Field Testing Integrated Interventions for Schistosomiasis Elimination in the People's Republic of China: Outcomes of a Multifactorial Cluster-Randomized Controlled Trial
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Williams, Gail; Li, Yuesheng; Gray, Darren; Zhao, Zheng Yuan; Harn, Donald A.; Shollenberger, Lisa M.; Li, Sheng-Ming; Yu, Xin-Ling; Feng, Zeng; Guo, Jia-Gang
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....[Show more]
dc.contributor.author | Williams, Gail | |
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dc.contributor.author | Li, Yuesheng | |
dc.contributor.author | Gray, Darren | |
dc.contributor.author | Zhao, Zheng Yuan | |
dc.contributor.author | Harn, Donald A. | |
dc.contributor.author | Shollenberger, Lisa M. | |
dc.contributor.author | Li, Sheng-Ming | |
dc.contributor.author | Yu, Xin-Ling | |
dc.contributor.author | Feng, Zeng | |
dc.contributor.author | Guo, Jia-Gang | |
dc.date.accessioned | 2020-02-17T03:14:53Z | |
dc.date.available | 2020-02-17T03:14:53Z | |
dc.identifier.issn | 1664-3224 | |
dc.identifier.uri | http://hdl.handle.net/1885/201717 | |
dc.description.abstract | 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. | |
dc.description.sponsorship | DM is a NHMRC Senior Principal Research Fellow. DG is a NHMRC Career Development Fellow | |
dc.format.mimetype | application/pdf | |
dc.language.iso | en_AU | |
dc.publisher | Frontiers Research Foundation | |
dc.rights | © 2019 Williams, Li, Gray, Zhao, Harn, Shollenberger, Li, Yu, Feng, Guo, Zhou, Dong, Li, Guo, Driguez, Harvie, You, Ross and McManus. | |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | |
dc.source | Frontiers in Immunology | |
dc.title | Field Testing Integrated Interventions for Schistosomiasis Elimination in the People's Republic of China: Outcomes of a Multifactorial Cluster-Randomized Controlled Trial | |
dc.type | Journal article | |
local.description.notes | Imported from ARIES | |
local.identifier.citationvolume | 10 | |
dc.date.issued | 2019 | |
local.identifier.absfor | 111706 - Epidemiology | |
local.identifier.absfor | 110803 - Medical Parasitology | |
local.identifier.absfor | 110309 - Infectious Diseases | |
local.identifier.ariespublication | u3102795xPUB2046 | |
local.publisher.url | https://www.frontiersin.org/ | |
local.type.status | Published Version | |
local.contributor.affiliation | Williams, Gail, University of Queensland | |
local.contributor.affiliation | Li, Yuesheng, WHO Collaborating Center for Research and Control of Schistosomiasis on Lake Region | |
local.contributor.affiliation | Gray, Darren, College of Health and Medicine, ANU | |
local.contributor.affiliation | Zhao, Zheng Yuan, Hunan Institute of Parasitic Diseases | |
local.contributor.affiliation | Harn, Donald A., University of Georgia | |
local.contributor.affiliation | Shollenberger, Lisa M., Old Dominion University | |
local.contributor.affiliation | Li, Sheng-Ming, Hunan Institute of Parasitic Diseases | |
local.contributor.affiliation | Yu, Xin-Ling, Hunan Institute of Parasitic Diseases | |
local.contributor.affiliation | Feng, Zeng, Chinese Centre for Disease Control and Prevention | |
local.contributor.affiliation | Guo, Jia-Gang, Hunan Institute of Parasitic Diseases | |
local.bibliographicCitation.startpage | 1 | |
local.bibliographicCitation.lastpage | 14 | |
local.identifier.doi | 10.3389/fimmu.2019.00645 | |
local.identifier.absseo | 920404 - Disease Distribution and Transmission (incl. Surveillance and Response) | |
local.identifier.absseo | 920503 - Health Related to Specific Ethnic Groups | |
dc.date.updated | 2019-11-25T07:33:21Z | |
local.identifier.thomsonID | 4.63316E+11 | |
dcterms.accessRights | Open Access | |
dc.provenance | © 2019 Williams, Li, Gray, Zhao, Harn, Shollenberger, Li, Yu, Feng, Guo, Zhou, Dong, Li, Guo, Driguez, Harvie, You, Ross and McManus. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. | |
dc.rights.license | Creative Commons Attribution License (CC BY) | |
Collections | ANU Research Publications |
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