Tropical Diseases in China: Schistosomiasis

Preface
Contents
Contributors
1: History of Schistosomiasis Japonica in China
	1.1	 Discovery of Schistosomiasis in China
	1.2	 History of the National Schistosomiasis Control Programme in China
	1.3	 Epidemiological Features of Schistosomiasis in Different Endemic Regions in China
		1.3.1	 Lake and Marshland Regions
		1.3.2	 Plain Regions with Waterway Networks
		1.3.3	 Hilly and Mountainous Regions
	1.4	 Burden and Impact of Schistosomiasis
		1.4.1	 Individual Impact
		1.4.2	 Burden of Disease
	References
2: Endemicity, Diagnosis and Treatment of Schistosomiasis in China
	2.1	 Diagnosis and Treatment of Acute Schistosomiasis
		2.1.1	 Epidemic Features of Acute Schistosomiasis
		2.1.2	 Symptomatology
		2.1.3	 Detection of Acute Schistosomiasis
		2.1.4	 Diagnostic Criteria
		2.1.5	 Treatment
		2.1.6	 Case Study
	2.2	 Diagnosis and Treatment of Chronic Schistosomiasis
		2.2.1	 Symptomatology
		2.2.2	 Detection of Chronic Schistosomiasis
		2.2.3	 Diagnositic Criteria
		2.2.4	 Treatment
	2.3	 Diagnosis and Treatment of Advanced Schistosomiasis
		2.3.1	 Clinical Subtypes
		2.3.2	 Clinical Features
		2.3.3	 Diagnostic Approach
		2.3.4	 Diagnostic Criteria
		2.3.5	 Treatment
		2.3.6	 Case Study
	References
3: Biology and Control of Oncomelania Snail in China
	3.1	 Biology of Oncomelania Snail
		3.1.1	 Taxonomic Category
		3.1.2	 Morphology
		3.1.3	 Ecology
	3.2	 Distribution and Survey of O. hupenesis in China
		3.2.1	 Distribution Characteristics
		3.2.2	 Factors Influencing Snail Distribution
		3.2.3	 Snail Detection
		3.2.4	 Snail Monitoring and Surveillance
		3.2.5	 Detection of Infected Snails
	3.3	 Control of Oncomelania hupensis
		3.3.1	 General Concept for Snail Control
		3.3.2	 Physical Control of Oncomelania
		3.3.3	 Chemical Control of Oncomelania
		3.3.4	 Biological Control of Oncomelania
	References
4: Progress on Schistosomiasis Research in China
	4.1	 Research Advances on Diagnostics
		4.1.1	 Historical Review of Diagnostic Tools in China
			Parasitological Approaches
				Stool Examination
				Tissue Biopsy
			Imaging Techniques
			Immunological Tests
				The Intradermal Test (ID)
				The Circumoval Precipitin Test (COPT)
				The Indirect Hemagglutination Assay (IHA)
				The Enzyme-Linked Immunosorbent Assay (ELISA)
				Rapid Diagnostic Kits
			Techniques Based on Molecular Biotechnology
		4.1.2	 Diagnostic Applications in the National Schistosomiasis Control Programme
			The Morbidity Control Stage
			The Infection Control Stage
			The Transmission Control Stage
			The Stage of Transmission Interruption and Elimination
		4.1.3	 Quality Control
		4.1.4	 Current Challenges
	4.2	 Advances in Treatment
		4.2.1	 Praziquantel: A Milestone in Schistosomicidal Treatment
			Mechanisms of Action of PZQ
			Enantioseparation and Schistosomicidal Efficacy of PZQ
				Formulation and Route of Administration for PZQ
				Lipid-Based Delivery Systems
				Transdermal Delivery of PZQ
				Injective Administration of PZQ
				Rectal Administration of PZQ
				Sustained-Release PZQ Tablet
				Film-Coated PZQ Tablets
			Evolution of Chemotherapy Model Based on PZQ in China
				Introduction Stage
				Clinical Use Stage
				Chemertherapy Stage
				Mass Chemertherapy Stage
				Selective Chemotherapy Stage
				Human and Animal Synchronous Chemotherapy Stage
		4.2.2	 Artemisinin: A Novel Prevention Drug for S. Japonicum
			Artemether
				Artemether Monotherapy
				Artemether–PZQ Combination
				Recommended Treatment Regimen and Contraindications
			Artesunate
				Artesunate Monotherapy
				Artesunate-PZQ Combination Therapy
				Recommended Treatment Option
				Concluding Remarks on Artemisinin
	4.3	 Advances in Molluscicides Application
		4.3.1	 Chemical Molluscicides
			Sodium Pentachlorophenate
			Niclosamide
			Rongbao and Rongya
			META-Li
			Other Chemical Molluscicides
		4.3.2	 Plant-Derived Molluscicides
			Saponins
			Alkaloids
			Flavonoids
		4.3.3	 New Types of Molluscicidal Compounds
			Plant-Derived Molluscicide
			(Chloroacetyl) Catechol
			Buddleja Lindleyana
		4.3.4	 Conclusion
	4.4	 Surveillance and Early Warning
		4.4.1	 Surveillance System
			Coverage
			Intensity
			Standardization
				Case Definition
				Data Collection
				Data Processing and Management
				Analysis and Interpretation
				Dissemination
				Evaluation
			Schistosomiasis Surveillance Systems in China
		4.4.2	 Early Warning System
			Basic Conception
				Conception and Classification
				Definitions and Features of Early Warning Indicators
				The Definition, Characteristics, and Component Framework of an Early Warning Mechanism
			Prediction Methods
			Qualitative Prediction
			Quantitative Prediction
			Integrated Prediction Method
		4.4.3	 Application of Prediction and Early Warning Methods in Schistosomiasis
			Prediction of Transmission Status of Schistosomiasis Japonica at Province and County Level
			Predication of Snail-Infested Areas Based on Ecological Model
			Prediction of Potential Transmission Areas of Schistosomiasis Japonica under the Scenarios of Environmental Changes
	4.5	 Applicable Technology
		4.5.1	 Applicable Technology for Infection Source Control
		4.5.2	 Applicable Technology for Snail Control
			A Machine for Snail Control Integrating Mechanized Vegetation Cleaning and Automatic Mollusciciding
			A Rapid Niclosamide Detector
			A Snail Control Approach Covering by Black Plastic Film
		4.5.3	 Applicable Technology for Detection and Monitoring S. Japonicum Infections
			An Intelligent Detector for S. Japonicum-Infested Water Using Sentinel Mice
			A Kit to Detect S. Japonicum DNA of Oncomelanid Snails
			Internet+ and Google Earth-Based Surveillance and Response System
		4.5.4	 Applicable Technology for Health Promotion
	References
5: China’s Experiences in the Combat of Schistosomiasis
	5.1	 Evolution of Schistosomiasis Control Strategies in China
		5.1.1	 Introduction
		5.1.2	 Schistosomiasis Control Strategies in China
			Preparation Stage (1950–1955)
				Preparation for Future Large-Scale Control Programmes
				Achievements and Lessons Learnt
			Mass-Campaign Stage Focused on Snail Control (1956–1985)
				Snail Control Strategy
				Achievements and Lessons Learnt
			Morbidity Control Stage Boosted by International Cooperation (1986–2003)
				Morbidity Control Strategy
				Achievements and Lessons
			Integrated Strategy to Block Schistosomiasis Transmission (2004–Present)
				Comprehensive Strategy of Blocking Schistosomiasis Transmission
				Achievements and Lessons Learnt
		5.1.3	 Conclusion
	5.2	 Development of Water Conservancy Projects for the Control of S. japonicum in China
		5.2.1	 Introduction
		5.2.2	 The Concept of Schistosomiasis Control Through Water Conservancy
		5.2.3	 The Guiding Principle of Schistosomiasis Control Through Water Conservancy
		5.2.4	 Building Water Resource Projects for Schistosomiasis Control: Current Approaches
			Measures Taken by Water Conservancy Engineering Facilities to Prevent Snail Diffusion or Barriers Erected to Prevent People and Livestock from Entering Snail Habitats
				Preventing the Spread of Oncomelanid Snails Through the Use of a Blocking Net
				The Settling Basin for O. hupensis
				Removing the Middle Layer of Water Without O. hupensis
				Building a Platform for O. hupensis Control
				Building an Isolation Ditch for Preventing People and Livestock from Entering Snail Habitats
			Measures of Water Conservancy Project Combined with Snail Habitat Modification for Snail Control
				The Soil or Sand Burying Method for Snail Control
				Soil Cement Hardening for Snail Control
				Falling the Bottomland or Elevating the Bottomland
		5.2.5	 Water Conservancy Cases in the Endemic Areas of China
			Snail Control and Flood Control Engineering on the Fu River, Yangxin County, Hubei Province, China
			Snail Control Project for Removing the Middle Layer of Water in the West Sluice in Junshan District, Hunan Province, China
			Snail Control Engineering of the Wangjiatai Sluice in Yingcheng City, Hubei Province, China
		5.2.6	 Project Management and Evaluation After Completion
			Assessment of Design and Operation Management of Water Conservancy Combined with Schistosomiasis Prevention
			Assessment of the Effects of Water Conservancy for Snail Control
		5.2.7	 Conclusions and Perspectives
	5.3	 Countermeasures for Controlling Schistosomiasis in Domestic Animals in China
		5.3.1	 The Epidemic Status and Impact of Domestic Animal Schistosomiasis in China
			The Epidemic Status of Domestic Animal Schistosomiasis in China
				Early Reports on Domestic Animal Schistosomiasis in China
				The Epidemic Status of Domestic Animal Schistosomiasis in China in the 1950s
				The Current Status of Schistosomiasis in Domestic Animals in China
			The Harmful Effects of Domestic Animal Schistosomiasis in China
			The Susceptibility of Different Species of Domestic Animals to S. japonicum Infection in China
			The Role of Domestic Animals as Carriers in the Transmission of S. japonicum
		5.3.2	 Countermeasures for the Control of Schistosomiasis in Domestic Animals in China
			The Processes for Controlling Schistosomiasis in Domestic Animals in China
			Diagnosis of Domestic Animal Schistosomiasis
				Etiological Diagnosis
				Serological Diagnosis
			Chemotherapy of Domestic Animal Schistosomiasis
			Housing of Domestic Animals
			Establishment of Safe Pastures and Safe Grazing for Livestock
			Banning Livestock Grazing on Marshlands or Hillside Grasslands with Snail Habitats
			Quarantine and Monitoring of Domestic Animals from Schistosomiasis-Endemic Areas
			Development of a Schistosomiasis Vaccine for Domestic Animals
			Other Methods for Controlling Domestic Animal Schistosomiasis
		5.3.3	 The Main Experiences for Domestic Animal Schistosomiasis Control in China
		5.3.4	 New Challenges for the Control of Domestic Animal Schistosomiasis in China
	5.4	 Comprehensive Agricultural Measures for Schistosomiasis Control in China
		5.4.1	 Agricultural Measures for Reducing the Number of Grazing Ruminants
			Replacing Bovine Plowing with Tractor Plowing
			Replacing Ruminants with Poultry
			Prohibiting Livestock Grazing on Marshlands or Hillsides with Oncomelania Snails
		5.4.2	 Feces Management
			Constructing Biogas Pools
			Construction of Septic Tanks for the Treatment of Animal Feces
			Stacking Fermentation of the Feces
		5.4.3	 Comprehensive Agricultural Measures for Snail Control
			Changing Rice Paddies to Dry Fields
			Rotational Planting of Rice and Other Crops
			Cementing Ditches
			Building Ponds for Aquatics Breeding
			Cultivation of High-Altitude Floodplain
			Storing Water to Raise Aquatic Products
		5.4.4	 Propaganda and Education
	5.5	 Schistosomiasis Prevention Through Afforestation
		5.5.1	 Why Does Afforestation Prevent Schistosomiasis?
			How Schistosomiasis Prevention through Afforestation Changes Local Farmers’ Lifestyles
		5.5.2	 The Secrets behind Afforestation Control of Schistosomiasis
			Differences Between Impacts of Afforestation on Female and Male Snails
		5.5.3	 The Main Afforestation Techniques for Schistosomiasis Prevention
			Tree Species Selection
				Marshland and Lake Regions; Plains Regions with Waterway Networks
				Mountainous and Hilly Regions
			Choosing Appropriate Areas for Afforestation
			Digging Ditches and Drainage; Making Ridges
			Suitable Seedlings and Seeds Choice
				Marshland and Lake Regions; Plains Regions with Waterway Networks
				Mountainous and Hilly Regions
			Land Preparation
				Marshland and Lake Regions
				Plains Regions with Waterway Networks
				Mountainous and Hilly Regions
			Proper Afforestation Density Design and Afforestation Patterns
				In Marshland and Lake Regions
				Afforestation Pattern in Marshland and Lake Regions
				In Plains Regions with Waterway Networks
				In Mountainous and Hilly Regions
			Afforestation Regulations, Operation Design, and Afforestation Times
				Afforestation Regulations and Operation Design
				Afforestation Time
			Tending and Managing Forests
				Forest Management and Protection
				Accompanying Measures
				Renewal of Trees
			Archive Management
		5.5.4	 Typical Modes for Schistosomiasis Prevention Through Forestry
			Agroforestry Mode
				How Afforestation Increases Local people’s Incomes
			Forestry and Husbandry Mode
			Forestry, Fishery, and Husbandry Mode
			Courtyard Forestry Mode
			Special Agroforestry Mode
		5.5.5	 Successful Experiences of Schistosomiasis Prevention through Afforestation
			Combination of Economic, Social, and Ecological Effects
			Combination of Multiple Departments
			Combination of Scientific Research with Practical Education
		5.5.6	 Planning Schistosomiasis Control through Forestry-Ecological Engineering
	References
6: National Plan for Schistosomiasis Control and Achievements
	6.1	 Public Health Campaign
		6.1.1	 Patriotic Health Movement
			Sanitary Toilets
			Biogas Production
		6.1.2	 Health Education
	6.2	 Strategic Plan for the Elimination of Schisto­Somiasis in the P.R. China (2016–2025)
		6.2.1	 Background
		6.2.2	 Vision, Goals, and Objectives
		6.2.3	 Guiding Principles
			Governmental Leadership and Multi-Sector Collaboration
			Comprehensive Interventions Adapted to Local Settings
			Empowerment of People and Communities
			Sensitive and Effective Surveillance and Response
			Improved Capacity for Control and Surveillance
		6.2.4	 Strategy
			Areas with Ongoing Transmission
			Areas where Schistosomiasis Has Been Eliminated or Transmission Interrupted
			Areas with Potential Risk of Schistosomiasis Transmission
		6.2.5	 Intervention Package
			Interventions from the Health Sector
				Screening and Treatment of Schistosomiasis Cases
				Clearing and Management of Schistosomiasis Foci
				Snail Survey and Control
				Construction of Harmless Latrines
				Surveillance and Early Warning of Schistosomiasis Emergence
				Health Education
			Interventions from the Agriculture Sector
				Management of Animal Reservoirs
				Snail Control in Combination with Agricultural Activities
				Surveillance on Animal Schistosomiasis
			Interventions from the Water Conservancy Sector
				Comprehensive Engineering of Rivers and Lakes
				Drainage System Modification Projects
				Rural Water Supply Projects
				Hydraulic Schistosomiasis Control Projects
			Interventions from the Forestry Sector
				Planting Forests in Favor of Snail Control and Prevention of Schistosomiasis
				Activities to Improve the Effectiveness of Snail Control
				Ecological Environment Surveillance
			Interventions from the Land Resources Sector
				Land Development and Consolidation Engineering
				Moving Villages from High Risk Areas
			Interventions from Other Related Sectors
		6.2.6	 Strategic Approaches to Guarantee the Implementation of the Strategic Plan
			Governmental Leadership and Coordination among Sectors and Districts
			Financial Support
			Technical Support
			Professional Workforce Support
		6.2.7	 Monitoring and Evaluation
	6.3	 Monitoring and Response Systems for Schistosomiasis
		6.3.1	 The History and Current Status of Schistosomiasis Surveillance Systems
			The History of Schistosomiasis Surveillance Systems
			The Contents of Schistosomiasis Surveillance Systems
				Schistosomiasis Cases
				Domestic Animals
				Snail Intermediate Hosts
				Related Epidemic Factors
			The Demand of the Current Schistosomiasis Surveillance Systems
		6.3.2	 Focus on Surveillance after Schistosomiasis Transmission Control
			The Purposes of Surveillance after Transmission Control
			Perfecting the Surveillance System after Transmission Control
				To Establish the Sensitive and Efficient Surveillance Indicators
				To Explore a Comprehensive Surveillance and Management Model
				To Develop and Utilize Advanced Techniques and Tools
				To Improve Capabilities for Detection of and Responses to Outbreaks
		6.3.3	 Case Study of the Emergency Response for a Schistosomiasis Outbreak
		6.3.4	 Conclusion
	6.4	 The Response Mechanism to the Epidemic Rebound of Schistosomiasis
		6.4.1	 The Standard for Rebound of Schistosomiasis Epidemics
		6.4.2	 Factors that Influence the Rebound of Schistosomiasis Epidemics
			Biological Factors
			Natural Factors
		6.4.3	 The Measures to Prevent the Rebound of Schistosomiasis Epidemics
			Snail Control
			Disease Control
			Professional Team
			Funding Levels
		6.4.4	 Establishing a Sensitive and Efficient Early Warning Mechanism for Schistosomiasis
			Epidemic Focus Disposal
				Treatment of Patients
				Preventive Chemotherapy for the Population at Risk
				Snail Control
				Health Education
				Safe Water Supply
				Manure Management
				Personal Protection
			Epidemiological Surveys
				Case Investigation
				Investigation on Epidemic Focus
				Investigation of Environmental and Social Factors
		6.4.5	 Case Study: The Disposal of New Snail Areas Occurring in Xiangyun County, Dali Prefecture, Yunnan Province
			Snail Control
			Schistosomiasis Surveyed among People and Livestock
			Health Education
	6.5	 Challenges and Requirements Relating to Schisto­Somiasis Elimination and Post-Elimination
		6.5.1	 Challenges to Eliminating Schistosomiasis and Post-Elimination
			Extensive and Complicated Snail Habitats
			Management of Different Sources of Infection
			Unbalanced Implementation of the Integrated Strategy
			Unavailability of Sensitive Tools for Elimination Certification and Surveillance
			Weak in Surveillance Capacity and Active Response System
		6.5.2	 Achieving Elimination and Preventing the Resurgence of Schistosomiasis Post-Elimination
			Encouraging Governmental Leadership and Intensifying the Responsibilities of Related Departments
			Insisting on a Comprehensive Control Strategy and Intensifying Integrated Interventions
			Improving the Surveillance and Response System to Control Risk Factors
			Intensifying Health Education and Health Promotion
			Strengthening Scientific Research and Capacity Building to Popularization and Implementation of New Techniques
	References