A multi-component integrated approach for the elimination of schistosomiasis in the People’s Republic of China: design and baseline results of a 4-year cluster-randomised intervention trial |
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| Authors: | Darren J. Gray Yue-Sheng Li Gail M. Williams Zheng-Yuan Zhao Donald A. Harn Sheng-Ming Li Mao-Yuan Ren Zeng Feng Feng-Ying Guo Jia-Gang Guo Jie Zhou Yu-Lan Dong Yuan Li Allen G. Ross Donald P. McManus |
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| Affiliation: | 1. Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, Australia;2. School of Population Health, University of Queensland, Brisbane, Australia;3. Research School of Population Health, Australian National University, Canberra, Australia;4. Hunan Institute of Parasitic Diseases, World Health Organisation Collaborating Centre for Research and Control of Schistosomiasis in Lake Region, Yueyang, Hunan Province, People’s Republic of China;5. Department of Infectious Diseases, College of Veterinary Medicine and Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, USA;6. National Institute of Parasitic Diseases, Chinese Centre for Disease Control and Prevention, Shanghai, People’s Republic of China;g Central South University, Changsha, People’s Republic of China;h Griffith Health Institute, Griffith University, Gold Coast, Australia |
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| Abstract: | Despite major successes in its control over the past 50 years, schistosomiasis japonica continues to be a public health problem in the People’s Republic of China (P.R. China). Historically, the major endemic foci occur in the lakes and marshlands along the Yangtze River, areas where transmission interruption has proven difficult. The current endemic situation may alter due to the closure of the Three Gorges Dam. Considerable environmental and ecological changes are anticipated that may result in new habitats for the oncomelanid intermediate snail host of Schistosoma japonicum (Sj), thereby increasing the risk of transmission. The current national control program for P.R. China involves a multi-component integrated strategy but, despite targeting multiple transmission pathways, certain challenges remain. As the Chinese government pushes towards elimination, there is a requirement for additional tools, such as vaccination, for long-term prevention. Whereas the zoonotic nature of schistosomiasis japonica adds to the complexity of control, it provides a unique opportunity to develop a transmission blocking vaccine targeting bovines to assist in the prevention of human infection and disease. Mathematical modelling has shown that control options targeting the various transmission pathways of schistosomiasis japonica and incorporating bovine vaccination, mass human chemotherapy and mollusciciding could lead to its elimination from P.R. China. Here we present the study design and baseline results of a four-year cluster randomised intervention trial we are undertaking around the schistosomiasis-endemic Dongting Lake in Hunan Province aimed at determining the impact on schistosome transmission of the multi-component integrated control strategy, including bovine vaccination using a heterologous “prime-boost” delivery platform based on the previously tested SjCTPI vaccine. |
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| Keywords: | Schistosomiasis Schistosomiasis japonica Schistosoma japonicum Transmission blocking vaccine Integrated control Cluster-randomised intervention trial Dongting Lake China |
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