Limits...
A cluster-randomised intervention trial against Schistosoma japonicum in the Peoples' Republic of China: bovine and human transmission.

Gray DJ, Williams GM, Li Y, Chen H, Forsyth SJ, Li RS, Barnett AG, Guo J, Ross AG, Feng Z, McManus DP - PLoS ONE (2009)

Bottom Line: Preliminary results (1998-2003) of a praziquantel (PZQ)-based pilot intervention study we undertook provided proof of principle that water buffaloes are major reservoir hosts for S. japonicum in the Poyang Lake region, Jiangxi Province.Results showed that combined human and bovine chemotherapy with PZQ had a greater effect on human incidence than human PZQ treatment alone.The results from this study, supported by previous experimental evidence, confirms that bovines are the major reservoir host of human schistosomiasis in the lake and marshland regions of southern China, and reinforce the rationale for the development and deployment of a transmission blocking anti-S. japonicum vaccine targeting bovines.

View Article: PubMed Central - PubMed

Affiliation: Molecular Parasitology Laboratory, Queensland Institute of Medical Research, Brisbane, Queensland, Australia.

ABSTRACT

Background: Zoonotic schistosomiasis japonica is a major public health problem in China. Bovines, particularly water buffaloes, are thought to play a major role in the transmission of schistosomiasis to humans in China. Preliminary results (1998-2003) of a praziquantel (PZQ)-based pilot intervention study we undertook provided proof of principle that water buffaloes are major reservoir hosts for S. japonicum in the Poyang Lake region, Jiangxi Province.

Methods and findings: Here we present the results of a cluster-randomised intervention trial (2004-2007) undertaken in Hunan and Jiangxi Provinces, with increased power and more general applicability to the lake and marshlands regions of southern China. The trial involved four matched pairs of villages with one village within each pair randomly selected as a control (human PZQ treatment only), leaving the other as the intervention (human and bovine PZQ treatment). A sentinel cohort of people to be monitored for new infections for the duration of the study was selected from each village. Results showed that combined human and bovine chemotherapy with PZQ had a greater effect on human incidence than human PZQ treatment alone.

Conclusions: The results from this study, supported by previous experimental evidence, confirms that bovines are the major reservoir host of human schistosomiasis in the lake and marshland regions of southern China, and reinforce the rationale for the development and deployment of a transmission blocking anti-S. japonicum vaccine targeting bovines.

Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12609000263291.

Show MeSH

Related in: MedlinePlus

Yearly relative risks.Relative risks for each year of follow-up for Hunan province, Jiangxi province, and both provinces combined.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC2690852&req=5

pone-0005900-g002: Yearly relative risks.Relative risks for each year of follow-up for Hunan province, Jiangxi province, and both provinces combined.

Mentions: Poisson regression analyses, yielding crude and adjusted relative risks for each year of the trial within each province and for the entire trial (provinces combined), are shown in Figure 2. A downward trend was observed within both provinces individually and combined for both crude and adjusted relative risks, although there was a slight increase in the adjusted relative risk in the final year of follow-up. These results were significant overall (provinces combined) (P<0.001) and for Jiangxi (P<0.001) but not for Hunan (P = 0.42 (crude) and P = 0.32 (adjusted)), as indicated by the wide confidence intervals (Figure 2).


A cluster-randomised intervention trial against Schistosoma japonicum in the Peoples' Republic of China: bovine and human transmission.

Gray DJ, Williams GM, Li Y, Chen H, Forsyth SJ, Li RS, Barnett AG, Guo J, Ross AG, Feng Z, McManus DP - PLoS ONE (2009)

Yearly relative risks.Relative risks for each year of follow-up for Hunan province, Jiangxi province, and both provinces combined.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2690852&req=5

pone-0005900-g002: Yearly relative risks.Relative risks for each year of follow-up for Hunan province, Jiangxi province, and both provinces combined.
Mentions: Poisson regression analyses, yielding crude and adjusted relative risks for each year of the trial within each province and for the entire trial (provinces combined), are shown in Figure 2. A downward trend was observed within both provinces individually and combined for both crude and adjusted relative risks, although there was a slight increase in the adjusted relative risk in the final year of follow-up. These results were significant overall (provinces combined) (P<0.001) and for Jiangxi (P<0.001) but not for Hunan (P = 0.42 (crude) and P = 0.32 (adjusted)), as indicated by the wide confidence intervals (Figure 2).

Bottom Line: Preliminary results (1998-2003) of a praziquantel (PZQ)-based pilot intervention study we undertook provided proof of principle that water buffaloes are major reservoir hosts for S. japonicum in the Poyang Lake region, Jiangxi Province.Results showed that combined human and bovine chemotherapy with PZQ had a greater effect on human incidence than human PZQ treatment alone.The results from this study, supported by previous experimental evidence, confirms that bovines are the major reservoir host of human schistosomiasis in the lake and marshland regions of southern China, and reinforce the rationale for the development and deployment of a transmission blocking anti-S. japonicum vaccine targeting bovines.

View Article: PubMed Central - PubMed

Affiliation: Molecular Parasitology Laboratory, Queensland Institute of Medical Research, Brisbane, Queensland, Australia.

ABSTRACT

Background: Zoonotic schistosomiasis japonica is a major public health problem in China. Bovines, particularly water buffaloes, are thought to play a major role in the transmission of schistosomiasis to humans in China. Preliminary results (1998-2003) of a praziquantel (PZQ)-based pilot intervention study we undertook provided proof of principle that water buffaloes are major reservoir hosts for S. japonicum in the Poyang Lake region, Jiangxi Province.

Methods and findings: Here we present the results of a cluster-randomised intervention trial (2004-2007) undertaken in Hunan and Jiangxi Provinces, with increased power and more general applicability to the lake and marshlands regions of southern China. The trial involved four matched pairs of villages with one village within each pair randomly selected as a control (human PZQ treatment only), leaving the other as the intervention (human and bovine PZQ treatment). A sentinel cohort of people to be monitored for new infections for the duration of the study was selected from each village. Results showed that combined human and bovine chemotherapy with PZQ had a greater effect on human incidence than human PZQ treatment alone.

Conclusions: The results from this study, supported by previous experimental evidence, confirms that bovines are the major reservoir host of human schistosomiasis in the lake and marshland regions of southern China, and reinforce the rationale for the development and deployment of a transmission blocking anti-S. japonicum vaccine targeting bovines.

Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12609000263291.

Show MeSH
Related in: MedlinePlus