Visceral Leishmaniasis in China: an Endemic Disease under Control.
Visceral leishmaniasis (VL) caused by Leishmania spp. is an important vector-borne and largely zoonotic disease. In China, three epidemiological types of VL have been described: anthroponotic VL (AVL), mountain-type zoonotic VL (MT-ZVL), and desert-type ZVL (DT-ZVL). These are transmitted by four different sand fly species: Phlebotomus chinensis, P. longiductus, P. wui, and P. alexandri. In 1951, a detailed survey of VL showed that it was rampant in the vast rural areas west, northwest, and north of the Yangtze River. Control programs were designed and implemented stringently by the government at all administrative levels, resulting in elimination of the disease from most areas of endemicity, except the western and northwestern regions. The control programs consisted of (i) diagnosis and chemotherapy of patients, (ii) identification, isolation, and disposal of infected dogs, and (iii) residual insecticide indoor spraying for vector control. The success of the control programs is attributable to massive and effective mobilization of the general public and health workers to the cause. Nationally, the annual incidence is now very low, i.e., only 0.03/100,000 according to the available 2011 official record. The overwhelming majority of cases are reported from sites of endemicity in the western and northwestern regions. Here, we describe in some depth and breadth the current status of epidemiology, diagnosis, treatment, and prevention of the disease, with particular reference to the control programs. Pertinent information has been assembled from scattered literature of the past decades in different languages that are not readily accessible to the scientific community. The information provided constitutes an integral part of our knowledge on leishmaniasis in the global context and will be of special value to those interested in control programs.
Center for Parasitic Organisms, Key Laboratory of Gene Engineering of the Ministry of Education, State Key Laboratory of Biocontrol, School of Life Sciences, and Key Laboratory of Tropical Disease Control of the Ministry of Education, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, People's Republic of China lsslzr@mail.sysu.edu.cn kwangpoo.chang@rosalindfranklin.edu.
Zhao-Rong
ZR
Lun
Center for Parasitic Organisms, Key Laboratory of Gene Engineering of the Ministry of Education, State Key Laboratory of Biocontrol, School of Life Sciences, and Key Laboratory of Tropical Disease Control of the Ministry of Education, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, People's Republic of China.
Ming-Shui
MS
Wu
Center for Parasitic Organisms, Key Laboratory of Gene Engineering of the Ministry of Education, State Key Laboratory of Biocontrol, School of Life Sciences, and Key Laboratory of Tropical Disease Control of the Ministry of Education, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, People's Republic of China.
Yun-Fu
YF
Chen
National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, the Key Laboratory of Parasite and Vector Biology of the Chinese Ministry of Health, WHO Collaborating Center for Malaria, Schistosomiasis and Filariasis, Shanghai, People's Republic of China.
Jun-Yun
JY
Wang
National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, the Key Laboratory of Parasite and Vector Biology of the Chinese Ministry of Health, WHO Collaborating Center for Malaria, Schistosomiasis and Filariasis, Shanghai, People's Republic of China.
Xiao-Nong
XN
Zhou
Center for Disease Control and Prevention of Xinjiang and Research Center for Laboratory Animals of Xinjiang, Urumqi, Xinjiang, People's Republic of China.
Li-Fu
LF
Liao
Department of Parasitology, West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu, Sichuan, People's Republic of China.
Jian-Ping
JP
Chen
Department of Applied Biology and Chemical Technology and the State Key Laboratory for Chirosciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, People's Republic of China.
Larry M C
LM
Chow
Department of Microbiology/Immunology, Chicago Medical School/Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA lsslzr@mail.sysu.edu.cn kwangpoo.chang@rosalindfranklin.edu.
Kwang Poo
KP
Chang
D000818:Animals; D002681:China / Q000453:epidemiology; D004197:Disease Reservoirs; D004283:Dog Diseases / Q000469:parasitology / Q000517:prevention & control / Q000635:transmission; D004285:Dogs; D019353:Endemic Diseases; D006801:Humans; D007303:Insect Vectors; D007898:Leishmaniasis, Visceral / Q000453:epidemiology / Q000469:parasitology / Q000517:prevention & control* / Q000635:transmission