Schistosomiasis Patients Research Articles

Correlation between hepatic fibrosis and anti - neutrophil cytoplasmic antibodies (ANCA) in schistosomiasis patients

To investigate the association between hepatic fibrosis and anti-neutrophil cytoplasmic antibodies (ANCA) in the patients with schistosomiasis. Totally 145 schistosomiasis patients confirmed by Jingzhou First People's Hospital during the period of February 2014 to June 2016 were randomly selected as an experimental group, and 100 healthy people during the same period were randomly selected as a control group. The serum samples of the two groups were collected and the level of ANCA was detected by indirect immunofluorescence, and the levels of hyaluronic acid, laminin, procollagen type III, and collagen type IV were detected by radioimmunoassay. The levels of the above indexes of the two groups were compared. The positive rate of ANCA was 28.96% (42/145) in the experimental group and 1.00% (1/100) in the healthy control group, and the difference between them was statistically significant (P < 0.05). The levels of hyaluronic acid, laminin, procollagen type III and collagen type IV in the experimental group were significantly higher than those in the control group, and the differences were statistically significant (all P < 0.05), and the proportions of those with abnormal levels of hyaluronic acid, laminin, procollagen type III and collagen type IV in the experimental group were significantly higher than those in the control group, and the differences were statistically significant (all P < 0.05). In the experimental group, among the 42 patients with ANCA positives, the proportions of those with abnormal levels of hyaluronic acid and laminin were significantly higher than the proportions of those with ANCA negatives, and in the former, the levels of the four indicators of liver fibrosis were all higher than the normal values, and the average levels of hyaluronic acid and laminin in the patients with ANCA positives were significantly higher than those in the patients with ANCA negatives (all P < 0.05). The patients with schistosomiasis hepatic fibrosis could be positive for the autoimmune antibody ANCA, and ANCA may be associated with the autoimmune process of liver fibrosis.

Enhanced Content of IgG in Burkitt’s Lymphoma Cells after Treatment with the Topoisomerase II Inhibitor, Lucanthone

Burkitt’s lymphoma cells (CRL-1647) which had survived treatment with lucanthone contained 3.6 fold more IgG than untreated cells, although most of the cellular immunoglobulins were still IgM. DNA activation induced cytidine deaminase (AID) was increased 5 fold in these surviving cells, consistent with active Class Switch Recombination (CSR). Progeny of the small fraction of cells which had survived 20 h exposure to 8 μM lucanthone before rescue were cloned. 1.5 × 108 cloned cells contained ~1 μg of cytidine DNA deaminase, as determined from affinity column isolation of the enzyme, assayed by digestion of a 30 nt 32P labeled specific DNA substrate. Before lucanthone treatment, little AID could be detected. After the second treatment, a six fold increase in AID was found. In confirmation, Western blot determinations of AID from lysates of lucanthone treated cells showed 5 fold increased AID content. These results suggest that lucanthone led to increased IgG content of surviving cells, consistent with their increased AID activity. The surviving cells were also more resistant to the standard lucanthone treatment, as determined in clonogenic assays. IgG could not be detected in the cell membranes of CRL cells before or after lucanthone by immunostaining and flow cytometry, but both cell types secreted 80 kDa and 25 kDa immunorelated protein. Lucanthone, formerly used to safely to treat hundreds of thousands of schistosomiasis patients, might be considered as a means to promote IgG synthesis in macroglobulinemia patients.

Schistosomiasis control progress and endemic situation in Sichuan Province

To understand the schistosomiasis control progress and endemic situation, so as to provide the evidence for formulating the strategy of schistosomiasis elimination in Sichuan Province. The schistosomiasis history data, working reports of schistosomiasis prevention and control, schistosomiasis surveillance data, and data of schistosomiasis prevention and control capacity were collected and analyzed for the schistosomiasis control progress and epidemic situation in Sichuan Province from 2004 to 2015. There were 63 schistosomiasis endemic districts in 11 cities in Sichuan Province, and the standard of schistosomiasis transmission interruption was achieved in the whole province in 2015. Currently, the area with Oncomelania hupensis snails was 2 537.54 hm2, and there were 1 769 advanced schistosomiasis patients. From 2004 to 2015, the accumulated survey area with snails was 433 065.80 hm2, and the area of snail control by molluscicides was 251 259 hm2. There were 26.017 144 million person-times of schistosomiasis blood tests and 7.89 million person-times of chemotherapy. There were 1.276 117 million head-times of cattle that received the schistosomiasis examinations. The schistosomiasis patients and livestock and the area with snails were decreased year by year. Since 2010, there were no local schistosome-infected residents and livestock and since 2004, there were no schistosome-infected snails. However, in some area, the professional personnel were less, the technology and hardware lagged behind, and the schistosomiasis prevention and control capacity was weak. Sichuan Province achieved the standard of schistosomiasis transmission interruption in 2015. In the future, the comprehensive schistosomiasis prevention and control strategy still should be strengthened, including the promotion of schistosomiasis prevention and control capacity, establishment of sensitive early-warning surveillance system, and implementation of accurate schistosomiasis prevention and control, in order to consolidate the control achievements and realize the aim of schistosomiasis elimination as soon as possible.

Application effect of pericardial devascularization plus gastric fundus transaction in advanced schistosomiasis

To discuss the effect of pericardial devascularization plus gastric fundus transaction in advance schistosomiasis patients with portal hypertension. Thirty-six advanced schistosomiasis patients with portal hypertension treated with devascularization plus gastric fundus transaction (a portal hypertension group), as well as 10 patients treated with modified Sugiura operation (a modified Sugiura operation group) in the Third People's Hospital of Yangxin County since 2006 were chosen as the observation objects, and the clinical effects of the two groups were observed and compared. The operation time, indwelling time of stomach tube, time to taking food after operation, drainage tube removal time of the portal hypertension group were all shorten than those of the modified Sugiura operation group (all P＜0.05). The hospitalization expenses of the two groups were (25 466.00 ± 2 888.48) Yuan and (34 517.10 ± 4 948.39) Yuan respectively, and the difference was also statistically significant (P＜0.05). The incidence rates of portal thrombosis of the portal hypertension group and modified Sugiura operation group were 33.33% (12/36) and 40.00% (4/10), respectively, and the incidence rates of rehaemorrhagia of the two groups 12 months after the operation were 16.67% (6/36) and 10.00% (1/10), respectively, but the differences had no statistically significance (both P ＞ 0.05). In addition, 1 case with delayed gastric emptying and 1 case with stomal leak of esophagus happened in the modified Sugiura operation group, while no corresponding complications happened in the portal hypertension group. Pericardial devascularization plus gastric fundus is a relatively easy procedure which has a good short-term clinical effect, and therefore it is suitable for application in primary hospitals. However, its long-term effect still needs further observation.

Long-term effectiveness of the integrated schistosomiasis control strategy with emphasis on infectious source control in China: a 10-year evaluation from 2005 to 2014.

Schistosomiasis is a neglected tropical parasitic disease of great public health significance worldwide. Currently, mass drug administration with praziquantel remains the major strategy for global schistosomiasis control programs. Since 2005, an integrated strategy with emphasis on infectious source control was implemented for the control of schistosomiasis japonica, a major public health concern in China, and pilot studies have demonstrated that such a strategy is effective to reduce the prevalence of Schistosoma japonicum infection in both humans and bovines. However, there is little knowledge on the long-term effectiveness of this integrated strategy for controlling schistosomiasis japonica. The aim of this study was to evaluate the long-term effectiveness of the integrated strategy for schistosomiasis control following the 10-year implementation, based on the data from the national schistosomiasis control program released by the Ministry of Health, People's Republic of China. In 2014, there were 5 counties in which the transmission of schistosomiasis japonica had not been interrupted, which reduced by 95.2% as compared to that in 2005 (105 counties). The number of schistosomiasis patients and acute cases reduced by 85.5 and 99.7% in 2014 (115,614 cases and 2 cases) as compared to that in 2005 (798,762 cases and 564 cases), and the number of bovines and S. japonicum-infected bovines reduced by 47.9 and 98% in 2014 (919,579 bovines and 666 infected bovines) as compared to that in 2005 (1,764,472 bovines and 33,736 infected bovines), respectively. During the 10-year implementation of the integrated strategy, however, there was a minor fluctuation in the area of Oncomelania hupensis snail habitats, and there was only a 5.6% reduction in the area of snail habitats in 2014 relative to in 2005. The results of the current study demonstrate that the 10-year implementation of the integrated strategy with emphasis on infectious source has greatly reduced schistosomiasis-related morbidity in humans and bovines. It is concluded that the new integrated strategy has remarkable long-term effectiveness on the transmission of schistosomiasis japonica in China, which facilitates the shift of the national schistosomiasis control program from transmission control to transmission interruption and elimination. However, such a strategy seems to have little effect on the shrinking of areas of snail habitats.

Discussion on ultrasonographic characteristics of schistosomal appendicitis lesions

To discuss the ultrasonographic characteristics of schistosomal appendicitis lesions. Among the patients with schistosomal hepatopathy who were discovered by Color Doppler ultrasound in Huzhou Central Hospital from January 2012 to December 2015, 50 cases with clear history of schistosomiasis and treatment were chosen as a schistosomal hepatopathy group, meanwhile, 50 normal people, who came from non-endemic areas, without schistosomal hepatopathy and schistosomiasis history were chosen as a control group. The two groups were examined by ultrasound scan of the appendix, and the data of the largest diameter of the appendix and the thickness of the appendix wall were collected, and the sonographic characteristics of their appendixes, such as whether the echo of the appendix wall was even or not, were observed. The minimum internal diameter of the appendix cavity and the thickness of the appendix wall of the schistosomal hepatopathy group were (2.090 ± 0.790) mm and (1.332 ± 0.313) mm, respectively, the former was significantly narrower than that of the control group, while the latter was significantly thicker than that of the control group (t = 2.647, - 4.526, respectively, both P＜0.05). The proportions of those with inhomogeneous echo, indistinctness structure, uneven thickening of the appendix wall, as well as having intestinal contents in the appendix cavity in the schistosomal hepatopathy group were higher than those in the control group (χ2 = 12.000, 18.537, 24.008, 4.244, respectively, all P＜0.05). Schistosomal appendicitis lesions have obvious ultrasonographic characteristics under ultrasound. Ultrasound can play an important role in judging whether the appendix of schistosomiasis patients is involved and discovering the lesion of appendix early.

Clinical characteristics of 96 patients with advanced schistosomiasis in Yingcheng City

To understand the clinical characteristics of patients with advanced schistosomiasis in Yingcheng City, so as to provide evidences for the assistance work of advanced schistosomiasis. The clinical data of all the advanced schistosomiasis patients in Yingcheng City were collected and analyzed. Up to December 30, 2014, there were 96 advanced schistosomiasis patients in Yingcheng City, among which, 68 cases (70.8%) were male, 28 cases (29.2%) were female, and their average age was 64.2 years. Most of the patients (90.6%) were ascitic type, followed by splenomegaly type (5.2%), colon proliferation type (2.1%), and dwarf type (2.1%). Totally 48 cases (50.0%) were positive in immunological detections, among which 8 cases (8.3%) were positive in ELISA and 12 cases (12.5%) were positive in IHA. For all the 4 indexes of hepatic fibrosis (HA, LN, CIV and PCⅢ), only 15 cases (15.6%) were normal. Though Yingcheng City has reached the criteria of transmission control, the hepatic fibrosis of some patients continues to progress. Therefore, the intensity of the treatment and assistance could not be weakened, especially for those of the ascitic type patients.

T follicular helper cells in patients with acute schistosomiasis.

BackgroundThe role of T follicular helper (Tfh) cells in schistosome infection is not fully defined. In a previous study, a higher frequency of circulating PD-1+CXCR5+CD4+ Tfh cells was observed in patients with chronic schistosomiasis relative to healthy controls (HCs) and it correlated positively with the level of soluble egg antigen (SEA) specific antibodies in serum. However, the function of Tfh cells in patients with acute schistosomiasis remains elusive; this was investigated in the present study.MethodsThe frequency of circulating Tfh cells and the expression of inducible T cell co-stimulator (ICOS), programmed cell death 1 (PD-1) and B cell subsets were analyzed in 12 patients with acute schistosomiasis and 10 HCs by flow cytometry. The expression of Bcl6, c-Maf and IL-21 mRNA were detected by quantitative real-time reverse transcriptase PCR (qRT-PCR). The concentration of serum IL-21 and IgG specific to Schistosoma japonicum antigen were then determined by enzyme linked immunosorbent assay (ELISA). Correlations between PD-1+CXCR5+CD4+ Tfh cells, memory B cells and IgG specific to S. japonicum were analyzed by Spearman’s rank correlation.ResultsThe frequency of PD-1+CXCR5+CD4+ Tfh and memory B cells was increased in acute schistosomiasis patients relative to HCs. Moreover, the levels of IL-21 in serum and the expression of IL-21 mRNA were higher in acute schistosomiasis patients. However, there was no significant correlation between PD-1+CXCR5+CD4+ Tfh cells, memory B cells and IgG specific to S. japonicum antigen in patients with acute schistosomiasis.ConclusionsPD-1+CXCR5+CD4+ Tfh cells in peripheral blood are involved in the immune response of patients with acute schistosomiasis. Understanding the immunological mechanism is helpful for the development of vaccination strategies to control schistosomiasis.

Management strategy and technology of medical assistance to advanced schistosomiasis patients in Hunan Province

The medical assistance to advanced schistosomiasis patients established by the Chinese government is a major public facility for patients with advanced schistosomiasis. Since the medical assistance to advance schistosomiasis patients in Hunan Province started ten years ago, a set of mature and operable programs with whole program management and related technologies has been developed. The author investigated the data on medical assistance to advanced schistosomiasis patients in Hunan Province during the last 10 years (from 2006 to 2015) retrospectively, and found that the program had high therapeutic effect and high satisfaction degree of both patients and the society. In order to improve the management of the medical assistance to advanced schistosomiasis patients and share our experiences of the whole program management and related technologies with the colleagues of other provinces, this paper mainly illustrates the experiences of the program, as well as the existing problems and related strategies.

Application of clinical nursing path integrated with holistic nursing in advanced schistosomiasis patients with ascites

To evaluate the effect of the clinical nursing path integrated with the holistic nursing on advanced schistosomiasis patients with ascites. A total of 226 advanced schistosomiasis patients with ascites were randomly divided into a control group and an experimental group (113 cases each group). The subjects in the experimental group were nursed by the clinical nursing path integrated with the holistic nursing, while those in the control group were nursed only by the holistic nursing. Then the clinical relevant indexes of the two groups were observed, and the quality of life of the patients before and after hospital discharge was assessed. The improvement rate, satisfaction degree, and awareness rate of health knowledge of the patients in the experiment group were 93.8%, 100% and 97.4%, respectively, which were significantly higher than those of the control group (all P < 0.05). The mortality rate and the complication rate of the patients in the experimental group were 0 and 2.7%, respectively, which were significantly lower than those of the control group (both P < 0.05). In addition, the average hospitalization days and the hospitalization cost of the experiment group were (12.2 ± 0.7) d and (4 725.0 ± 310.1) Yuan respectively, which were less than those of the control group (both P < 0.01). When 6 months after the discharge from hospital, the quality of life of the patients in the experimental group in various fields was significantly better than that of the control group (all P < 0.05). The clinical nursing pathway integrated with holistic nursing can effectively improve the improvement rate and decrease the mortality of the advanced schistosomiasis patients with ascites; meanwhile, it can shorten the hospitalization time and save the hospitalization cost. Therefore, this nursing model is suitable for popularization and application in the treatment and nursing work of the advanced schistosomiasis assistance.

Surveillance of imported schistosomiasis in non-endemic areas in Changshu City from 2006 to 2015

To understand the situation of imported schistosomiasis in non-endemic areas along the Yangtze River in Changshu City, so as to provide the evidence for formulating and adjusting control measures. The data of Oncomelania hupensis snails and schistosomiasis patients in Changshu City from 2006 to 2015 were collected and analyzed. Totally 1 650 residents of Changshu City were tested by serum tests from 2006 to 2015, and 35 cases were positive, with a positive rate of 2.12%. No positive cases were found in etiological tests. No O. hupensis snails were found. No imported schistosomiasis cases are found in the areas along the Yangtze River in Changshu City, but the infection source is still possible to be imported, and the surveillance work should be strengthened.

Application of solution focused approach in nursing of patients with advanced schistosomiasis

To investigate the effect of nursing with solution focused approach in advanced schistosomiasis patients. Fifty three patients with advanced schistosomiasis in the Liujiahu Hospital for Schistosomiasis Control of Yiyang City were randomized selected and separated into an intervention group and a control group. The patients of the intervention group received the conventional nursing plus solution focused approach, while the patients of the control group received only the conventional nursing. The effectiveness of nursing and treatment was evaluated in the two groups comparatively. The knowledge of self-care skills, medical compliance behaviors and services satisfaction degree in the intervention group were higher than those in the control group (χ2 = 3.78, 2.87, 4.09 respectively, all P < 0.05). The occurrence rate of upper gastrointestinal bleeding in the intervention group was significantly lower than that in the control group (χ2 = 4.894, P < 0.05). The average hospitalization duration of the intervention group was shorter than that of the control group (t = 4.17, P < 0.05). The solution focused approach is a feasible and effective method in course of nursing of advanced schistosomiasis patients. It enhances the confidence of the patients and the trustiness of the patients to the health care providers. The complications and the hospitalization duration of the patients are reduced.

Surveillance of schistosomiasis in Hubei Province in 2014

To analyze the surveillance results of schistosomiasis and understand the transmission situation in Hubei Province in 2014. According to the Scheme of Schistosomiasis Surveillance in Hubei Province (the 2009 edition), 207 endemic sites were selected, where the schistosome infections of residents and livestock, and the distribution of Oncomelania hupensis snails were investigated. In the 207 sites, there were 27 sites without positive results of the blood tests and 129 sites without positive results of the stool tests. The infection rates of residents and cattle were 0.17% and 0, respectively. The density of living snails was 0.339 3 snails/0.1m2, the rate of living snails was 10.12%, and the infection rate of snails was 0. The infection rate of residents in the inner embankment type was 0.22%, higher than the rates in the other types. In different age groups, the infection rate in the 50-59 years age group was higher than the rates in other age groups. The infection rates of residents in farmer and fisherman were higher than those in the other occupation groups. The infection rate of floating people was 0, and no acute schistosomiasis patients were found. The endemic situation of schistosomiasis has decreased obviously in Hubei Province, and the whole province has achieved the criteria for transmission control of schistosomiasis.

Independent origins of loss-of-function mutations conferring oxamniquine resistance in a Brazilian schistosome population

Molecular surveillance provides a powerful approach to monitoring the resistance status of parasite populations in the field and for understanding resistance evolution. Oxamniquine was used to treat Brazilian schistosomiasis patients (mid-1970s to mid-2000s) and several cases of parasite infections resistant to treatment were recorded. The gene underlying resistance (SmSULT-OR) encodes a sulfotransferase required for intracellular drug activation. Resistance has a recessive basis and occurs when both SmSULT-OR alleles encode for defective proteins. Here we examine SmSULT-OR sequence variation in a natural schistosome population in Brazil ∼40years after the first use of this drug. We sequenced SmSULT-OR from 189 individual miracidia (1–11 per patient) recovered from 49 patients, and tested proteins expressed from putative resistance alleles for their ability to activate oxamniquine. We found nine mutations (four non-synonymous single nucleotide polymorphisms, three non-coding single nucleotide polymorphisms and two indels). Both mutations (p.E142del and p.C35R) identified previously were recovered in this field population. We also found two additional mutations (a splice site variant and 1bp coding insertion) predicted to encode non-functional truncated proteins. Two additional substitutions (p.G206V, p.N215Y) tested had no impact on oxamniquine activation. Three results are of particular interest: (i) we recovered the p.E142del mutation from the field: this same deletion is responsible for resistance in an oxamniquine selected laboratory parasite population; (ii) frequencies of resistance alleles are extremely low (0.27–0.8%), perhaps due to fitness costs associated with carriage of these alleles; (iii) that four independent resistant alleles were found is consistent with the idea that multiple mutations can generate loss-of-function alleles.

Sex bias in generation and functional phenotypes of peripheral T follicular helper cells in schistosomiasis japonica

To study the influence of sex on the generation and function of T follicular helper (Tfh) cells in the process of Schistosoma japonicum infection. Totally 50 schistosomiasis patients were selected in the endemic areas of Chizhou City, Anhui Province, and totally 50 healthy people were selected in the non-endemic areas of Chizhou City as the controls. The peripheral bloods were collected from the above study subjects, and the human peripheral blood mononuclear cells from male/female schistosomiasis japonica patients or healthy controls were collected into the sodium heparin tubes and purified by Ficoll-paque plus density gradient centrifugation. Then, the percentages of total Tfh cell, ICOS+ Tfh cells, and PD-1+ Tfh cells in the schistosomiasis male/female patients or healthy controls were evaluated by flow cytometry. Compared with the male and female healthy controls, the frequency of the total Tfh cells (Umale = 149.0, Ufemale = 39.5, both P < 0.01), the percentages of PD-1+ Tfh cells (tmale = 5.9, tfemale = 7.7, both P < 0.01) and ICOS+ Tfh cells (tmale = 3.2, tfemale = 5.9, both P < 0.01) of the male and female patients with schistosomiasis increased, all the differences were statistically significant. The further analysis showed that the percentage of total Tfh cells (U = 187.5, P < 0.05), ICOS+ Tfh cells (t = 3.2, P < 0.05), and PD-1+ Tfh cells (t = 3.0, P < 0.05) of the female patients were markedly higher than those of the male patients, all the differences were also statistically significant. Sex may be a crucial role in the generation and function of Tfh cells in the process of Schistosoma japonicum infection.

Hepatitis E virus seroprevalence among schistosomiasis patients in Northeastern Brazil

BackgroundHepatitis E virus (HEV) can cause chronic infection with rapid progression to liver cirrhosis in immunocompromised patients. HEV seroprevalence in patients with Schistosoma mansoni in Brazil is unknown. We evaluated the prevalence of past or present HEV infection in schistosomiasis patients in Recife, Pernambuco, Brazil. A total of 80 patients with Schistosoma mansoni were consecutively enrolled in a cross-sectional study. Serum samples were tested for the presence of anti-HEV IgG antibodies by enzyme immunoassay (Wantai anti-HEV IgG, Beijing, China) and for the presence of HEV RNA using real time reverse transcriptase-polymerase chain reaction with primers targeting the HEV ORF2 and ORF3. Clinical and laboratory tests as well as abdominal ultrasound were performed at the same day of blood collection. ResultsAnti-HEV IgG was positive in 18.8% (15/80) of patients with SM. None of the samples tested positive for anti-HEV IgM or HEV-RNA. Patients with anti-HEV IgG positive presented higher levels of alanine aminotranferase (p=0.048) and gama-glutamil transferase (p=0.022) when compared to patients without anti-HEV IgG antibodies. ConclusionThis study demonstrates that the seroprevalence of HEV is high in patients with Schistosoma mansoni in Northeastern of Brazil. Past HEV infection is associated with higher frequency of liver enzymes abnormalities. HEV infection and its role on the severity of liver disease should be further investigated among patients with Schistosoma mansoni.

Schistosomiasis control effect of agricultural integrated development in Tieban Marshland of Yangtze River

To evaluate the schistosomiasis control effect of the comprehensive measures that focused on beachland smoothing and tillage cultivation in Tieban Marshland, Wuhan Section of the Yangtze River. From 2011 to 2015, before and after the comprehensive control, the Oncomelania hupensis snail situations in Tieban Marshland were investigated in spring annually, and the residents aged 6-65 years in Huayuan Community which was next to the marshland were examined to understand their schistosome infection status. In late July, 2014, the sentinel mouse surveillance was carried out. Moreover, the economic effectiveness of comprehensive development was evaluated. The schistosome infection rates of residents in 2011 (before the comprehensive control), 2012 (after the comprehensive control), and 2013 were 0.72% (3/414), 0.37% (2/536) and 0.31% (1/326), respectively, and no schistosomiasis patients were found in 2014 and 2015. The snail area, the occurrence rate of frames with snails, and the average density of living snails in Tieban Marshland in 2005 decreased by 22.18%, 97.83% and 98.25%, respectively compared to those in 2011, and no schistosome infected snails were found. No positive mice were found in the sentinel mouse surveillance. The annual net income of Tieban Marshland increased by 233.33% compared to that before the comprehensive development. The endemic situation of schistosomiasis and snail situation declined significantly after the comprehensive development in Tieban Marshland, and the economic and social benefits are significant.

Evaluation of end-term effectiveness of medium-and-long-term programme for schistosomiasis control in Fanchang County, Anhui Province

To evaluate the end-term effectiveness of the medium-and-long-term programme for prevention and control of schistosomiasis in Fanchang County, Anhui Province. The epidemiological data of schistosomiasis were collected and analyzed in Fanchang County from 2004 to 2014. The end-term effectiveness of the programme was observed and evaluated. From 2004 to 2014, 1 938 schistosomiasis patients and 64 256 persons with the history of infested water contact were treated. Totally 12 cattle-times of schistosome infected cattle and 2 745 cattle-times of cattle with the history of infested water contact were treated. The area with snails controlled by molluscicides was 7 758.1 hm2, and the area with snails controlled by environmental modification was 36.0 hm2. The integrated control measures were carried out in all of the endemic villages with human infection rate being higher than 1%. Up to 2014, the infection rates of human and cattle, and the incidence rate of acute schistosomiasis were reduced to 0.27%, 0 and 0, respectively; the area with snails reduced to 103.20 hm2; the densities of both living snails and infected snails showed a declining trend in general. The effect of the integrated strategies of schistosomiasis control is remarkable, and the whole county reached the criteria of transmission-controlled of schistosomiasis.

Assessment of the diagnostic efficacy of enolase as an indication of active infection of Schistosoma japonicum.

Schistosomiasis is a common zoonoses affecting humans. The atypical clinical symptoms, low morbidity, and low degree of infection impede diagnosis and assessment of epidemics. Detecting circulating antigens from adult worms in patients' body fluids should be diagnostically superior to examining eggs in feces. Herein, the excretory-secretory proteins of adult worms were analyzed by using 2-D protein electrophoresis and mass spectrometry. The Schistosoma japonicum enolase (Sj enolase) was identified as the most abundant excretory-secretory antigen. Purified recombinant Sj enolase was prepared, and specific monoclonal and polyclonal antibodies were raised against it. A sandwich enzyme-linked immunoassay (sandwich ELISA) was established that used the monoclonal antibody as a capture antibody and the polyclonal antibody as a detection antibody. The linear detection range was 0.7-1000 ng/ml (minimum 700 pg/ml). Sj enolase could be detected in the sera of infected rabbits and disappeared rapidly postpraziquantel treatment. The sensitivity and specificity of this sandwich ELISA to detect field serum samples of schistosomiasis were 84.61 and 95.83 %, respectively. The cross-reaction rates for clonorchiasis and paragonimiasis were 3.33 and 5 %, respectively. This ELISA assay was used to test 45 matching sera of schistosomiasis patients before treatment and at 3, 6, 9, and 12 months posttreatment. Among the sera, 88.89 % were positive before treatment. At 3, 6, 9, and 12 months postpraziquantel treatment, 93.33, 97.78, 100, and 100 % tested negative, respectively. Therefore, Sj enolase can be used to indicate active Schistosoma infection, and detecting serum Sj enolase is important for diagnosis and evaluating treatment effect.

International research collaboration: the key to combating pulmonary vascular diseases in the developing world.

International research collaboration: the key to combating pulmonary vascular diseases in the developing world.