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Field Testing Integrated Interventions for Schistosomiasis Elimination in the People's Republic of China: Outcomes of a Multifactorial Cluster-Randomized Controlled Trial

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

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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.authorWilliams, Gail
dc.contributor.authorLi, Yuesheng
dc.contributor.authorGray, Darren
dc.contributor.authorZhao, Zheng Yuan
dc.contributor.authorHarn, Donald A.
dc.contributor.authorShollenberger, Lisa M.
dc.contributor.authorLi, Sheng-Ming
dc.contributor.authorYu, Xin-Ling
dc.contributor.authorFeng, Zeng
dc.contributor.authorGuo, Jia-Gang
dc.date.accessioned2020-02-17T03:14:53Z
dc.date.available2020-02-17T03:14:53Z
dc.identifier.issn1664-3224
dc.identifier.urihttp://hdl.handle.net/1885/201717
dc.description.abstractDespite 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.sponsorshipDM is a NHMRC Senior Principal Research Fellow. DG is a NHMRC Career Development Fellow
dc.format.mimetypeapplication/pdf
dc.language.isoen_AU
dc.publisherFrontiers 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.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourceFrontiers in Immunology
dc.titleField Testing Integrated Interventions for Schistosomiasis Elimination in the People's Republic of China: Outcomes of a Multifactorial Cluster-Randomized Controlled Trial
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume10
dc.date.issued2019
local.identifier.absfor111706 - Epidemiology
local.identifier.absfor110803 - Medical Parasitology
local.identifier.absfor110309 - Infectious Diseases
local.identifier.ariespublicationu3102795xPUB2046
local.publisher.urlhttps://www.frontiersin.org/
local.type.statusPublished Version
local.contributor.affiliationWilliams, Gail, University of Queensland
local.contributor.affiliationLi, Yuesheng, WHO Collaborating Center for Research and Control of Schistosomiasis on Lake Region
local.contributor.affiliationGray, Darren, College of Health and Medicine, ANU
local.contributor.affiliationZhao, Zheng Yuan, Hunan Institute of Parasitic Diseases
local.contributor.affiliationHarn, Donald A., University of Georgia
local.contributor.affiliationShollenberger, Lisa M., Old Dominion University
local.contributor.affiliationLi, Sheng-Ming, Hunan Institute of Parasitic Diseases
local.contributor.affiliationYu, Xin-Ling, Hunan Institute of Parasitic Diseases
local.contributor.affiliationFeng, Zeng, Chinese Centre for Disease Control and Prevention
local.contributor.affiliationGuo, Jia-Gang, Hunan Institute of Parasitic Diseases
local.bibliographicCitation.startpage1
local.bibliographicCitation.lastpage14
local.identifier.doi10.3389/fimmu.2019.00645
local.identifier.absseo920404 - Disease Distribution and Transmission (incl. Surveillance and Response)
local.identifier.absseo920503 - Health Related to Specific Ethnic Groups
dc.date.updated2019-11-25T07:33:21Z
local.identifier.thomsonID4.63316E+11
dcterms.accessRightsOpen 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.licenseCreative Commons Attribution License (CC BY)
CollectionsANU Research Publications

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