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


RESULTS
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.


BACKGROUND
Australian New Zealand Clinical Trials Registry ACTRN12609000263291.
Gray
Darren J
DJ
Molecular Parasitology Laboratory, Queensland Institute of Medical Research, Brisbane, Queensland, Australia.
Williams
Gail M
GM
Li
Yuesheng
Y
Chen
Honggen
H
Forsyth
Simon J
SJ
Li
Robert S
RS
Barnett
Adrian G
AG
Guo
Jiagang
J
Ross
Allen G
AG
Feng
Zheng
Z
McManus
Donald P
DP
D000818:Animals; D002020:Buffaloes; D002417:Cattle; D002681:China; D015331:Cohort Studies; D006801:Humans; D010865:Pilot Projects; D015995:Prevalence; D012107:Research Design; D012306:Risk; D012549:Schistosoma japonicum / Q000378:metabolism*; D012554:Schistosomiasis japonica / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy* / Q000635:transmission / Q000662:veterinary*; D012908:Snails; D016896:Treatment Outcome