Effectiveness of the new integrated strategy to control the transmission of Schistosoma japonicum in China: a systematic review and meta-analysis

Since 2004, the national schistosomiasis control strategy in China has shifted from the morbidity control strategy (conventional strategy) to an integrated strategy (new strategy). We investigated the effectiveness of the new strategy and compared it against the conventional strategy. We retrieved from electronic databases the literature regarding the new strategy published from 2000 to 2017. The effect of the new or conventional strategy on infection by Schistosoma japonicum of humans and snails (Oncomelania hupensis) was evaluated with pooled log relative risk (logRR). A total of only eight eligible publications were included in the final meta-analysis. The results showed that implementation of the new strategy reduced the infection risk by 3–4 times relative to the conventional strategy. More specifically, the conventional strategy caused a reduction in both human (logRR = 0.56, 95% CI: 0.12–0.99) and snail infections (logRR = 0.34, 95% CI: −0.69–1.37), while the new strategy also significantly reduced both human (logRR = 1.89, 95% CI: 1.33–2.46) and snail infections (logRR = 1.61, 95% CI: 1.06–2.15). In contrast to the conventional strategy, the new strategy appeared more effective to control both human (logRR difference = 1.32, 95% CI: 0.78–1.86) and snail infections (logRR difference = 1.53, 95% CI: 0.76–2.31). Our data demonstrate that the new integrated strategy is highly effective to control the transmission of S. japonicum in China, and this strategy is recommended for schistosomiasis elimination in other affected regions across the world, with adaptation to local conditions.

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Cost-effectiveness Analysis of the Integrated Control Strategy for Schistosomiasis Japonica in Lake Region of China: a Jiangling Case Study

10.21203/rs.3.rs-168300/v1 ◽

2021 ◽

Author(s):

Ling-Ling Wu ◽

He-Hua Hu ◽

Xia Zhang ◽

Xiao-Nong Zhou ◽

Tie-Wu Jia ◽

...

Keyword(s):

Cost Effectiveness ◽

Incremental Cost ◽

Control Strategy ◽

Prevention And Control ◽

Disease Burden ◽

Integrated Control ◽

Schistosomiasis Control ◽

Morbidity Control ◽

Transmission Interruption ◽

And Control

Abstract Background: Under the condition of low epidemic level and limited funding, it is urgent to carry out health economic evaluation on the integrated schistosomiasis control strategy currently implemented in lake region in order to rationally allocate and utilize health resources and maximize benefits. The objective of this study is to provide reference for understanding the effectiveness of the integrated control strategy and adjusting prevention and control strategies or measures. Methods: The investment in schistosomiasis control and disability adjusted life years （DALYs）caused by schistosomiasis were calculated. Incremental cost-effectiveness ratio (ICER) was conducted through calculating the incremental cost of every additional case averted, the incremental cost of every additional DALY averted through implementation of the integrated schistosomiasis control at different control stages in Jiangling County. Results: The total expenditure for schistosomiasis control in Jiangling County from 2009 to 2019 was 607 million Chinese yuan (CNY). The average annual costs for schistosomiasis prevention and control in stages of morbidity control (2009-2012), transmission control (2013-2016), and transmission interruption (2017-2019) were 41.98 million CNY，90.19 million CNY and 26.06 million CNY 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 to1031.59 person-years. Most disease burden occurred in the age group over 45 years old (especially the elderly over 60 years old). Taking the morbidity control stage as an analysis control, incremental cost-effectiveness analysis (ICEA) showed that the cost increased by 8505.5 CNY and decreased by 2217.6 CNY respectively to avert one additional case in transmission control stage and transmission interruption stage respectively in Jiangling County. Correspondingly, to avert one additional DALY, the cost increased by 73937.6 CNY and decreased by 21508.6 CNY respectively. Conclusions: As the epidemic declines, the integrated prevention and control strategy is more cost-effective. Surveillance and management on elder population should be strengthened to avert higher diseases burden.

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The spatio-temporal distribution of Oncomelania hupensis along Yangtze river in Jiangsu Province, China after implementation of a new, integrated schistosomiasis control strategy

Geospatial health ◽

10.4081/gh.2016.480 ◽

2016 ◽

Vol 11 (3) ◽

Cited By ~ 2

Author(s):

Jian He ◽

Wei Li ◽

Robert Bergquist ◽

Jian-Feng Zhang ◽

Liang Shi ◽

...

Keyword(s):

Spatial Autocorrelation ◽

Control Strategy ◽

Yangtze River ◽

High Density ◽

Jiangsu Province ◽

Oncomelania Hupensis ◽

Risk Area ◽

Schistosomiasis Control ◽

Spatio Temporal ◽

Strong Control

This study concerns an integrated strategy of schistosomiasis control, focusing on the management and elimination of the main transmission cycles and reservoirs along Yangtze river, Jiangsu Province (China), instituted in 2004. Our analysis, including mapping, spatial autocorrelation and spatio-temporal scanning, was implemented between 2001 and 2013 to explore the changes in the distribution of <em>Oncomelania hupensis</em>, the intermediate host of <em>Schistosoma japonicum</em>. Two high-density snail locations in the upper and middle reaches of the river were observed along with one high-risk area due to infected snails in the upper reaches at the beginning of the study period. The number of high-density snail habitats declined sharply after 2004 and infected snails disappeared completely by 2010. Global spatial autocorrelation showed spatial clustering of snails in general, as well as of infected ones when snail densities were relatively high, while local spatial autocorrelation showed the number of specific clusters declining and switching spatially from the upper to the middle reaches of the Yangtze river in Jiangsu Province during the study period. The integrated snail control strategy was found to be effective, but the middle reaches of the river will require continued strong control resources.

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Evaluasi Pengendalian Schistosomiasis oleh Lintas Sektor Tahun 2018

Buletin Penelitian Kesehatan ◽

10.22435/bpk.v47i4.1861 ◽

2019 ◽

Vol 47 (4) ◽

Author(s):

Hayani Anastasia ◽

Junus Widjaja ◽

Anis Nurwidayati

Keyword(s):

Schistosoma Japonicum ◽

Interactive Media ◽

Control Program ◽

Cross Sectional Study ◽

Oncomelania Hupensis ◽

Cross Sectional ◽

Schistosomiasis Control ◽

Control Programs ◽

Significant Difference ◽

Central Sulawesi

Abstract In Indonesia, schistosomiasis is caused by Schistosoma japonicum with Oncomelania hupensis lindoensis as the intermediate host. Schistosomiasis can infect humans and all species of mammals. In order to achieve schistosomiasis elimination by 2020, schistosomiasis control including environmental management, has been carried out by multi-sectors. A cross-sectional study was conducted in 2018 to evaluate multi-sectoral schistosomiasis control programs. Data were collected by in-depth interviews with stakeholders, stool survey, snail survey, field observation, and document reviews. About 53.6% of control programs targeted in the schistosomiasis control roadmap were not achieved. Moreover, there was no significant difference between the number of foci area prior to the control programs and that of after the control programs completed in 2018. In addition, the prevalence of schistosomiasis in the humans was 0-5.1% and in mammals was in the range of 0 to 10%. In order to overcome the problems, establishment of a policy concerning schistosomiasis as a priority program beyond the Ministry of Health is needed. Innovative health promotion with interactive media is also needed to be applied. Nonetheless, the schistosomiasis work teams need to be more active to collaborate with other sectors and the Agency of Regional Development of Central Sulawesi Province as the leading sector. Keywords: schistosomiasis, control program, multi-sector, evaluation Abstrak Schistosomiasis di Indonesia disebabkan oleh cacing trematoda jenis Schistosoma japonicum dengan hospes perantara keong Oncomelania hupensis lindoensis. Schistosomiasis selain menginfeksi manusia, juga menginfeksi semua jenis mamalia. Untuk mencapai eliminasi schistosomiasis pada tahun 2020 dilakukan pengendalian schistosomiasis oleh lintas sektor termasuk di dalamnya pelaksanaan manajemen lingkungan. Upaya pencapaian eliminasi schistosomiasis dilakukan terutama dengan manajemen lingkungan yang direncanakan bersama oleh lintas sektor. Penelitian cross sectional dilakukan untuk mengevaluasi pelaksanaan program pengendalian schistosomiasis oleh lintas sektor dan implementasi pengendalian schistosomiasis terpadu untuk eliminasi schistosomiasis. Pengumpulan data dilakukan dengan wawancara mendalam stakeholder, review dokumen, survei keong, observasi lapangan, dan survei tinja. Hasil penelitian menunjukkan 53,6% kegiatan yang direncanakan dalam roadmap tidak terlaksana tahun 2018. Perbandingan jumlah fokus yang ditemukan pada akhir tahun 2018 tidak jauh berbeda dengan sebelum kegiatan pengendalian. Prevalensi schistosomiasis pada manusia tahun 2018 berkisar 0-5,1%. Prevalensi schistosomiasis pada hewan berkisar 0-10%. Untuk mengatasi permasalahan yang dihadapi perlu adanya rekomendasi kebijakan schistosomiasis sebagai kegiatan prioritas di kementerian di luar kesehatan sehingga memungkinkan perencanaan kegiatan yang lebih terarah oleh lintas sektor. Selain itu perlu dilakukan promosi kesehatan yang lebih inovatif dengan menggunakan media yang lebih menarik dan interaktif. Peranan aktif kelompok kerja tim pengendalian schistosomiasis perlu ditingkatkan dengan Bappeda sebagai leading sector. Kata kunci: schistosomiasis, pengendalian, lintas sektor, evaluasi

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