newly detected nationwide through the year 2008-2010, of which the proportion of Anhui was 42% (5.03/11.98) in 2008, 95% (8.39/8.79) in 2009 and 79% (8.52/10.81) in 2010. Sentinel surveillance showed eight, nine and five confirmed cases of acute schistosomiasis in mobile populations (fishermen, migrant workers) in 2008, 2009 and 2010, respectively. All these cases were detected in Chaohu County, which must therefore be deemed an area at risk. We conclude that continuous surveillance with an emphasis on snails must be enhanced in potential risk areas in PR China., (Copyright © 2013 Elsevier B.V. All rights reserved.)

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 establish an index system for rapid assessment of environment with high transmission risk of schistosomiasis in marshland and lake regions., Methods: The alternative indices were established preliminarily by the documentary method, and then the Delphi method was used two rounds to select the indices and establish the index system. The degree of familiar and authority of the experts as well as the weights of all indices were assessed., Results: A total of 3 primary indices namely morbidity in domestic animals, morbidity in humans and Oncomelania snail status were established, among which the weight of morbidity in domestic animals (0.68) was the highest. Totally 16 secondary indices were established, among which the combinative weights of the positive rate of wild feces (0.09), the infection rate of livestock (0.09), the infection rate of humans (0.07), the number of cases with acute schistosomiasis (0.07), the area with infected snails (0.07), and the density of infected snails (0.07) were the highest. The coefficients of familiar degree and authority degree of the experts of the primary indices were 0.79-0.85 and 0.88-0.91, and those of the secondary indices were 0.68-0.86 and 0.77-0.91, respectively., Conclusions: The index system for rapid assessment of environment with high transmission risk of schistosomiasis in marshland and lake regions is established preliminarily. Using this system, we can assess the key endemic indices of humans, domestic animals and snails to understand the endemic situation in the investigated sites.

Objective: To explore the impact of the impoundment of Three Gorges reservoir on Oncomelania snail habitats of Poyang Lake., Methods: Four counties with schistosomiasis endemic around the Poyang Lake, naming as Xingzi, Duchang, Jinxian and Xinjian, were selected as study areas. The average daily water level of four major hydrological stations near the above 4 counties from 1997 to 2008 were collected, as well as the elevation of 215 marshlands with snails in those 4 counties, the data of schistosomiasis endemic situation and snail survey of 4 counties in the year before the impoundment of Three Gorges reservoir (2002) and the 6th year after the impoundment of Three Gorges reservoir (2008). The fluctuations of water levels of Poyang Lake, flooding day of marshland with snails as well as the changes of the indicators in snail survey and prevention and control measures before and after the impoundment of Three Gorges reservoir were compared., Results: Before the impoundment of Three Gorges reservoir, the fluctuations of average water level of the four hydrological stations around Poyang Lake was 6.91-12.93 m; which reduced to 5.72 - 10.75 m after the impoundment. The D-value of the fluctuations of average water level was (1.06 ± 0.47) m. The date of the annual maximum water level delayed by an average of 12 d; while the date of annual minimum water level arrived an average of 12 d earlier than the impoundment of Three Gorges reservoir. The average flooding days of marshland with snails were separately (100.04 ± 42.06) d before the impoundment and (64.13 ± 22.30) d after the impoundment. The difference was statistically significant (t = 3.70, P < 0.05). The density of snails in the 4 counties around Poyang Lake was 0.8437/0.1 m(2) after the impoundment; declining by 31.04% from the snail density (1.2234/0.1 m(2)) before the impoundment. The density of infectious snails was 0.0014/0.1 m(2) after the impoundment; dropping by 67.34% from it (0.0042/0.1 m(2)) before the impoundment; the infection rate of snails was separately 0.34% after the impoundment and 0.16% before the impoundment. The difference was statistically significant (χ(2) = 53.25, P < 0.05). The coverage rate of chemotherapy increased from 4.45% (35 558/798 200) in 2002 to 9.80% (79 457/810 400) in 2008; the difference was statistically significant (χ(2) = 17 336.63, P < 0.05). The coverage rate of snail killing increased from 1.35% (389.04/28 824.66) in 2002 to 7.49% (2260.90/30 166.22) in 2008; the difference was also statistically significant (χ(2) = 28 824.66, P < 0.05)., Conclusion: The impact of the impoundment of Three Gorges reservoir shortened the flooding days of marshland with snails and helped the prevention and control of schistosomiasis in Poyang Lake regions as the environment went against the breeding of the snails.

Objective: With Landsat TM remote sensing images, snail habitats in Poyang Lake region were identified, using two indices: the modified normalized difference water index (MNDWI) and the normalized difference vegetation index (NDVI)., Methods: Two Remote sensing images of both wet and drought seasons in Poyang Lake region were obtained. MNDWI and NDVI were extracted from the images respectively, to present the regions of "water in summer and land in winter" and the coverage of vegetation. By overlaying those two regions, the areas of potential snail habitats were drawn. Finally, sensitivities and specificities of the recommended methods were assessed and compared to that of the traditional methods for the sake of extracting the areas of snail habitats., Results: The threshold values of MNDWI for the wet and drought seasons were 0.34 and 0.58, respectively and the threshold value for NDVI of the drought season was 0.02. Sensitivity and specificity of our method were 95% and 100%, respectively, higher than the conventional approach (se. = 75%, sp. = 100%)., Conclusion: Joint application of MNDWI and NDVI seemed a better method to detect the snail habitats and could be used for the quantitative and automatic surveillance program on snails.

Objective: To summarize and analyze the process of the changes of schistosomiasis infection and Oncomelania snails in schistosomiasis transmission-controlled areas to explore the rules of the impact of changes of snail indexes on human infection before and after the stage of transmission control, so as to provide the evidence for editing snail indexes in the schistosomiasis controlled criterion and a more scientific, standardized control assessment and evaluation., Methods: Twenty-one schistosomiasis transmission-controlled or transmission-interrupted counties in lake endemic areas and hilly endemic areas in 8 provinces were selected and investigated retrospectively to collect schistosomiasis epidemiological information 10 years before these counties reached the criterion of transmission control and the subsequent years until 2008 or 2009. A " Standard county schistosomiasis epidemic survey data review software" was developed to establish a national epidemic retrospectively database; the trends of changes of snail status, infected snail status and human infection status were analyzed in different years. The trends and rules of the changes of snail areas, emerging snail areas, living snail densities, infected snail densities, snail infection rates and human infection rates were analyzed and compared before and after the counties reached the schistosomiasis transmission-controlled criterion in different types of endemic areas., Results: Before the transmission control, the human infection rate presented a declining trend in endemic areas. In lake endemic areas, the human infection rate declined to below 5% 4 years before the transmission control; in hilly endemic areas, the human infection rate declined to below 3% 8 years before the transmission control, and the human infection rates of the lake and hilly endemic areas declined to 2.10% and 1.45%, respectively, at the year of transmission control. However, 3 to 4 years after transmission control, the disease began to rebound, especially in lake endemic areas. The snail areas and snail densities declined year by year 10 years before the transmission control in the lake and hilly endemic areas, and the proportion of snail areas occupying the historic snail areas declined the lowest, being 2.75% and 0.55%, respectively, at the year of transmission control. The average densities of living snails kept a low level from 3-4 years before the transmission control to 9-10 years after the transmission control, and then rebounded. The new snail areas appeared 6-7 years after the transmission control and the snail areas and densities of living snails rebounded 9-12 years after the transmission control., Conclusions: The snail status can maintain a relatively low level during about 10 years after the transmission control in the lake and hilly schistosomiasis endemic areas, but the schistosomiasis status rebounded 5 years after the transmission control. While the comprehensive measures mainly including infectious source controlled are implemented, the snail surveillance and control should be still strengthened, and it is recommended that "the proportion of snail areas decreased" and "the control of infected snails" would be the indicators of the criterion of schistosomiasis transmission control.

Objective: To analyze the changing rules of schistosomiasis endemic situation in the area of transmission that has been interrupted before and after they reach the criteria of transmission interruption, so as to offer the basis of amending to the criteria of schistosomiasis transmission interruption and a more scientific, standardized assessment and evaluation of the effects of schistosomiasis control in the future., Methods: Nineteen counties of transmission that has been interrupted in 9 provinces nationwide were selected and investigated with the retrospective research method to collect and record the endemic detailed data 10 years before they reach the criteria of transmission interruption and several years later (ended in 2008 or 2009) and then a database was established. The changing rules of various disease indices in different endemic areas before and after reaching the criteria of transmission interruption were analyzed and compared., Results: The average time from the transmission control to the transmission interruption was 17 years in the 17 counties. After reaching the criteria of transmission interruption, the infection rates of people turned down to a minimum level in various endemic areas, the infection rates in a few numbers of lake endemic areas and hilly endemic areas increased slightly after the transmission interruption 4-9 years later, but all of them were below 1%. The densities of living Oncomelania snails in lake endemic areas and water-network endemic areas were high and the changes were great each year, and the densities of living snails were much lower in hilly endemic areas than in the above two types of areas and they came to the lowest 4 years before and after the transmission interruption. The infected snails appeared occasionally in lake endemic areas, and they recurred 6 years and 10 years after the transmission interruption in water-network endemic areas and hilly endemic areas, respectively. The continued time without infected snails found before reaching transmission interruption was 2.71 +/- 1.10 years averagely in transmission-interrupted counties with endemic stable, and was 3. 80 +/- 1.43 years in lake endemic areas., Conclusions: It is possible to maintain a low level of population schistosome infection, and the endemic rebound is shown as snail rebound after the endemic areas reach the criteria of transmission interruption, The infected snails could be the comprehensive index reflecting the control achievement and the risk of schistosomiasis transmission. So the persistent control of infected snails is the fundament of schistosomiasis transmission interruption. It is suggested that in our current social and economic development and science and technology capacity conditions, the status of no infected snails found continuously for 5 years would be one of the criteria of schistosomiasis transmission interruption.

Objective: To study the impact of water level changes on the distribution of snails around lakes, and to study the possibility of forecasting the distribution of snails according to changes of water level reacted by remote sensing images., Methods: All information including water level information of Xingzi Hydrometric Station from 1997 to 2007, twelve TM images of Poyang Lake between 1998 and 2006 were collected. The water areas of Poyang Lake was extracted by MNDWI threshold approach, and the relationships between water areas from TM images and water level from Hydrometric Station was analyzed; Majiawan and Menqiantan marshland of Zhuxi village, Xingzi county was chosen as study pilot to set frames and investigate snails 2991 frames in 2007, and the information of snails of this pilot from 1998 to 2006 was collected to analyze the relationships between snails and water level., Results: The water areas of Poyang Lake extracted from Remote Sensing images from 1998 to 2006 was 1658.73 - 5873.48 km(2), and the corresponding daily water level of Xingzi Hydrometric Station was 9.96 - 21.72 m, according to correlation analysis, they were positive correlation relationship, the correlation coefficient was 0.96 (P < 0.01), and build a model: S = 5189.96 x ln(h) - 10 284.97; the percent of frames with living snail of zhuxi pilot from 1998 - 2007 was 28.33% - 77.46%, the corresponding monthly average water level of last August was 13.19 - 21.96 m, the corresponding highest water level of last year was 15.97 - 21.96 m, according to correlation analysis. The percent of frames with living snail of zhuxi pilot was negatively correlated with the corresponding monthly average water level of last August and the corresponding highest water level of last year, and the correlation coefficient was -0.69 (P < 0.05), and -0.77 (P < 0.01) respectively., Conclusion: Water areas of Poyang Lake extracted from remote sensing images could well express the actual changes of water level, and the highest water level ahead of the year investigating snails influence the distribution of snails, thus we can estimate the distribution of snails around lakes by remote sensing images.

Objective: To study the environmental changes of new snail habitual by using multi-temporal relative radiometric normalized TM images taken in Wuzhoutou of Nanchang, Jiangxi province., Methods: TM images of Poyang Lake were collected on 3rd April 1998, 16th April 2000 and 5th May 2004. Taking images in 2004 as a reference, the TM images in 1998 and 2000 were radiometric normalized. The images were analyzed to trace the vegetation background and snail historical information., Results: The vegetation coverage rate of Wuzhaoutou on April 3rd in 1998 was 4.76%, but the vegetation coverage rates of Wuzhoutou on April 16th in 2000 and May 5th in 2004 were above 80%; the NDVI values of Wuzhoutou on April 3rd in 1998 were around -0.4 to 0.2, but the NDVI values of Wuzhoutou on April 16th in 2000 and May 5th in 2004 were mainly around 0.2 to 0.6, which had statistical difference with that in 1998 (q = 162.285321, P < 0.01 and q = 161.669725, P < 0.01). The greenness of three images have statistical differences(q = 178.679245, P < 0.01; q = 130.320755, P < 0.01 and q = - 48.358491, P < 0.01)., Conclusion: Combining with the snail survey, the TM images could be an effective measure for setting up models to forecast the areas where snails might live to control the Schistosomiasis epidemic.

Background: Due to sustained control activities, the prevalence of Schistosoma japonicum infection in humans, livestock and snails has decreased significantly in P. R. China, and the target has shifted from control to elimination according to the Outline of Healthy China 2030 Plan. Applying highly sensitive methods to explore the presence of S. japonicum infection in its intermediate host will benefit to assess the endemicity or verify the transmission interruption of schistosomiasis accurately. The aim of this study was to access the presence of S. japonicum infection by a loop-mediated isothermal amplification (LAMP) method through a 5-year longitudinal study in five lake provinces along the Yangtze River. Methods: Based on previous epidemiological data, about 260 villages with potential transmission risk of schistosomiasis were selected from endemic counties in five lake provinces along the Yangtze River annually from 2015 to 2019. Snail surveys were conducted in selected villages by systematic sampling method and/or environmental sampling method each year. All live snails collected from field were detected by microscopic dissection method, and then about one third of them were detected by LAMP method to assess the presence of S. japonicum infection with a single blind manner. The infection rate and nucleic acid positive rate of schistosomes in snails, as well as the indicators reflecting the snails' distribution were calculated and analyzed. Fisher's exact test was used to examine any change of positive rate of schistosomes in snails over time. Results: The 5-year survey covered 94,241 ha of environment with 33,897 ha of snail habitats detected accumulatively. Totally 145.3 ha new snail habitats and 524.4 ha re-emergent snail habitats were found during 2015–2019. The percentage of frames with snails decreased from 5.93% [45,152/761,492, 95% confidence intervals (CI): 5.88–5.98%] in 2015 to 5.25% (30,947/589,583, 95% CI: 5.19–5.31%) in 2019, while the mean density of living snails fluctuated but presented a downward trend generally from 0.20 snails/frame (155,622/761,492, 95% CI: 0.17–0.37) in 2015 to 0.13 snails/frame (76,144/589,583, 95% CI: 0.11–0.39) in 2019. A total of 555,393 live snails were collected, none of them was positive by dissection method. Totally 17 pooling snail samples were determined as positives by LAMP method among 8716 pooling samples with 174,822 of living snails, distributed in 12 villages of Hubei, Hunan, Jiangxi and Anhui provinces. The annual average positive rate was 0.41% (95% CI: 0.13–0.69%) in 2015, 0% in 2016, 0.36% (95% CI: 0.09–0.63%) in 2017, 0.05% (95% CI: 0–0.16%) in 2018, 0.05% (95% CI: 0–0.15%) in 2019, respectively, presenting a downward trend from 2015 to 2019 with statistical significance (χ2 = 11.64, P < 0.05). Conclusions: The results suggest that S. japonicum infection still persisted in nature along the Yangtze River and traditional techniques might underestimate the prevalence of schistosomiasis in its intermediate hosts. Exploring and integrating molecular techniques into national surveillance programme could improve the sensitivity of surveillance system and provide guidance on taking actions against schistosomiasis. [ABSTRACT FROM AUTHOR]

China has made remarkable progress in reducing schistosomiasis caused by Schistosoma japonicum over the past 7 decades but now faces a severe threat from imported schistosomiasis. Results from national surveillance during 2010-2018 indicate integrating active surveillance into current surveillance models for imported cases is urgently needed to achieve schistosomiasis elimination in China. [ABSTRACT FROM AUTHOR]