Schistosomiasis research in the dongting lake region and its impact on local and national treatment and control in China

Schistosomiasis is a chronic and debilitating parasitic disease that has often been neglected because it is a disease of poverty, affecting poor rural communities in the developing world. This is not the case in the People's Republic of China (PRC), where the disease, caused by Schistosoma japonicum, has long captured the attention of the Chinese authorities who have, over the past 50-60 years, undertaken remarkably successful control programs that have substantially reduced the schistosomiasis disease burden. The Dongting Lake region in Hunan province is one of the major schistosome-endemic areas in the PRC due to its vast marshland habitats for the Oncomelania snail intermediate hosts of S. japonicum. Along with social, demographic, and other environmental factors, the recent completion and closure of the Three Gorges dam will most likely increase the range of these snail habitats, with the potential for re-emergence of schistosomiasis and increased transmission in Hunan and other schistosome-endemic provinces being a particular concern. In this paper, we review the history and the current status of schistosomiasis control in the Dongting Lake region. We explore the epidemiological factors contributing to S. japonicum transmission there, and summarise some of the key research findings from studies undertaken on schistosomiasis in Hunan province over the past 10 years. The impact of this research on current and future approaches for sustainable integrated control of schistosomiasis in this and other endemic areas in the PRC is emphasised.     

A vaccine against Asian schistosomiasis

There is continued transmission of schistosomiasis japonica in China and Philippines despite highly effective control programs that focus on the application of the highly effective drug praziquantel (PZQ). The massive Three Gorges Dam across the Yangtze River in Southern China, soon to be completed, is expected to significantly increase schistosomiasis transmission and introduce the disease into areas currently unaffected. After long-term experience it is generally accepted that PZQ chemotherapy, although the cornerstone of current control programs, does have significant limitations. Furthermore, efficient drug delivery requires a substantial infrastructure to regularly cover all parts of an endemic area. Although there is not yet clear-cut evidence for the existence of PZQ-resistant schistosome strains, decreased susceptibility to the drug has been observed in several countries. As a result, a protective vaccine represents an essential component for the long-term control of schistosomiasis. This article briefly reviews aspects of anti-schistosome protective immunity that are important in the context of vaccine development. The current status in the development of vaccines against Schistosoma japonicum will then be discussed as will new approaches that may improve on the efficacy of available vaccines, and aid in the identification of new targets for immune attack. With new and extensive data becoming available from the S. japonicum genome project, the prospects for developing an effective vaccine are encouraging. The challenges that remain are many but it is crucial that the momentum towards developing effective anti-schistosome vaccines is maintained.     

Implementation of an Intersectoral Program to Eliminate Human and Canine Rabies: The Bohol Rabies Prevention and Elimination Project

Background

The province of Bohol, located in the Visayas islands region in the Philippines has a human population of 1.13 million and was the 4th highest region for human rabies deaths in the country, averaging 10 per year, prior to the initiation of the Bohol Rabies Prevention and Elimination Project (BRPEP).

Aims

The BRPEP was initiated in 2007 with the goal of building a sustainable program that would prevent human rabies by eliminating rabies at its source, in dogs, by 2010. This goal was in line with the Philippine National Rabies Program whose objective is to eliminate rabies by 2020.

Methods

The intersectoral BRPEP was launched in 2007 and integrated the expertise and resources from the sectors of agriculture, public health and safety, education, environment, legal affairs, interior and local government. The program included: increasing local community involvement; implementing dog population control; conducting mass dog vaccination; improving dog bite management; instituting veterinary quarantine; and improving diagnostic capability, surveillance and monitoring. Funding was secured from the national government, provincial, municipal and village units, dog owners, NGOs, the regional office of the WHO, the UBS Optimus Foundation, and the Global Alliance for Rabies Control. The BRPEP was managed by the Bohol Rabies Prevention and Eradication Council (BRPEC) under the jurisdiction of the Governor of Bohol. Parallel organizations were created at the municipal level and village level. Community volunteers facilitated the institution of the program. Dog population surveys were conducted to plan for sufficient resources to vaccinate the required 70% of the dogs living in the province. Two island-wide mass vaccination campaigns were conducted followed by “catch up” vaccination campaigns. Registration of dogs was implemented including a small fee that was rolled back into the program to maintain sustainability. Children were educated by introducing rabies prevention modules into all elementary schools in Bohol. Existing public health legislation at the national, provincial, and municipal level strengthened the enforcement of activities. A Knowledge, Attitude and Practices (KAP) survey was conducted in 2009 to evaluate the educational knowledge of the population. Increased surveillance was instituted to ensure that dogs traveling into and out of the province were vaccinated against rabies. Human and animal cases of rabies were reported to provincial and national authorities.

Key Results

Within the first 18 months of the BRPEP, human rabies deaths had decreased annually from 0.77 to 0.37 to zero per 100,000 population from 2007–2009. Between October 2008 and November 2010 no human and animal cases were detected. Increased surveillance on the island detected one suspected human rabies case in November 2010 and one confirmed case of canine rabies in April 2011. Two mass vaccination campaigns conducted in 2007 and 2008 successfully registered and vaccinated 44% and 70% of the dogs on the island. The additional surveillance activities enabled a mobilization of mop up vaccination activities in the region where the human and canine case was located. Due to the increased effective and continuous surveillance activities, rabies was stopped before it could spread to other areas on the island. The program costs totaled USD 450,000. Registration fees collected to maintain the program amounted to USD 105,740 and were re-allocated back into the community to sustain the program.     

Host--parasite relationships of Schistosoma japonicum in mammalian hosts.

Control of schistosomiasis caused by Schistosoma japonicum has been severely hindered by the fact that several non-human mammalian species, including domesticated as well as wild animals, serve as zoonotic carriers of this infection. For effective control, it is imperative that the full host spectrum of this infection is understood. Although about 46 species of mammals are known to carry natural infection with S. japonicum, only a few might be of potential threat to human infection. Generally, in an endemic area, transmission of schistosomiasis to human depends largely on the availability and abundance of permissive hosts. Another important factor that needs to be taken into consideration in developing control measures against S. japonicum is potential strain differences. This review collates pertinent host-parasite relationship of S. japonicum in mammals in an endemic area and assesses the epidemiological significance of these findings for human infection.     

Clean and Green: Indigenous Knowledge and Cultural Models in a Philippine Community

This article demonstrates how the study of indigenous knowledge can be enhanced by paying attention to the forms in which this knowledge is organized and the way it is embedded in a wider cultural matrix. The empirical setting is a community of small-scale farmers on the Philippine island of Bohol, where much agricultural knowledge is organized in a cultural model built around a concept of cleanliness. The main part of the article is concerned with analyzing this symbolic model of cleanliness. I examine how it is applied within agriculture as well as in other domains; its esthetic, moral and practical dimensions; and how it can be said to embody a particular vision of the nature-culture opposition. In conclusion, I suggest that the cultural models approach may also facilitate the analysis of how indigenous knowledge changes over time.     

A potential impact of climate change and water resource development on the transmission of Schistosoma japonicum in China

There is growing consensus among climate modellers that the unusual global warming observed in the last decades of the 20th century is primarily forced by human activities, namely greenhouse gas increases in the atmosphere. Global warming will trigger alterations in physical and biological systems, including shifts in the spatio-temporal distribution of disease vectors, but the nature and extent of these changes are poorly understood. The purpose of the present study was to assess the potential impact of climate change and water resource development on the distribution of Oncomelania hupensis, the intermediate host snail of Schistosoma japonicum. We employed two 30-year composite datasets comprising average monthly temperatures collected at 623 observing stations throughout China, spanning the periods 1961-1990 and 1971-2000. Temperature changes were assessed spatially between the 1960s and 1990s for January, as this is the critical month for survival of O. hupensis. Our database shows that January temperatures increased at 590 stations (94.7%), and that China's average January temperature in the 1990s was 0.96 degrees C higher than 30 years earlier. The historical 0-1 degrees C January isotherm, which was considered the approximate northern limit of S. japonicum transmission, has shifted from 33 degrees 15' N to 33 degrees 41' N, expanding the potential transmission area by 41,335 km2. This translates to an additional 20.7 million people at risk of schistosomiasis. Two lakes are located in this new transmission area that form part of the proposed South-North water transfer project. Climate change, coupled with water resource developments in China, may pose additional challenges for the control of schistosomiasis.     

Complete genomic sequence of nitrogen-fixing symbiotic bacterium Bradyrhizobium japonicum USDA110.

The complete nucleotide sequence of the genome of a symbiotic bacterium Bradyrhizobium japonicum USDA110 was determined. The genome of B. japonicum was a single circular chromosome 9,105,828 bp in length with an average GC content of 64.1%. No plasmid was detected. The chromosome comprises 8317 potential protein-coding genes, one set of rRNA genes and 50 tRNA genes. Fifty-two percent of the potential protein genes showed sequence similarity to genes of known function and 30% to hypothetical genes. The remaining 18% had no apparent similarity to reported genes. Thirty-four percent of the B. japonicum genes showed significant sequence similarity to those of both Mesorhizobium loti and Sinorhizobium meliloti, while 23% were unique to this species. A presumptive symbiosis island 681 kb in length, which includes a 410-kb symbiotic region previously reported by G?ttfert et al., was identified. Six hundred fifty-five putative protein-coding genes were assigned in this region, and the functions of 301 genes, including those related to symbiotic nitrogen fixation and DNA transmission, were deduced. A total of 167 genes for transposases/104 copies of insertion sequences were identified in the genome. It was remarkable that 100 out of 167 transposase genes are located in the presumptive symbiotic island. DNA segments of 4 to 97 kb inserted into tRNA genes were found at 14 locations in the genome, which generates partial duplication of the target tRNA genes. These observations suggest plasticity of the B. japonicum genome, which is probably due to complex genome rearrangements such as horizontal transfer and insertion of various DNA elements, and to homologous recombination.     

Predicting reef fish connectivity from biogeographic patterns and larval dispersal modelling to inform the development of marine reserve networks

Developing networks of no-take marine reserves is often hindered by uncertainty in the extent to which local marine populations are connected to one another through larval dispersal and recruitment (connectivity). While patterns of connectivity can be predicted by larval dispersal models and validated by empirical methods, biogeographic approaches have rarely been used to investigate connectivity at spatial scales relevant to reserve networks (10's–100's of km). Here, species assemblage patterns in coral reef fish were used together with an individual-based model of dispersal of reef fish larvae to infer patterns of connectivity in a ∼300 km wide region in the Philippines that included the Bohol Sea and adjacent bodies of water. A dominant current flows through the study region, which may facilitate connectivity among >100 no-take reserves. Connectivity was first investigated by analysing data on the presence/absence of 216 species of reef fish and habitat variables across 61 sites. Hierarchical clustering of sites reflecting species assemblage patterns distinguished a major group of sites in the Bohol Sea (Bray–Curtis similarity >70%) from sites situated in adjacent bodies of water (bays, channels between islands and a local sea). The grouping of sites could be partly explained by a combination of degree of embayment, % cover of sand and % cover of rubble (Spearman rank correlation, ρ_w = 0.42). The individual-based model simulated dispersal of reef fish larvae monthly for three consecutive years in the region. The results of simulations, using a range of pelagic larval durations (15–45 days), were consistent with the species assemblage patterns. Sites in the model that showed strongest potential connectivity corresponded to the majority of sites that comprised the Bohol Sea group suggested by hierarchical clustering. Most sites in the model that exhibited weak connectivity were groups of sites which had fish assemblages that were least similar to those in the Bohol Sea group. Concurrent findings from the two approaches suggest a strong influence of local oceanography and geography on broad spatial patterns of connectivity. The predictions can be used as an initial basis to organise existing reserves to form ecologically meaningful networks. This study showed that species assemblage patterns could be a viable supplementary indicator of connectivity if used together with predictions from a larval dispersal model and if the potential effect of habitat on the structuring of species assemblages is taken into consideration.     

基于GISP模型的城市绿色基础设施多功能性评估

绿色基础设施建设是加强城市生态弹性力的重要手段之一。绿色基础设施多功能性是实现城市生态系统服务功能综合效益最大化的前提,这一点已被众多学者认可。构建绿色基础设施规划(GISP,Green Infrastructure Spatial Planning)模型,基于绿色基础设施的雨洪管理、绿色空间可达性、净化空气、缓解热岛效应、景观连通性五大功能指标,开展城市绿色基础设施多功能性评估,明确合肥市绿色基础设施的高需求地区,探讨绿色基础设施不同功能之间的权衡和协同关系。结果表明:合肥市东北部对于绿色基础设施缓解城市热岛效应、净化空气的需求最强烈,城市一环区域对于绿色基础设施的雨洪管理需求最为强烈,城市东部、南部对于绿色基础设施的绿色空间可达性需求显著;总体而言,绿色基础设施选址的热点区域为城市一环内及东北区域;绿色基础设施的雨洪管理、缓解城市热岛和净化空气间存在着协同关系,与景观连通性之间存在着权衡关系;运用GISP模型评估合肥生态空间体系控制规划以及合肥市域空间绿道网络系统建设总体规划,规划中绿地选址不在绿色基础设施的高需求区域,也没有在战略上整合绿地多功能的生态系统服务、获得更大的生态弹性力。     

An impact assessment of the alien lizard Plestiodon japonicus (Scincidae, Reptilia) on a threatened island population of the native lizard P. latiscutatus at an early phase of the biological invasion

On the island of Hachijojima, central Japan, a formerly abundant population of native lizard, Plestiodon latiscutatus has become endangered by predation from an alien weasel (Mustela itatsi). Recently, an alien lizard, P. japonicus, became established on the island. The impact of the alien lizard and current distribution of the native lizard were assessed by field surveys and DNA analyses. The native lizard was sparsely distributed in the western part of the island. The alien lizard occurred in the northeastern region of the island. Between these regions, several hybrid populations were identified, including some with non-F1 genotypes, suggesting that introgression is occurring. The distribution of the weasel was examined based on field observations, allowing us to estimate predator impacts on both lizard species. We found evidence that the weasel was present throughout the entire island, suggesting that the alien lizard was able to become established despite the presence of the weasel. This indicates that the alien lizard is likely to expand its habitat range and that introgression may spread. We conclude that P. latiscutatus populations will become increasingly endangered by the synergism of genetic introgression from P. japonicus and predation pressure from the weasel.     

The integration of biodiversity conservation with oil and gas exploration in sensitive tropical environments

This paper describes the approach of TOTAL Exploration & Production concerning the protection of biodiversity during oil and gas exploration and production activities, particularly in sensitive environments such as tropical islands. This approach was developed according to three stages: knowing biodiversity, protecting biodiversity and, going further, by contributing to scientific research. This three step approach is embedded in an environment protection policy and an associated set of actions already implemented for many years. Knowledge of the biodiversity is an indispensable preliminary to evaluating the sensitivity of a site which is likely to be impacted by an industrial activity. TOTAL E&P Indonésie (TI) has been operating for over 30 years in the East part of Borneo Island in areas of increasing sensitivity with respect to mangrove ecosystems; for example the Mahakam delta which includes the Tambora, Handil and Tunu fields. This area was initially covered by dense mangrove vegetation. Regular biodiversity surveys in the delta, especially for fishes, birds and benthos, have allowed TI to witness the progressive changes occurring in the delta. Reducing significant impacts and conserving biodiversity is considered as an integral part of sustainable development. With regard to the Mahakam delta, in the last decades there has been a marked increase of local population activities and deforestation due to shrimp-culture development. TI has made significant efforts with environmental management actions to protect the mangrove ecosystem through several environmental programs such as minimizing land clearing and reinstating cleared areas. The programs have involved local communities and other stakeholders such as NGO’s and governmental bodies. Contributing to scientific knowledge of biodiversity is of mutual interest to both science and industry. The TOTAL Group, through its Foundation for Biodiversity and the Sea, has supported the establishment of a comprehensive inventory of the marine biodiversity of the island of Panglao, situated southwest of Bohol, Philippines. The Panglao Marine Biodiversity project was driven in collaboration between the Muséum National d’Histoire Naturelle, Paris, and the University of San Carlos, Cebu City, Philippines. Recently, another major biodiversity inventory has been also supported by the TOTAL Foundation: the Santo 2006 biodiversity project. On this island, located in the Vanuatu archipelago, the research program has focused on four themes: marine, forest, karstic environments and alien species. Furthermore, TOTAL in partnership with IFREMER, a French oceanographic research centre, has also developed a comprehensive biodiversity research and development program dedicated to Deep Sea ecosystems. Even if initially focused off Western Africa, this emerging issue is also of concern in most of the tropical areas in the world where deep offshore environments are present.     

Survival of Mycobacterium bovis on feedstuffs commonly used as supplemental feed for white-tailed deer (Odocoileus virginianus)

Mycobacterium bovis, the causative agent of bovine tuberculosis, has become established in free-ranging white-tailed deer Odocoileus virginianus in northeastern Michigan. The practice of supplemental feeding of white-tailed deer during the winter is believed to contribute to transmission of M. bovis between deer. The current study was conducted to determine the ability of M. bovis to survive on various feedstuffs commonly used as supplemental feed for deer in northeast Michigan (i.e., apples, corn, carrots, sugar beets, potatoes, and hay) and the effect of maintenance at -20 C, 8 C, and 23 C on survival. Mycobacterium bovis survived on all feedstuffs at all temperatures tested for at least 7 days. At 23 C, M. bovis could still be isolated from samples of apples, corn and potatoes at 112 days. This study suggests that contamination of feedstuffs by M. bovis-infected deer could act as a source of indirect transmission between deer because M. bovis is able to survive in temperatures similar to those recorded during winter months in northeastern Michigan. Current efforts to ban or control supplemental feeding of deer should have a positive effect on decreasing transmission of M. bovis among deer.     

Vectorial capacity of North American Ixodes ticks.

Ixodes dammini, the vector of Lyme disease and babesiosis, is distributed in various locations in the northeastern quadrant of the United States and nearby Canada. The life cycle of this tick, which includes larval, nymphal, and adult stages, spans at least two years. The tick over-winters between larval and nymphal feeding. Horizontal transmission of pathogens is facilitated by a feeding pattern in which both the larval and nymphal stages feed on the white-footed mouse, Peromyscus leucopus, and by a seasonal pattern of activity in which nymphs precede larvae. The species range appears to have expanded from a single island location, and has invaded new sites since the 1940s, some as recently as 1980. This increased abundance appears to be related to the increased abundance of deer, the preferred host of the adult stage. I. muris predominated in coastal Massachusetts before I. dammini became abundant, but is probably now extinct. I. scapularis, which is present in the southern U.S., is a poor vector of mouse parasites because about 90 percent of these immature ticks feed on lizards. To the extent that horizontal transmission occurs, we suggest that mice serve as the principal reservoir for the Lyme spirochete as well as Babesia microti.     

Modelling sexually transmitted infections: the effect of partnership activity and number of partners on R0

We model a sexually transmitted infection in a network population where individuals have different numbers of partners, separated into steady and casual partnerships, where the risk of transmission is higher in steady partnerships. An individual's number of partners of the two types defines its degree, and the degrees in the community specify the degree distribution. For this structured network population a simple model for disease transmission is defined and the basic reproduction number R0 is derived, R0 being a size-biased (i.e. biasing individuals with many partners) average number of new infections caused by individuals during the early stages of the epidemic. First a homosexual population is considered and then a heterosexual population. The heterosexual model is fitted to data from a census survey on sexual activity from the Swedish island of Gotland. The main empirical finding is that, for relevant transmission rates, the effect that so-called superspreaders have on R0 is over-estimated when not admitting for different types of partnerships.     

Visceral leishmaniasis in the Indian subcontinent: modelling epidemiology and control

Background

In the Indian subcontinent, about 200 million people are at risk of developing visceral leishmaniasis (VL). In 2005, the governments of India, Nepal and Bangladesh started the first regional VL elimination program with the aim to reduce the annual incidence to less than 1 per 10,000 by 2015. A mathematical model was developed to support this elimination program with basic quantifications of transmission, disease and intervention parameters. This model was used to predict the effects of different intervention strategies.

Methods and Findings

Parameters on the natural history of Leishmania infection were estimated based on a literature review and expert opinion or drawn from a community intervention trial (the KALANET project). The transmission dynamic of Leishmania donovani is rather slow, mainly due to its long incubation period and the potentially long persistence of parasites in infected humans. Cellular immunity as measured by the Leishmanin skin test (LST) lasts on average for roughly one year, and re-infection occurs in intervals of about two years, with variation not specified. The model suggests that transmission of L. donovani is predominantly maintained by asymptomatically infected hosts. Only patients with symptomatic disease were eligible for treatment; thus, in contrast to vector control, the treatment of cases had almost no effect on the overall intensity of transmission.

Conclusions

Treatment of Kala-azar is necessary on the level of the individual patient but may have little effect on transmission of parasites. In contrast, vector control or exposure prophylaxis has the potential to efficiently reduce transmission of parasites. Based on these findings, control of VL should pay more attention to vector-related interventions. Cases of PKDL may appear after years and may initiate a new outbreak of disease; interventions should therefore be long enough, combined with an active case detection and include effective treatment.     

Strengths and Weaknesses of a Population Viability Analysis for Philippine Tarsiers (<Emphasis Type="Italic">Tarsius syrichta</Emphasis>)

Population viability analysis (PVA) has been increasingly used to guide conservation planning for many primate species. I present an assessment of a PVA for Philippine tarsiers (Tarsius syrichta) in Corella, Bohol. The objectives were to determine 1) area requirements and 2) spatial configurations of habitat patches necessary for viable populations in Corella. I used available life history parameters and ecological data for the Philippine tarsier derived from a radiotelemetry study on 4 male and 6 female Tarsius syrichta in Corella from early March to October 1999. I used analysis of the likelihood of extinction (ALEX), a Monte Carlo simulation model that uses pseudorandom numbers to simulate a scenario involving different stochastic processes. Sensitivity analysis showed that the model output, i.e. extinction risk, was influenced by the values used for newborn, juvenile, and adult mortality but the effect of variation on adult mortality was more pronounced; a slight increase in adult mortality renders the population very unstable. Simulation of movements between habitat patches showed that addition of diffusion corridors and variation in diffusion parameters did not significantly alter the probability of extinction of the species. Models are only as useful as the data that are input, and a major weakness of this model is the lack of detailed life history and mortality data for Philippine tarsiers. Future studies should concentrate on obtaining more life history data and ecological data from additional localities. I discuss key priorities for future research that include use of alternative PVA software, a simpler modeling approach, and extensive genetic studies of different Philippine tarsier island populations.     

The insulin receptor is a transmission blocking veterinary vaccine target for zoonotic Schistosoma japonicum

Insulin receptors have been previously identified in Schistosoma japonicum that can bind human insulin. We used the purified recombined protein of the ligand domain of S.japonicum insulin receptor 2 (SjLD2) in three independent murine vaccine/challenge trials. Compared with controls, vaccination of mice with SjLD2 resulted in a significant reduction in faecal eggs, the stunting of adult worms and a reduction in liver granuloma density in all three trials. Furthermore, in the final trial, in which mature intestinal eggs were also quantified, there was a reduction in their number. These results suggest that development of a vaccine based on rSjLD2 for preventing transmission of zoonotic schistosomiasis is feasible.     

Treatment and reinfection of water buffaloes and cattle infected with Schistosoma japonicum in Yangtze River Valley, Anhui province, China

The aim of the present study was to evaluate the efficacy of praziquantel treatment of Schistosoma japonicum infections in cattle and water buffaloes and to assess the natural rate of reinfection after treatment. The studies were conducted on 2 islands in the Yangtze River, Anhui province, China, from March 2003 to January 2004. The efficacy of praziquantel was 97% when applied orally wrapped in tree leaves at the recommended doses. The efficacy was measured using a miracidium hatching technique on fecal samples collected 20 days after treatment. The treatment did not give rise to any major side effects. Reinfection after treatment was high and occurred throughout the year in both cattle and water buffaloes. Age-related resistance was only observed in water buffaloes. It is concluded that although praziquantel is highly effective against S. japonicum in cattle and water buffaloes, a single annual treatment strategy does not effectively control transmission. New strategies for integrated control of animal schistosomiasis are needed to control schistosomiasis transmission more effectively in farm areas of China.     

东北地区中生代化石木异木属及其古生态

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Genetic diversity of Schistosoma japonicum miracidia from individual rodent hosts

Schistosoma japonicum is an important parasite in terms of clinical, veterinary and socio-economic impacts, and rodents, a long neglected reservoir for the parasite, have recently been found to act as reservoir hosts in some endemic areas of China. Any difference in the host's biological characteristics and/or associated living habitats among rodents may result in different environments for parasites, possibly resulting in a specific population structure of parasites within hosts. Therefore knowledge of the genetic structure of parasites within individual rodents could improve our understanding of transmission dynamics and hence our ability to develop effective control strategies. In this study, we aimed to describe a host-specific structure for S. japonicum and its potential influencing factors. The results showed a significant genetic differentiation among hosts. Two factors, including sampling seasons and the number of miracidia genotyped per host, showed an effect on the genetic diversity of an infrapopulation through a univariable analysis but not a multivariable analysis. A possible scenario of clustered infection foci and the fact of multiple definitive host species, the latter of which is unique to S. japonicum compared with other schistosomes, were proposed to explain the observed results and practical implications for control strategies are recommended.