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

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

    Research output: Contribution to journalArticlepeer-review

    32 Citations (Scopus)

    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.

    Original languageEnglish
    Pages (from-to)659-668
    Number of pages10
    JournalInternational Journal for Parasitology
    Volume44
    Issue number9
    DOIs
    Publication statusPublished - Aug 2014

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