Abstract
BackgroundThe Poyang Lake Region, one of the major epidemic sites of schistosomiasis in China, remains a severe challenge. To improve our understanding of the current endemic status of schistosomiasis and to better control the transmission of the disease in the Poyang Lake Region, it is important to analyse the clustering pattern of schistosomiasis and detect the hotspots of transmission risk.ResultsBased on annual surveillance data, at the village level in this region from 2009 to 2014, spatial and temporal cluster analyses were conducted to assess the pattern of schistosomiasis infection risk among humans through purely spatial (Local Moran’s I, Kulldorff and Flexible scan statistic) and space-time scan statistics (Kulldorff). A dramatic decline was found in the infection rate during the study period, which was shown to be maintained at a low level. The number of spatial clusters declined over time and were concentrated in counties around Poyang Lake, including Yugan, Yongxiu, Nanchang, Xingzi, Xinjian, De’an as well as Pengze, situated along the Yangtze River and the most serious area found in this study. Space-time analysis revealed that the clustering time frame appeared between 2009 and 2011 and the most likely cluster with the widest range was particularly concentrated in Pengze County.ConclusionsThis study detected areas at high risk for schistosomiasis both in space and time at the village level from 2009 to 2014 in Poyang Lake Region. The high-risk areas are now more concentrated and mainly distributed at the river inflows Poyang Lake and along Yangtze River in Pengze County. It was assumed that the water projects including reservoirs and a recently breached dyke in this area were partly to blame. This study points out that attempts to reduce the negative effects of water projects in China should focus on the Poyang Lake Region.
Highlights
The Poyang Lake Region, one of the major epidemic sites of schistosomiasis in China, remains a severe challenge
Intestinal schistosomiasis caused by infection with S. japonicum, a water-borne parasitic disease, has brought about significant economic and public health concerns in south-east Asia [1, 2] with a history of more than 2100 years in China [3]
Despite the remarkable success achieved in schistosomiasis control in China through the measures mentioned, schistosomiasis remains a serious problem in the lake and marshland regions, especially along the middle of the Yangtze River basin
Summary
The Poyang Lake Region, one of the major epidemic sites of schistosomiasis in China, remains a severe challenge. To improve our understanding of the current endemic status of schistosomiasis and to better control the transmission of the disease in the Poyang Lake Region, it is important to analyse the clustering pattern of schistosomiasis and detect the hotspots of transmission risk. Despite the remarkable success achieved in schistosomiasis control in China through the measures mentioned, schistosomiasis remains a serious problem in the lake and marshland regions, especially along the middle of the Yangtze River basin (including both Dongting and Poyang Lakes). It has been estimated that people infected with S. japonicum in swamp and lake areas account for approximately 86% of the total number in the whole country [11]. Poyang Lake Region, which includes the largest freshwater lake in China, constitutes the largest continuous area endemic for schistosomiasis in the country and was historically reported with 2.5 million people at risk for infection and 340,000 infected [12]
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