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Purpose: A comprehensive survey was conducted to assess the prevalence of Schistosoma japonicum infection in humans, water buffaloes, and snails in the two endemic municipalities of Talibon and Trinidad in Bohol, Philippines, which are nearing elimination., Methods and Results: Human stool and blood samples were collected from barangays with snail breeding sites, and results showed higher positivity rates using the rSjTPx-1-ELISA compared to the Kato-Katz technique. Human stool examination for showed a 0.57% positivity rate for S. japonicum in San Vicente, Trinidad, while no cases were found in San Roque, Talibon. On the other hand, 3.43% of human serum samples from San Vicente, Trinidad, and 46.20% from San Roque, Talibon tested seropositive. Similarly, water buffalo samples revealed 16.95% seropositivity in Talibon and 10% in Trinidad. Additionally, snail infection was determined microscopically from collected Oncomelania hupensis quadrasi snails in Talibon, but no schistosome parasites were detected in the crushed snail tissues., Conclusion: These findings highlight that despite progress towards elimination, schistosomiasis transmission persists in these areas, emphasizing the need for continued surveillance and targeted interventions., Competing Interests: Declarations. Ethical approval: This study was done following the ethical guidelines for the epidemiological study using human (UPM-REB 2020-761-01) and animal samples (IACUC 2021-004) provided by the University of the Philippines Manila. Consents for sample collection, participation in the study and publication of the results were obtained from human participants and owners of the water buffaloes. Conflict of interest: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Depression is the second leading-cause of disability in China. Although studies have shown that more than 80% of patients with advanced schistosomiasis (AS) suffer from anxiety and depression, these study groups are all hospitalized patients with AS and do not represent the extent of the disease in the whole group. To our knowledge, there are no studies assessing the severity of depression in patients with other forms of schistosomiasis japonicum. Therefore, it is necessary to evaluate the occurrence and potential risk factors of depression in the schistosomiasis endemic population. This cross-sectional study was conducted in Jiangxi Province, where schistosomiasis is relatively common in China, as the investigation site. The Patient Health Questionnaire-9 (PHQ-9) scale was selected to assess the depressive symptoms in the study population. At the same time, basic personal information of the research subjects and relevant socio-economics and schistosomiasis endemic area indicators were collected. The survey results show that AS has the highest incidence of depression (34.35%), while non-advanced schistosomiasis (N-AS) and control group (CG) have 22.35% and 22.24% respectively; the incidence of depression in AS is significantly higher than in N-AS and CG, while there is no statistical significance in the comparison between N-AS and CG; the incidence of mild depressive symptoms accounts for 61.08%-75.54% of the total incidence of depression in different groups; multivariate analysis shows that the occurrence of moderate/severe depressive symptoms in the AS group was significantly related to above 60 years old, male, the combination of other serious diseases, personal financial difficulties, and marshland and lake endemic areas. In the N-AS group, the occurrence of moderate/severe depressive symptoms was significantly related to the combination of other serious diseases, personal financial difficulties, significant correlation between marshland and lake endemic areas and the level of control of schistosomiasis epidemics. In conclusion, depression is still relatively common among patients with schistosomiasis patients, especially those with AS. It is recommended that the government and relevant departments consider mental health care when developing prevention and control work in schistosomiasis-endemic areas, in order to effectively protect the physical and mental health of schistosomiasis patients and residents in endemic areas., (© 2024. The Author(s).)

Background: Schistosomiasis is a global public health issue. In China, while the seroprevalence of Schistosomiasis japonica has currently reduced to a relatively low level, risk of infection still exists in certain areas. However, there has been a lack of comprehensive research on the long-term trends of national seroprevalence, changes across age groups, and characteristics in spatial distribution, which is crucial for effectively targeting interventions and achieving the goal of eliminating schistosomiasis by 2030. Our study aimed to address this gap by analyzing the long-term trends of Schistosomiasis japonica seroprevalence in China from 1982 to 2020 based on the data from diverse sources spanning a period of 39 years., Methodology: Seroprevalence data were collected from literature databases and national schistosomiasis surveillance system. Meta-analysis was conducted to estimate the seroprevalence. Joinpoint model was used to identify changing trend and inflection point. Inverse distance weighted interpolation was used to determine the spatial distribution of seroprevalence., Principal Findings: The seroprevalence decreased from 34.8% in 1982 to 2.4% in 2020 in China. Before 2006, the seroprevalence was higher in the middle age group, and a pattern of increasing with age was observed afterwards. The areas with high seroprevalence existed in Dongting Lake, Poyang Lake, Jianghan Plain, the Anhui branch of the Yangtze River and some localized mountainous regions in Sichuan and Yunnan provinces., Conclusions/significance: There was a significant decline in the seroprevalence of Schistosomiasis japonica from 1982 to 2020 in China. Nevertheless, schistosomiasis has not been eradicated; thus, implementing precise and personalized monitoring measures is crucial for the elimination of schistosomiasis, especially in endemic areas and with a particular focus on the elderly., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Zhou et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Schistosomiasis is a significant public health threat, and Oncomelania hupensis is the only intermediate host for schistosoma japonicum. We conducted 12-year monthly repeated surveys to explore the interactive and lag effects of environmental factors on snail density and to monitor their long-term and seasonal trends in a bottomland around the Dongting Lake region in China. Relevant environmental data were obtained from multiple sources. A Bayesian kernel machine regression model and a Bayesian temporal model combined with a distributed lag model were constructed to analyze interactive and lag effects of environmental factors on snail density. The results indicated the average annual snail density in the study site exhibited an increasing and then decreasing trend, peaking in 2013. Snail densities were the highest in October and the lowest in January in a year. Normalized Difference Vegetation Index (NDVI) and water level were the most effective predictors of snail density, with potential interactions among temperature, precipitation, and NDVI. The mean minimum temperature in January, water level, precipitation and NDVI were positively correlated with snail density at lags ranging from 1 to 4 months. These findings could serve as references for relevant authorities to monitor the changing trend of snail density and implement control measures, thereby reducing the occurrence of schistosomiasis., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Oncomelania hupensis is the exclusive intermediate host of Schistosoma japonicum in China. Snail control is an essential component of schistosomiasis elimination programme. With 70 years of continuous efforts, the range of O. hupensis had reduced significantly, but slowed down in last decades. A large number of levees against flooding were constructed along Yangtze River and its affiliated lakes in the middle and lower reaches, which influenced the hydrology and ecology in the alluvial plains. The purpose of this study was to assess the impact of levees on the distribution of O. hupensis in the middle and lower reaches of the Yangtze River., Methods: The snail habitats were digitalised by hand-held GPS system. The years for discovery and elimination of snail habitats were extracted from historical records. The accumulated snail-infested range for each habitat was calculated on the basis of annual reports. The current distribution of O. hupensis was determined by systematic and environmental sampling. The geographical distribution of levees was obtained from satellite imagery. To assess the impact of levees, the data pertaining to O. hupensis were divided into two parts: inside and outside the Yangtze River. Joinpoint regression was utilised to divide the study time span and further characterise the regression in each period. The 5-year-period moving averages of eliminated area infested by snails were calculated for the habitats inside and outside Yangtze River. The moving routes of corresponding geographical median centres were simulated in ArcGIS. Hotspot analysis was used to determine the areas with statistical significance clustering of O. hupensis density., Results: Three periods were identified according to Joinpoint regression both inside and outside Yangtze River. The area infested by O. hupensis increased in the first two periods. It decreased rapidly outside Yangtze River year over year after 1970, while that inside the Yangtze River did not change significantly. Furthermore, the latter was significantly higher than the former. It was observed that the present density of O. hupensis inside Yangtze River was lower than outside the Yangtze River. The median centre for eliminated ranges inside Yangtze River wavered between the east (lower reach) and the west (middle reach). In contrast, the median centre for eliminated ranges continuously moved from the east to the west., Conclusions: Our findings indicated that the levees had a considerable negative impact on the distribution of O. hupensis outside Yangtze River. Some hotspots observed in the irrigation areas need a sluice system at the inlet of branch for snail control. The major distribution of O. hupensis located in Hubei might be caused by severe waterlogging. The intensive surveillance should be implemented there. The biggest two freshwater lakes, the major endemic regions historically, were identified as cold spots. The long-term impact of Three Gorges Dam on the distribution of O. hupensis in the lakes should be monitored and evaluated., (© 2024. The Author(s).)

Purpose: The Government of Indonesia committed to eliminating schistosomiasis by 2025. Collaboratively snail control became one of the crucial strategies to ensure that the prevalence of Schistosoma japonicum in Oncomelania hupensis lindoensis reaches zero by the end of the program. This research investigated the spatial cluster change of S. japonicum transmission foci in Indonesia between 2017 and 2021., Methods: We mapped the snail foci, collected the snails, and calculated the snail density. We also conducted laboratory tests to detect the existence of cercariae in the snails. Identified infected snails were used to calculate the infection rate (IR) or snails' prevalence of schistosome cercariae among freshwater snails. We then analysed the spatial cluster using the Getis-Ord Gi* statistic to identify the hot and cold spots., Results: The 5-year schistosomiasis elimination program successfully declined 18.84% of the snail foci and reduced 40.37% of the infected snail foci. Local spatial autocorrelation of snail density and infection rate identified that in 2017 and 2021, the number of cold spots decreased by 53.91% and 0%, while hot spots increased by 2.63% and 56.1%. The presence of more hot spots suggests a rise in the number of foci with high snail density and infection rates. The implementation of snail control was not optimal, and the parasite transmission through domestic animals still existed, causing the spatial cluster of hot spots to change during this period. Most hotspots have been observed near settlements, primarily in cocoa plantations, developed and deserted rice fields, grassland, and bush wetlands., Conclusion: During the schistosomiasis elimination program, the number of hot spots increased while cold spots decreased, and there were notable changes in the geographical distribution of hot spots, indicating a shift in the clustering pattern of schistosomiasis cases. The findings become essential for policymakers, particularly in selecting priority areas for intervention. In the Discussion section, we demonstrated the selection process based on the existence of hot and cold spots. Furthermore, we proposed that enhancing cross-sector integration is crucial, particularly in connection with the management of S. japonicum transmission through domestic animals., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

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.

Bovines are important reservoir hosts of schistosomiasis, placing humans and animals in rice fields areas at risk of infection. This study reported the prevailing infection of zoonotic parasites from bovine feces in the rice fields adjacent to Lake Mainit, Philippines. Formalin Ethyl Acetate Sedimentation was performed on 124 bovine fecal samples from rice fields and documented eggs and cysts from seven parasites: Schistosoma japonicum, Fasciola gigantica, Ascaris sp., Strongyloides sp., Balantidium coli, coccidian oocyst and a hookworm species. Among these parasites, F. gigantica harboured the highest infection with a 100% prevalence rate, followed by hookworms (51.61%), B. coli (30.64%) and S. japonicum (12.09%), respectively. The intensity of infection of S. japonicum eggs per gram (MPEG = 4.19) among bovines is categorized as ‘light.’ Bovine contamination index (BCI) calculations revealed that, on average, infected bovines in rice fields excrete 104 750 S. japonicum eggs daily. However, across all ricefield stations, bovines were heavily infected with fascioliasis with BCI at 162 700 F. gigantica eggs per day. The study reports that apart from the persistent cases of schistosomiasis in the area, bovines in these rice fields are also heavily infected with fascioliasis. The study confirms the critical role of bovines as a reservoir host for continued infection of schistosomiasis, fascioliasis and other diseases in the rice fields of Lake Mainit. Immediate intervention to manage the spread of these diseases in bovines is recommended.

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.

Background: Although the presence of intermediate snails is a necessary condition for local schistosomiasis transmission to occur, using them as surveillance targets in areas approaching elimination is challenging because the patchy and dynamic quality of snail host habitats makes collecting and testing snails labor-intensive. Meanwhile, geospatial analyses that rely on remotely sensed data are becoming popular tools for identifying environmental conditions that contribute to pathogen emergence and persistence., Methods: In this study, we assessed whether open-source environmental data can be used to predict the presence of human Schistosoma japonicum infections among households with a similar or improved degree of accuracy compared to prediction models developed using data from comprehensive snail surveys. To do this, we used infection data collected from rural communities in Southwestern China in 2016 to develop and compare the predictive performance of two Random Forest machine learning models: one built using snail survey data, and one using open-source environmental data., Results: The environmental data models outperformed the snail data models in predicting household S. japonicum infection with an estimated accuracy and Cohen's kappa value of 0.89 and 0.49, respectively, in the environmental model, compared to an accuracy and kappa of 0.86 and 0.37 for the snail model. The Normalized Difference in Water Index (an indicator of surface water presence) within half to one kilometer of the home and the distance from the home to the nearest road were among the top performing predictors in our final model. Homes were more likely to have infected residents if they were further from roads, or nearer to waterways., Conclusion: Our results suggest that in low-transmission environments, leveraging open-source environmental data can yield more accurate identification of pockets of human infection than using snail surveys. Furthermore, the variable importance measures from our models point to aspects of the local environment that may indicate increased risk of schistosomiasis. For example, households were more likely to have infected residents if they were further from roads or were surrounded by more surface water, highlighting areas to target in future surveillance and control efforts., (© 2023. The Author(s).)

Background: Schistosoma japonicum remains endemic in China and the Philippines. Substantial progress has been made in the control of Japonicum in both China and the Philippines. China is reaching elimination thanks to a concerted effort of control strategies. Mathematical modelling has been a key tool in the design of control strategies, in place of expensive randomised-controlled trials. We conducted a systematic review to investigate mathematical models of Japonicum control strategies in China and the Philippines., Methods: We conducted a systematic review on July 5, 2020, in four electronic bibliographic databases - PubMed, Web of Science, SCOPUS and Embase. Articles were screened for relevance and for meeting the inclusion criteria. Data extracted included authors, year of publication, year of data collection, setting and ecological context, objectives, control strategies, main findings, the form and content of the model including its background, type, representation of population dynamics, heterogeneity of hosts, simulation period, source of parameters, model validation and sensitivity analysis. Results After screening, 19 eligible papers were included in the systematic review. Seventeen considered control strategies in China and two in the Philippines. Two frameworks were identified; the mean-worm burden framework and the prevalence-based framework, the latter of which increasingly common. Most models considered human and bovine definitive hosts. There were mixed additional elements included in the models, such as alternative definitive hosts and the role of seasonality and weather. Models generally agreed upon the need for an integrated control strategy rather than reliance on mass drug administration alone to sustain reductions in prevalence., Conclusions: Mathematical modelling of Japonicum has converged from multiple approaches to modelling using the prevalence-based framework with human and bovine definitive hosts and find integrated control strategies to be most effective. Further research could investigate the role of other definitive hosts and model the effect of seasonal fluctuations in transmission., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)

Objective: Schistosomiasis is a neglected tropical parasitic disease caused by blood flukes of the genus Schistosoma. Schistosoma japonicum is zoonotic in China, the Philippines, and Indonesia, with bovines acting as major reservoirs of human infection. The primary objective of the trial was to examine the impact of a combination of human mass chemotherapy, snail control through mollusciciding, and SjCTPI bovine vaccination on the rate of human infection., Methods: A 5-year phase IIIa cluster randomized control trial was conducted among 18 schistosomiasis-endemic villages comprising 18,221 residents in Northern Samar, The Philippines., Results: Overall, bovine vaccination resulted in a statistically significant decrease in human infection (relative risk [RR] = 0.75; 95% confidence interval [CI] = 0.69 to 0.82) across all trial follow-ups. The best outcome of the trial was when bovine vaccination was combined with snail mollusciciding. This combination resulted in a 31% reduction (RR = 0.69; 95% CI = 0.61 to 0.78) in human infection., Conclusion: This is the first trial to demonstrate the effectiveness of a bovine vaccine for schistosomiasis in reducing human schistosome infection. The trial is registered with Australian New Zealand Clinical Trials Registry (ACTRN12619001048178)., Competing Interests: Declaration of competing interest The authors have no competing interests to declare., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Schistosoma japonicum is one of the major infectious agents of human schistosomiasis, mainly endemic in China and the Philippines. We have previously reported the finding of two schistosome isolates, each with a different cercarial emergence pattern adapted to their different hosts. However, there are currently no whole-genome sequencing studies to investigate the underlining genetics of the adaptive traits. We sampled schistosomes in 2013 and 2020 from a hilly area Shitai (ST) and a marshland area Hexian (HX) of Anhui, China. Ten to 15 male or female adult worms from each site/year were sent for whole genome sequencing. Genetics were analyzed, and selection signals along genomes were detected. Gene enrichment analysis was performed for the genome regions under selection. The results revealed considerable genetic differentiation between the two isolates. The genome "windows" affected by natural selection were fewer in ST (64 windows containing 78 genes) than in HX (318 windows containing 276 genes). Twelve significantly enriched genes were identified in ST, but none in HX. These genes were mainly related to specific DNA binding and intercellular signaling transduction. Some functional region changes identified along the genome of the hilly schistosome may be related to its unique late afternoon cercarial emergence., (© H.-Y. Sun et al., published by EDP Sciences, 2023.)

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.

In China, bovines are believed to be the most common animal source of human schistosomiasis infections, though little is known about what factors promote bovine infections. The current body of literature features inconsistent, and sometimes contradictory results, and to date, few studies have looked beyond physical characteristics to identify the broader environmental conditions that predict bovine schistosomiasis. Because schistosomiasis is a sanitation-related, water-borne disease transmitted by many animals, we hypothesised that several environmental factors - such as the lack of improved sanitation systems, or participation in agricultural production that is water-intensive - could promote schistosomiasis infection in bovines. Using data collected as part of a repeat cross-sectional study conducted in rural villages in Sichuan, China from 2007 to 2016, we used a Random Forests, machine learning approach to identify the best physical and environmental predictors of bovine Schistosoma japonicum infection. Candidate predictors included: (i) physical/biological characteristics of bovines, (ii) human sources of environmental schistosomes, (iii) socio-economic indicators, (iv) animal reservoirs, and (v) agricultural practices. The density of bovines in a village and agricultural practices such as the area of rice and dry summer crops planted, and the use of night soil as an agricultural fertilizer, were among the top predictors of bovine S. japonicum infection in all collection years. Additionally, human infection prevalence, pig ownership and bovine age were found to be strong predictors of bovine infection in at least 1 year. Our findings highlight that presumptively treating bovines in villages with high bovine density or human infection prevalence may help to interrupt transmission. Furthermore, village-level predictors were stronger predictors of bovine infection than household-level predictors, suggesting future investigations may need to apply a broad ecological lens to identify potential underlying sources of persistent transmission., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

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.

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 (χ 2  = 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., (© 2022. The Author(s).)

The construction of spatio-temporal models can be either descriptive or dynamic. In this study we aim to evaluate the differences in model fitting between a descriptive model and a dynamic model of the transmission for intestinal schistosomiasis caused by Schistosoma japonicum in Guichi, Anhui Province, China. The parasitological data at the village level from 1991 to 2014 were obtained by cross-sectional surveys. We used the fixed rank kriging (FRK) model, a descriptive model, and the integro-differential equation (IDE) model, a dynamic model, to explore the space-time changes of schistosomiasis japonica. In both models, the average daily precipitation and the normalized difference vegetation index are significantly positively associated with schistosomiasis japonica prevalence, while the distance to water bodies, the hours of daylight and the land surface temperature at daytime were significantly negatively associated. The overall root mean square prediction error of the IDE and FRK models was 0.0035 and 0.0054, respectively, and the correlation reflected by Pearson's correlation coefficient between the predicted and observed values for the IDE model (0.71; p<0.01) was larger than that for the FRK model (0.53; p=0.02). The IDE model fits better in capturing the geographic variation of schistosomiasis japonica. Dynamic spatio-temporal models have the advantage of quantifying the process of disease transmission and may provide more accurate predictions., (© The Author(s) 2021. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)

Background: We compared individuals' self-reported water contact from a questionnaire to direct observation of water contact. Questionnaires that accurately capture water contact are necessary to risk-stratify individuals and communities at high risk for schistosomiasis., Methods: Individuals (N=677) ages 7-30 y were included from three Schistosoma japonicum-endemic villages in Leyte, The Philippines. Each individual was observed for 12 d over the course of the 18-month study and the questionnaire was administered six times. A questionnaire index was derived that captured the number of self-reported contacts with water bodies for any purpose. An exposure index was created based on the sum of contacts that was weighted by the percentage of body surface area (BSA) exposed and exposure duration., Results: Of 16 water contact activities, only bathing and washing clothes exhibited a significant, positive correlation between self-reported contacts and the observed exposure index related to those contacts., Conclusions: We found that only the reported frequencies of bathing and washing clothes were significantly related to an individual's overall observed exposure index, while use of all reported contacts was not related to the observed exposure. This study further supports the need for questionnaires to be augmented by some measure of how much BSA is exposed and/or time is spent in the water on average for a specific activity., (© The Author(s) 2021. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)

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.

Background: Schistosoma japonicum was once one of the most severe parasitic diseases in China. After 70 years of national schistosomiasis control programmes, the prevalence and associated morbidity of the infection have been reduced to a much lower level. However, due to the low sensitivity of the current detection approaches, many minor infections in humans could not be identified and ultimately develop chronic injuries with liver abnormalities, a specific 'network' echogenic pattern under ultrasonography. Therefore, as more people take part in physical examinations, we performed this meta-analysis to estimate the overall prevalence of schistosomiasis-associated liver abnormalities in China., Methods: The publications were searched systematically across five electronic databases. All eligible studies were assessed with quality evaluation forms. Heterogeneity of studies was determined using the I 2 and Q tests. A random effects or fixed effects model was employed based on heterogeneity results. The pooled prevalence and its 95% confidence intervals were calculated with the Freeman-Tukey double arcsine transformation. All analyses were conducted using R with the "meta" package. The protocol registration number was CRD42021232982., Results: A total of 19 relevant articles, including 21 studies, were included. The average score of study quality was 6.4 (total score 7), indicating high quality of all included studies. A total of 268, 247 persons were included, and 43, 917 persons were diagnosed with schistosomiasis liver abnormalities by ultrasonography. High degrees of heterogeneity existed among all studies or within subgroups. The overall pooled prevalence was 18.64% (95% CI: 11.88-26.50%). The estimate significantly increased over time and varied among provinces, with the highest in Shanghai and the lowest in Sichuan. The estimate in people aged 60 years or older was significantly higher than that in people of all ages. No significant difference was seen when based on study areas (urban or rural areas) or gender., Conclusion: The long-term burden of schistosomiasis in China remains large, as nearly one-fifth of the examined persons were diagnosed with schistosomiasis liver abnormalities. The pooled prevalence was associated with regions or age groups. Such may have a high reference value in the exact calculation of the disease burden and can be helpful for policy makers in prioritizing public health., (© 2022. The Author(s).)

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.

Schistosomiasis has been subjected to extensive control efforts in the People's Republic of China (China) which aims to eliminate the disease by 2030. We describe baseline results of a longitudinal cohort study undertaken in the Dongting and Poyang lakes areas of central China designed to determine the prevalence of Schistosoma japonicum in humans, animals (goats and bovines) and Oncomelania snails utilizing molecular diagnostics procedures. Data from the Chinese National Schistosomiasis Control Programme (CNSCP) were compared with the molecular results obtained.Sixteen villages from Hunan and Jiangxi provinces were surveyed; animals were only found in Hunan. The prevalence of schistosomiasis in humans was 1.8% in Jiangxi and 8.0% in Hunan determined by real-time polymerase chain reaction (PCR), while 18.3% of animals were positive by digital droplet PCR. The CNSCP data indicated that all villages harboured S. japonicum-infected individuals, detected serologically by indirect haemagglutination assay (IHA), but very few, if any, of these were subsequently positive by Kato-Katz (KK).Based on the outcome of the IHA and KK results, the CNSCP incorporates targeted human praziquantel chemotherapy but this approach can miss some infections as evidenced by the results reported here. Sensitive molecular diagnostics can play a key role in the elimination of schistosomiasis in China and inform control measures allowing for a more systematic approach to treatment.

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.

Background: Zoonotic schistosomiasis, caused by Schistosoma japonicum, remains a major public health problem in the Philippines. This study aimed to evaluate the commercially available rapid diagnostic point-of-care circulating cathodic antigen (POC-CCA) test in detecting individuals infected with S. japonicum in a human cohort from an endemic area for schistosomiasis japonica in the Philippines., Methods: Clinical samples were collectedin 18 barangays endemic for S. japonicum infection in Laoang and Palapag municipalities, Northern Samar, the Philippines, in 2015. The presence of CCA in filter-concentrated urine samples (n = 412) was evaluated using the commercial kits and the results were converted to images, which were further analyzed by ImageJ software to calculate R values. The diagnostic performance of the immunochromatographic POC-CCA test was compared using the Kato-Katz (KK) procedure, in-house enzyme-linked immunosorbent assays (ELISAs) and droplet digital (dd) PCR assays as reference., Results: The POC-CCA test was able to detect S. japonicum-infected individuals in the cohort with an eggs per gram of faeces (EPG) more than or equal to 10 with sensitivity/specificity values of 63.3%/93.3%. However, the assay showed an inability to diagnose schistosomiasis japonica infections in all cohort KK-positive individuals, of which the majority had an extremely low egg burden (EPG: 1-9). The prevalence of S. japonicum infection in the total cohort determined by the POC-CCA test was 12.4%, only half of that determined by the KK method (26.2%). When compared with the ELISAs and ddPCR assays as a reference, the POC-CCA assay was further shown to be a test with low sensitivity. Nevertheless, the assay exhibited significant positive correlations with egg burden determined by the KK technique and the target gene copy number index values determined by the ddPCR assays within the entire cohort., Conclusions: By using in silico image analysis, the POC-CCA cassette test could be converted to a quantitative assay to avoid reader-variability. Because of its low sensitivity, the commercially available POC-CCA assay had limited potential for determining the status of a S. japonicum infection in the target cohort. The assay should be applied with caution in populations where schistosome parasites (especially S. japonicum) are present at low infection intensity., (© 2021. The Author(s).)

In the past decade, ecological surveys emphasized rats and dogs as the most significant animal reservoirs for Schistosoma japonicum (S.j) in the Philippines. However, recent studies demonstrated 51-91% prevalence of schistosomiasis among water buffalo using qPCR in the Sj endemic regions in the Philippines. In order to resolve the inconsistency of reported surveys regarding Sj endemicity among carabao, a domestic water buffalo that is the most important draught animal, we introduced 42 schistosome negative water buffalo to Macanip, Jaro municipality, Leyte, the Philippines, a subsistence rice-farming village that has been the focus of schistosomiasis japonica studies of our group for the past 20 years. We conducted perfusion to the remaining 34 buffalo that survived 10 months of nature exposure and Typhoon Haiyan. Thirty-three water buffalo were found to be positive with at least 1 pair of worms from the mesenteric vein. The infection rate is 97%, with the worm burden of 94 (95% confidence interval, 49-138 worms) worms. To our knowledge, this is the first report about S. japonicum worm burden in naturally infected water buffalo in the Philippines. The fact that with less than one-year of exposure, in this human schistosomiasis endemic area, only 1 out of 34 water buffalo was uninfected is striking. Urgent attention is needed for a cost-effective technique for monitoring Sj infection in animals and humans. Meanwhile, intervention implementation, including water buffalo treatment and vaccination, should be taken into consideration., Competing Interests: The authors have declared that no competing interests exist. Author Remigio Olveda was unable to confirm their authorship contributions. On their behalf, the corresponding author has reported their contributions to the best of their knowledge.

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.

Urbanization increases human mobility in ways that can alter the transmission of classically rural, vector-borne diseases like schistosomiasis. The impact of human mobility on individual-level Schistosoma risk is poorly characterized. Travel outside endemic areas may protect against infection by reducing exposure opportunities, whereas travel to other endemic regions may increase risk. Using detailed monthly travel- and water-contact surveys from 27 rural communities in Sichuan, China, in 2008, we aimed to describe human mobility and to identify mobility-related predictors of S. japonicum infection. Candidate predictors included timing, frequency, distance, duration, and purpose of recent travel as well as water-contact measures. Random forests machine learning was used to detect key predictors of individual infection status. Logistic regression was used to assess the strength and direction of associations. Key mobility-related predictors include frequent travel and travel during July-both associated with decreased probability of infection and less time engaged in risky water-contact behavior, suggesting travel may remove opportunities for schistosome exposure. The importance of July travel and July water contact suggests a high-risk window for cercarial exposure. The frequency and timing of human movement out of endemic areas should be considered when assessing potential drivers of rural infectious diseases., (© The Author(s) 2021. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

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.

Background: Schistosomiasis japonica remains an important public health concern due to its potential to cause severe outcomes and long-term sequelae. An integrated control strategy implemented in the Peoples' Republic of China has been shown to be effective to control or interrupt the transmission of schistosomiasis. The objective of this study is to estimate the disease burden of schistosomiasis and assess the cost-effectiveness of the integrated control strategy focused on different major interventions at three stages for schistosomiasis control in a lake setting, to provide reference for policy making or planning., Methods: Annual cost data of schistosomiasis control during 2009-2019 were obtained from the control program implementers in Jiangling County, Hubei Province, China. Economic costs are provided in constant 2009 Chinese Yuan (CNY). Epidemiological data of schistosomiasis were collected from the Jiangling county station for schistosomiasis control. Disease burden of schistosomiasis was assessed by calculating years of life lost (YLLs) owing to premature death, years lived with disability (YLDs) and disability-adjusted life years (DALYs). DALYs were calculated as the sum of YLLs and YLDs. We then conducted a rudimentary cost-effectiveness analysis by determining the ratio by dividing the difference between the average cost of integrated control strategy at transmission control (2013-2016) or transmission interruption (2017-2019) and the average cost at stage of infection control (2009-2012) with the difference between the DALYs of schistosomiasis at different control stages. Descriptive statistics on the costs and DALYs were used in the analysis., Results: The total economic costs for schistosomiasis control in Jiangling County from 2009 to 2019 were approximately CNY 606.88 million. The average annual economic costs for schistosomiasis prevention and control at stages of infection control (2009-2012), transmission control (2013-2016), and transmission interruption (2017-2019) were approximately CNY 41.98 million, CNY 90.19 million and CNY 26.06 million respectively. The overall disease burden caused by schistosomiasis presented a downward trend. Meanwhile, the disease burden of advanced cases showed an upward trend with the DALY increased from 943.72 to 1031.59 person-years. Most disease burden occurred in the age group over 45 years old (especially the elderly over 60 years old). Taking the infection control stage as the control, the incremental cost-effectiveness ratio of integrated control strategy was CNY 8505.5 per case averted, CNY 60 131.6 per DALY decreased at transmission control stage and CNY -2217.6 per case averted, CNY -18 116.0 per DALY decreased at transmission interruption stage., Conclusions: The disease burden of schistosomiasis decreased significantly with the implementation of the integrated prevention and control strategy. Surveillance and management on elder population should be strengthened to decrease diseases burden. There remains a need for well-conducted studies that examine the long-term cost-effectiveness of the integrated control strategy for schistosomiasis. GRAPHIC ABSTARCT.

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.

Schistosomiasis persists in Asian regions despite aggressive elimination measures. To identify factors enabling continued parasite transmission, we performed reduced representation genome sequencing on Schistosoma japonicum miracidia collected across multiple years from transmission hotspots in Sichuan, China. We discovered strong geographic structure, suggesting that local, rather than imported, reservoirs are key sources of persistent infections in the region. At the village level, parasites collected after referral for praziquantel treatment are closely related to local pre-treatment populations. Schistosomes within villages are also highly related, suggesting that only a few parasites from a limited number of hosts drive re-infection. The close familial relationships among miracidia from different human hosts also implicate short transmission routes among humans. At the individual host level, genetic evidence indicates that multiple humans retained infections following referral for treatment. Our findings suggest that end-game schistosomiasis control measures should focus on completely extirpating local parasite reservoirs and confirming successful treatment of infected human hosts.

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.

Schistosomiasis is an acute and chronic parasitic disease caused by blood flukes (trematode worms) of the genus Schistosoma. Schistosoma japonicum (S. japonicum) infection has decreased significantly in prevalence and intensity of infection in China. However, this disease still remains a serious public health problem in some endemic areas of the Philippines and Indonesia. Thus, more accurate and sensitive methods are much needed for further control of this disease. Here, we review the research progress in techniques for the diagnosis of S. japonicum infection., (Copyright © 2020. Published by Elsevier B.V.)

Schistosomiasis japonica is an ancient parasitic disease that has severely impacted human health causing a substantial disease burden not only to the Chinese people but also residents of other countries such as the Philippines, Indonesia and, before the 1970s, Japan. Since the founding of the new People's Republic of China (P. R. China), effective control strategies have been implemented with the result that the prevalence of schistosomiasis japonica has decreased markedly in the past 70 years. Historically, the Dongting Lake region in Hunan province is recognised as one of the most highly endemic for schistosomiasis in the P.R. China. The area is characterized by vast marshlands outside the lake embankments and, until recently, the presence of large numbers of domestic animals such as bovines, goats and sheep that can act as reservoir hosts for Schistosoma japonicum . Considerable social, economic and environmental changes have expanded the Oncomelania hupensis hupensis intermediate snail host areas in the Dongting lake region increasing the potential for both the emergence of new hot spots for schistosomiasis transmission, and for its re-emergence in areas where infection is currently under control. In this paper, we review the history, the current endemic status of schistosomiasis and the control strategies in operation in the Dongting Lake region. We also explore epidemiological factors contributing to S. japonicum transmission and highlight key research findings from studies undertaken on schistosomiasis mainly in Hunan but also other endemic Chinese provinces over the past 10 years. We also consider the implications of these research findings on current and future approaches that can lead to the sustainable integrated control and final elimination of schistosomiasis from the P. R. China and other countries in the region where this unyielding disease persists., (Copyright © 2020 Li, Hou, Tan, Williams, Gray, Gordon, Kurscheid, Clements, Li and McManus.)

Objectives: Progress in national schistosomiasis control in China has successfully reduced disease transmission in many districts. However, a low transmission rate hinders conventional snail surveys in identifying areas at risk. In this study, Schistosoma japonicum-infected sentinel mice surveillance was conducted to identify high-risk areas of schistosomiasis transmission in Hubei province, China., Methods: The risk of schistosomiasis transmission was assessed using sentinel mice monitoring in Hubei province from 2010 to 2018. Field detections were undertaken in June and September, and the sentinel mice were kept for approximately 35 days in a laboratory. They were then dissected to determine whether schistosome infection was present. Ripley's K-function and kernel density estimation were applied to analyze the spatial distribution and positive point pattern of schistosomiasis transmission., Results: In total, 190 sentinel mice surveillance sites were selected to detect areas of schistosomiasis infection from 2010 to 2018, with 29 (15.26%) sites showing infected mice. Of 4723 dissected mice, 256 adult worms were detected in 112 infected mice. The infection rate was 2.37%, with an average of 2.28 worms detected per infected mouse. Significantly more infected mice were detected in the June samples than in the September samples (χ 2 =12.11, p<0.01). Ripley's L(d) index analysis showed that, when the distance was ≤34.52km, the sentinel mice infection pattern showed aggregation, with the strongest aggregation occurring at 7.86km. Three hotspots were detected using kernel density estimation: at the junction of Jingzhou District, Gong'an County, and Shashi District in Jingzhou City; in Wuhan City at the border of the Huangpi and Dongxihu Districts, and in the Hannan and Caidian Districts., Conclusion: The results showed that sentinel mice surveillance is useful in identifying high-risk areas, and could provide valuable information for schistosomiasis prevention and control, especially concerning areas along the Yangtze River, such as the Fu-Lun, Dongjing-Tongshun, and Juzhang River basins., (Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

China once suffered greatly from schistosomiasis japonica, a major zoonotic disease. Nearly 70 years of multidisciplinary efforts have achieved great progress in disease control, with infections in both humans and bovines significantly reduced to very low levels. However, reaching for the target of complete interruption of transmission at the country level by 2030 still faces great challenges, with areas of ongoing endemicity and/or re-emergence within previously 'eliminated' regions. The objectives of this study were, by using meta-analytical methods, to estimate the overall prevalence of Schistosoma japonicum infections in abundant commensal rodent species in mainland China after the introduction of praziquantel for schistosomiasis treatment in humans and bovines in 1980s. In doing so we thereby aimed to further assess the role of wild rodents as potential reservoirs in ongoing schistosome transmission. Published studies on infection prevalence of S. japonicum in wild rodents in mainland China since 1980 were searched across five electronic bibliographic databases and lists of article references. Eligible studies were selected based on inclusion and exclusion criteria. Risks of within and across study biases, and the variations in prevalence estimates attributable to heterogeneities were assessed. The pooled infection prevalence and its 95% confidence intervals (CIs) were calculated with the Freeman-Tukey double arcsine transformation. We identified a total of 37 relevant articles involving 61 field studies which contained eligible data on 8,795 wild rodents across mainland China. The overall pooled infection prevalence was 3.86% (95% CI: 2.16-5.93%). No significant change in the overall pooled prevalence was observed between 1980-2003 (n = 23 studies) and 2004-current (n = 38 studies). However, whilst the estimated prevalence decreased over time in the marshland and lake regions, there was an apparent increase in prevalence within hilly and mountainous regions. Among seven provinces, a significant prevalence reduction was only seen in Jiangsu where most endemic settings are classified as the marshland and lakes. These estimates changed over season, ranging from 0.58% in spring to 22.39% in winter, in association with increases in rodent density. This study systematically analyzed S. japonicum infections in wild rodents from the published literature over the last forty years after the introduction of praziquantel for schistosomiasis treatment in humans and bovines in 1980s. Although numbers of schistosomiasis cases in humans and bovines have been greatly reduced, no such comparable overall change of infection prevalence in rodents was detected. Furthermore, there appeared to be an increase in S. japonicum prevalence in rodents over time within hilly and mountainous regions. Rodents have been projected to become the dominant wildlife in human-driven environments and the main reservoir of zoonotic diseases in general within tropical zones. Our findings thus suggest that it is now necessary to include monitoring and evaluation of potential schistosome infection within rodents, particularly in hilly and mountainous regions, if we are ever to reach the new 2030 elimination goals and to maximize the impact of future public, and indeed One Health, interventions across, regional, national and international scales., Competing Interests: The authors have declared that no competing interests exist.

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.

Background: The modifiable areal unit problem (MAUP) arises when the support size of a spatial variable affects the relationship between prevalence and environmental risk factors. Its effect on schistosomiasis modelling studies could lead to unreliable parameter estimates. The present research aims to quantify MAUP effects on environmental drivers of Schistosoma japonicum infection by (i) bringing all covariates to the same spatial support, (ii) estimating individual-level regression parameters at 30 m, 90 m, 250 m, 500 m and 1 km spatial supports, and (iii) quantifying the differences between parameter estimates using five models., Methods: We modelled the prevalence of Schistosoma japonicum using sub-provinces health outcome data and pixel-level environmental data. We estimated and compared regression coefficients from convolution models using Bayesian statistics., Results: Increasing the spatial support to 500 m gradually increased the parameter estimates and their associated uncertainties. Abrupt changes in the parameter estimates occur at 1 km spatial support, resulting in loss of significance of almost all the covariates. No significant differences were found between the predicted values and their uncertainties from the five models. We provide suggestions to define an appropriate spatial data structure for modelling that gives more reliable parameter estimates and a clear relationship between risk factors and the disease., Conclusions: Inclusion of quantified MAUP effects was important in this study on schistosomiasis. This will support helminth control programmes by providing reliable parameter estimates at the same spatial support and suggesting the use of an adequate spatial data structure, to generate reliable maps that could guide efficient mass drug administration campaigns.

Dipstick Dye Immunoassay (DDIA) and Indirect Haemagglutination Assay (IHA), are two commercially available kits which have been widely used for screening Schistosoma japonicum in P.R. China. Whether they can be used for screening of Schistosoma haematobium are not clear. In order to evaluate the diagnostic efficiency of DDIA and IHA for screening Schistosoma haematobium, serum samples were collected from pupils in endemic areas in Zambia, Southern Africa, and tested by DDIA and IHA by single-blind manner. Meanwhile, the pupils were microscopically examined by infection with Schistosoma and soil-transmitted helminths, visually observed for parasite eggs. Of the enrolled 148 pupils, 61% tested positive for S. haematobium infection, while 31% and 36% of pupils were infected with hookworm and Ascaris respectively. Regarding the parasitological tests as reference standard, for the diagnosis of S. haematobium infection, IHA performed higher sensitivity (74%, 95% CI: 65%-83%) than that of DDIA (60%, 95%CI: 49%-70%). The sensitivities of IHA and DDIA are significant higher in 10-14 years old students than those of 7-9 years old group. The specificity of DDIA and IHA were 61% (95%CI: 49%-74%) and 72% (95%CI: 60%-84%), respectively. The co-infection with STHs decreased the specificity of DDIA but had no impact on that of IHA. Our study indicated that IHA has more potential as an alternative diagnostic tool for identifying schistosomiasis haematobium but need further improvement., Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests., (Copyright © 2019 Elsevier B.V. All rights reserved.)