Assessment of knowledge, attitude and practices and the analysis of risk factors regarding schistosomiasis among fishermen and boatmen in the Dongting Lake Basin, the People's Republic of China.
ABSTRACT: BACKGROUND:Fishermen and boatmen are a population at-risk for contracting schistosomiasis due to their high frequency of water contact in endemic areas of schistosomiasis in the People's Republic of China (P. R. China). To develop specific interventions towards this population, the present study was designed to assess the knowledge, attitudes and practices (KAPs) towards schistosomiasis of fishermen and boatmen, and to identify the risk factors associated with schistosome infection using a molecular technique in a selected area of Hunan Province in P. R. China. METHODS:A cross sectional survey was conducted in the Dongting Lake Basin of Yueyang County, Hunan Province. A total of 601 fishermen and boatmen were interviewed between October and November 2017. Information regarding sociodemographic details and KAPs towards schistosomiasis were collected using a standardized questionnaire. Fecal samples of participants were collected and tested by polymerase chain reaction (PCR). Logistic regression analysis was conducted to explore the risk factors related to the positive results of PCR. RESULTS:Of the 601 respondents, over 90% knew schistosomiasis and how the disease was contracted, the intermediate host of schistosomes and preventive methods. The majority of respondents had a positive attitude towards schistosomiasis prevention. However, only 6.66% (40/601) of respondents had installed a latrine on their boats, while 32.61% (196/601) of respondents defecated in the public toilets on shore. In addition, only 4.99% (30/601) respondents protected themselves while exposed to freshwater. The prevalence of schistosomiasis, as determined by PCR, among fishermen and boatmen in Yueyang County was 13.81% (83/601). Age, years of performing the current job, number of times receiving treatment, and whether they were treated in past three years were the main influencing factors of PCR results among this population. CONCLUSIONS:Fishermen and boatmen are still at high risk of infection in P. R. China and gaps exist in KAPs towards schistosomiasis in this population group. Chemotherapy, and health education encouraging behavior change in combination with other integrated approaches to decrease the transmission risk in environments should be improved.
Project description:Thanks to Spatial Information Technologies (SITs) such as Remote Sensing (RS) and Geographical Information System (GIS) that are being quickly developed and updated, SITs are being used more widely in the public health field. The use of SITs to study the characteristics of the temporal and spatial distribution of Schistosoma japonicum and to assess the risk of infection provides methods for the control and prevention of schistosomiasis japonica has gradually become a hot topic in the field. The purpose of the present paper was to use RS and GIS technology to develop an efficient method of prediction and assessment of the risk of schistosomiasis japonica. We choose the Yueyang region, close to the east DongTing Lake (Hunan Province, China), as the study area, where a recent serious outbreak of schistosomiasis japonica took place. We monitored and evaluated the transmission risk of schistosomiasis japonica in the region using SITs. Water distribution data were extracted from RS images. The ground temperature, ground humidity and vegetation index were calculated based on RS images. Additionally, the density of oncomelania snails, which are the Schistosoma japonicum intermediate host, was calculated on the base of RS data and field measurements. The spatial distribution of oncomelania snails was explored using SITs in order to estimate the area surrounding the residents with transmission risk of schistosomiasis japonica. Our research result demonstrated: (1) the risk factors for the transmission of schistosomiasis japonica were closely related to the living environment of oncomelania snails. Key factors such as water distribution, ground temperature, ground humidity and vegetation index can be quickly obtained and calculated from RS images; (2) using GIS technology and a RS deduction technique along with statistical regression models, the density distribution model of oncomelania snails could be quickly built; (3) using SITs and analysis with overlaying population distribution data, the range of transmission risk of schistosomiasis japonica of the study area can be quickly monitored and evaluated. This method will help support the decision making for the control and prevention of schistosomiasis and form a valuable application using SITs for the schistosomiasis research.
Project description:We have performed a genome wide transcriptional survey of liver biopsies obtained from patients in Hunan China, who have chronic schistosomiasis with and without past viral hepatitis history, compared to patients with no liver disease history or indicators. These results present a comprehensive transcriptional profile of chronic schistosomiasis japonica patients and demonstrate similarities and differences with other hepatic diseases. These unique features of gene expression, in conjunction with previous reports of the cellular composition of granuloma formation and recovery, present an improved understanding of the molecular immunopathology and general physiological status underlying hepatic schistosomiasis. The gene expression profile of the human liver was examined for chronic patients with Schistosoma japonicum infections. Microarray analysis was performed on cRNA synthesised from total RNA derived from the liver biopsy tissue from huan China. Three groups were examined based on infections status [C] were without history or indicators of schistosomiasis or viral heapatitis controls ; [S] with a history or active for schistosomiasis but no indicators of viral heapatitis; and [S]
Project description: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.
Project description:BACKGROUND: Schistosomiasis japonica is still endemic in the People's Republic of China (P.R. China) in five provinces of lake and marshland regions and in two provinces of mountainous regions. Studies elucidated that individual and community perception, attitudes towards schistosomiasis, and hygiene behaviors were crucial factors for preventing schistosomiasis. This study sought to assess the knowledge of, attitudes towards, and practices (KAP) relating to schistosomiasis in two subtypes of a mountainous region in Eryuan County, Yunnan Province, P.R. China. The study's aim is to make suggestions for establishing more specific and effective control measures for disease transmission and interruption in two subtypes of a mountainous region with low-level infection rates. METHODS: A cross-sectional study of 3,000 inhabitants was carried out in the Yongle (plateau basin) and Xinzhuang (plateau canyon) communities of Eryuan County, Yunnan Province in November and December 2011. Stratified cluster random sampling was undertaken using a uniform set of quantitative questionnaires administered by trained assistants. This was further supported with qualitative data from in-depth interviews (IDIs) conducted with ten farmers and ten students. All participants were examined for schistosomiasis using both a serological test (indirect hemagglutination assay [IHA]) and a stool examination (Kato-Katz). RESULTS: The total schistosomiasis knowledge rate in Yongle (83.4%) was significantly lower than that in Xinzhuang (95.5%). In both communities, among the respondents aged 15 years or below, more than one third didn't know the name, endemic areas, and animal reservoirs of schistosomiasis. The majority of respondents in Eryuan acquired their schistosomiasis knowledge from doctors, followed by handouts and hearing from others. The infection rate was once the highest in Yongle, but is now the highest in Xinzhuang, where there are more risk factors for schistosomiasis, such as frequently grazing cattle, digging vegetables or cutting grass in the field, as well as raising cattle by free grazing. CONCLUSION: In short, Eryuan County's overall knowledge rate of schistosomiasis was found to be high. Due to various dominating risk factors, different control strategies should be designed keeping in mind the two different subtypes of endemic areas for schistosomiasis in mountainous regions, namely plateau basins and plateau canyons.
Project description:BACKGROUND:Porcine circovirus type 3 (PCV3), recently widely isolated from pigs with various clinical conditions, is likely globally epidemic. However, development of serological diagnosis for PCV3 in pigs is ongoing. Our objectives were to: 1) establish an indirect ELISA, using PCV3 capsid protein (Cap) prepared by Baculovirus Expression Vector System (BEVS) as a high-quality coating antigen for detection of PCV3-associated antibodies in serum samples; and 2) use this ELISA to conduct a serological survey for PCV3 in various regions of Hunan province, China. RESULTS:The PCV3 positive rate to the ELISA assay (total of 190 serum samples) was higher in sows with reproductive failure compared to healthy sows (34/85, 40.0% versus 30/105, 28.6%), with similar results using qPCR assays. Further, in an additional 1038 serum samples collected from January 2016 to May 2018 in various regions of Hunan province and tested with this established ELISA, 20 to 84% were positive for PCV3 (according to region of sera collection), with high PCV3 seroprevalence (>?50%) in herds in Changde, Hengyang and Yueyang. Moreover, among serum samples from herds in Shaoyang and Changde, PCV3 seroprevalence was higher in sows than in other classes of pigs (i.e., suckling piglets, nursery pigs, gilts, growing-finishing pigs and boars). CONCLUSIONS:We developed a full-length PCV3 Cap-based ELISA using a eukaryotic expression system with excellent potential to elucidate PCV3 epidemiology. Based on this assay, PCV3 has been circulating in Hunan province. PCV3 prevalence was lower in healthy sows than in those with reproductive failure. Further studies are warranted to identify the PCV3 responsible for high seroprevalence in sows and determine pathogenesis of PCV3 in sows with reproductive failure.
Project description:BACKGROUND:Zoonotic schistosomiasis japonica is a major public health problem in China. Bovines, particularly water buffaloes, are thought to play a major role in the transmission of schistosomiasis to humans in China. Preliminary results (1998-2003) of a praziquantel (PZQ)-based pilot intervention study we undertook provided proof of principle that water buffaloes are major reservoir hosts for S. japonicum in the Poyang Lake region, Jiangxi Province. METHODS AND FINDINGS:Here we present the results of a cluster-randomised intervention trial (2004-2007) undertaken in Hunan and Jiangxi Provinces, with increased power and more general applicability to the lake and marshlands regions of southern China. The trial involved four matched pairs of villages with one village within each pair randomly selected as a control (human PZQ treatment only), leaving the other as the intervention (human and bovine PZQ treatment). A sentinel cohort of people to be monitored for new infections for the duration of the study was selected from each village. Results showed that combined human and bovine chemotherapy with PZQ had a greater effect on human incidence than human PZQ treatment alone. CONCLUSIONS:The results from this study, supported by previous experimental evidence, confirms that bovines are the major reservoir host of human schistosomiasis in the lake and marshland regions of southern China, and reinforce the rationale for the development and deployment of a transmission blocking anti-S. japonicum vaccine targeting bovines. TRIAL REGISTRATION:Australian New Zealand Clinical Trials Registry ACTRN12609000263291.
Project description:BACKGROUND:Recent reports indicate racial disparities in the rates of infection and mortality from the 2019 novel coronavirus (coronavirus disease 2019 [COVID-19]). The aim of this study was to determine whether disparities exist in the levels of knowledge, attitudes and practices (KAPs) related to COVID-19. METHODS:We analyzed data from 1216 adults in the March 2020 Kaiser Family Foundation 'Coronavirus Poll', to determine levels of KAPs across different groups. Univariate and multivariate regression analysis was used to identify predictors of KAPs. RESULTS:In contrast to White respondents, Non-White respondents were more likely to have low knowledge (58% versus 30%; P < 0.001) and low attitude scores (52% versus 27%; P < 0.001), but high practice scores (81% versus 59%; P < 0.001). By multivariate regression, White race (odds ratio [OR] 3.06; 95% confidence interval [CI]: 1.70-5.50), higher level of education (OR 1.80; 95% CI: 1.46-2.23) and higher income (OR 2.06; 95% CI: 1.58-2.70) were associated with high knowledge of COVID-19. Race, sex, education, income, health insurance status and political views were all associated with KAPs. CONCLUSIONS:Racial and socioeconomic disparity exists in the levels of KAPs related to COVID-19. More work is needed to identify educational tools that tailor to specific racial and socioeconomic groups.
Project description:The Three Gorges Dam (TGD) is a remarkable, far-reaching project in China. This study was conducted to assess the impact of TGD on changes in the ecological environment, snail distribution and schistosomiasis transmission in Dongting Lake area.Hydrological data were collected from 12 monitoring sites in Hunan section of Yangtze River before and after TGD was established. Data on snail distribution and human schistosomiasis infection were also collected. Correlation analyses were performed to detect the significance of snail distribution to changes in ecological environmental factors and human schistosomiasis infection.A series of ecological environmental factors have changed in Dongting Lake area following the operation of TGD. Volume of annual runoff discharged into Dongting Lake declined by 20.85%. Annual sediment volume discharged into the lake and the mean lake sedimentation rate decreased by 73.9% and 32.2%, respectively. From 2003 to 2015, occurrence rate of frames with living snails and mean density of living snails decreased overall by 82.43% and 94.35%, respectively, with annual decrements being 13.49% and 21.29%. Moreover, human infection rate of schistosomiasis had decreased from 3.38% in 2003 to 0.44% in 2015, with a reduction of 86.98%. Correlation analyses showed that mean density of living snails was significantly associated with water level (r = 0.588, p<0.001), as well as the mean elevation range of the bottomland (r = 0.374, p = 0.025) and infection rate of schistosomiasis (r = 0.865, p<0.001).Ecological environmental changes caused by the TGD were associated with distribution of snails, and might further affect the transmission and prevalence of schistosomiasis. Risk of schistosomiasis transmission still exists in Dongting Lake area and long-term monitoring is required.
Project description:Background:The presence of COVID-19 in low- and middle-income countries (LMICs) is raising important concerns about effective pandemic response and preparedness in the context of fragile health systems and the pervasiveness of misinformation. The objective of this study was to gain an understanding of how COVID-19 was perceived by households experiencing extreme poverty in the Philippines. Methods:This study was conducted in partnership with International Care Ministries (ICM), a Philippine-based non-governmental organization (NGO) that runs a poverty-alleviation program called Transform targeted towards extreme low-income households. We integrated knowledge, attitudes, and practices (KAP) questions into ICM's cross-sectional program monitoring and evaluation systems from February 20 through March 13, 2020. Frequencies and proportions were calculated to describe the respondents' responses, and the Kruskal-Wallis test and binomial logistic regression were undertaken to determine the socio-demographic characteristics associated with COVID-19 KAPs. Results:In total, 2224 respondents from 166 communities in rural, urban and coastal settings were surveyed. Although the survey was administered during the earlier stages of the pandemic, 94.0% of respondents had already heard of COVID-19. Traditional media sources such as television (85.5%) and radio (56.1%) were reported as the main sources of information about the virus. Coughing and sneezing were identified as a transmission route by 89.5% of respondents, while indirect hand contact was the least commonly identified transmission route, recognized by 72.6% of respondents. Handwashing was identified by 82.2% of respondents as a preventive measure against the virus, but social distancing and avoiding crowds were only identified by 32.4% and 40.6%, respectively. Handwashing was the most common preventive practice in response to COVID-19, adopted by 89.9% of respondents. A greater number of preventive measures were taken by those with more knowledge of potential transmission routes. Conclusions:There is a need for targeted health education as a response strategy to COVID-19 in low-income settings, and it is important that strategies are contextually relevant. Understanding KAPs among populations experiencing extreme poverty will be important as tailored guidance for public health response and communication strategies are developed for LMICs.
Project description:Despite significant progress, China faces the challenge of re-emerging schistosomiasis transmission in currently controlled areas due, in part, to the presence of a range of animal reservoirs, notably water buffalo and cattle, which can harbor Schistosoma japonicum infections. Environmental, ecological and social-demographic changes in China, shown to affect the distribution of oncomelanid snails, can also impact future schistosomiasis transmission. In light of their importance in the S. japonicum, lifecycle, vaccination has been proposed as a means to reduce the excretion of egg from cattle and buffalo, thereby interrupting transmission from these reservoir hosts to snails. A DNA-based vaccine (SjCTPI) our team developed showed encouraging efficacy against S. japonicum in Chinese water buffaloes. Here we report the results of a double-blind cluster randomized trial aimed at determining the impact of a combination of the SjCTPI bovine vaccine (given as a prime-boost regimen), human mass chemotherapy and snail control on the transmission of S. japonicum in 12 selected administrative villages around the Dongting Lake in Hunan province. The trial confirmed human praziquantel treatment is an effective intervention at the population level. Further, mollusciciding had an indirect ~50% efficacy in reducing human infection rates. Serology showed that the SjCTPI vaccine produced an effective antibody response in vaccinated bovines, resulting in a negative correlation with bovine egg counts observed at all post-vaccination time points. Despite these encouraging outcomes, the effect of the vaccine in preventing human infection was inconclusive. This was likely due to activities undertaken by the China National Schistosomiasis Control Program, notably the treatment, sacrifice or removal of bovines from trial villages, over which we had no control; as a result, the trial design was compromised, reducing power and contaminating outcome measures. This highlights the difficulties in undertaking field trials of this nature and magnitude, particularly over a long period, and emphasizes the importance of mathematical modeling in predicting the potential impact of control intervention measures. A transmission blocking vaccine targeting bovines for the prevention of S. japonicum with the required protective efficacy would be invaluable in tandem with other preventive intervention measures if the goal of eliminating schistosomiasis from China is to become a reality.