Abstract
BackgroundsHuman schistosomiasis is caused by schistosome, with annual loss of over 70 million disability adjusted life years in the world. China is endemic with Schistosoma japonicum and large-scale chemotherapy with praziquantel has become the mainstay of control in China since 1990s. However, the control effects of mass treatment in the field have been uneven. Moreover, mass treatment has come into a wide use in other countries with limited health resources. Therefore, a better understanding of the control effect of mass treatment is in an urgent need.MethodsWe performed a systematic search of the literature to investigate the control efficiency of annual community-wide treatment (ACWT, treatment to an entire community without any preliminary screening) with a single dose of PZQ (40 mg kg−1 bodyweight) against schistosome in humans in China. Three Chinese literature databases, including China National Knowledge Infrastructure, WanFang and Chinese Scientific Journal Databases, and the PubMed were searched. Pooled prevalence ratios (prevalence after to before treatment) were used to assess effect. Our protocol is available on PROSPERO (No. CRD42013003628).Results22 articles were included. Meta-analyses on data from 18 studies on one round of ACWT, 17 studies on two consecutive rounds and 6 studies on three consecutive rounds were performed. The results showed control effects of ACWT plus other measures were statistically significant, with prevalence ratios being 0.38 (0.31, 0.46) for one round, 0.28 (0.22, 0.35) for two rounds and 0.22 (0.10, 0.46) for three rounds. When ACWT was performed alone or with health education only, the values for one and two rounds were 0.389 (0.307, 0.492) and 0.348 (0.300, 0.403), respectively.ConclusionsThe control effect of ACWT alone or with other measures is significant and increases with the number of rounds. Such program is recommended in high endemic areas and the criteria yet merit further assessment.
Highlights
The results showed control effects of annual community-wide treatment (ACWT) plus other measures were statistically significant, with prevalence ratios being 0.38 (0.31, 0.46) for one round, 0.28 (0.22, 0.35) for two rounds and 0.22 (0.10, 0.46) for three rounds
The control effect of ACWT alone or with other measures is significant and increases with the number of rounds. Such program is recommended in high endemic areas and the criteria yet merit further assessment
Human schistosomiasis is caused by schistosome including Schistosoma haematobium, S. intercalatum, S. mansoni, S. japonicum and S. mekongi, a parasite that is the second most important after Plasmodium to the public health in tropical and subtropical regions, resulting in 207 million people infections [1] and annual loss of over 70 million disability adjusted life years (DALYs) [2]
Summary
Human schistosomiasis is caused by schistosome including Schistosoma haematobium, S. intercalatum, S. mansoni, S. japonicum and S. mekongi, a parasite that is the second most important after Plasmodium to the public health in tropical and subtropical regions, resulting in 207 million people infections [1] and annual loss of over 70 million disability adjusted life years (DALYs) [2]. A series of control measures, as a consequence, has been developed to reduce schistosome infections and infection-associated morbidity in endemic populations during the last several decades [3,4,5], which include health education, snail control, environment management and modification, sanitation and water supply, and large-scale chemotherapy. After the founding of the new government, a high priority has been given to schistosomiasis control in the public health work and the national control program, aiming to eliminate the disease, was developed and implemented mainly through snail control. Since 1990s with an efficient and high safety treatment available for infected individuals with the drug Praziquantel (PZQ), with a special support from the World Bank Loan Project during 1992–2001 [8], China had adopted morbidity control as its main aim in most endemic areas, which mainly relied on large scale chemotherapy. More comments or reviews are seen in [11,12,13,14]
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