Elsevier

Acta Tropica

Volume 212, December 2020, 105670
Acta Tropica

Helminthiases in the People's Republic of China: Status and prospects

https://doi.org/10.1016/j.actatropica.2020.105670Get rights and content

Abstract

Helminth infections, many of them listed as neglected tropical diseases by the World Health Organization, remain a public health issue in many parts of the world. The People's Republic of China (P.R. China) stands out due to impressive progress in the control and local elimination of helminth infections. An important contextual factor is P.R. China's sustained social and economic development that allowed implementation of health-related poverty alleviation, improving water, sanitation and hygiene, enhancing information, education and communication, coupled with major engineering and infrastructure development and intersectoral collaboration. Nonetheless, food-borne trematodiases, soil-transmitted helminthiases, echinococcosis, cysticercosis/taeniasis and schistosomiasis still exert a considerable burden in P.R. China, even though the numbers of infected people have decreased substantially since the new millennium. This special issue of Acta Tropica provides a comprehensive update of the current knowledge of the main helminth infections in P.R. China, summarises progress in research and discusses future prospects for gaining and sustaining control towards the final goal of breaking transmission and hence, eliminating helminthiases. It consists of 34 articles with a wide coverage that can be grouped into six domains: (i) epidemiological assessment and disease burden estimates; (ii) diagnostics and antigen characterisation; (iii) drug and vaccine development; (iv) host-parasite interactions and snail genetics; (v) surveillance and public health response; and (vi) capacity building and international cooperation. The control and elimination of helminthiases not only furthers the health and wellbeing of the Chinese people, but also provides innovative approaches, tools and strategies, which can be adopted and applied in other countries and regions of the world where helminthiases still prevail.

Introduction

This special issue of Acta Tropica pertaining to the status and prospects of helminthiases in the People's Republic of China (P.R. China) was initiated to shed new light on which helminth infections pose the greatest threat and what is being done domestically to improve the situation. In spite of available drugs and vaccines for some helminth infections, continuation of deeply rooted lifestyles and behaviours contribute to the emergence, re-emergence and spread of infections, while the lack of sufficiently sensitive diagnostics makes it difficult to produce reliable estimates of the distribution and burden of the endemic helminth diseases when infection intensity falls (Bergquist et al., 2009; Utzinger et al., 2015).

The cross-disciplinary perspective applied here brings together disease-specific research, innovative approaches and information on prevalence rates as it highlights research priorities and suggests ways to take them forward. Early recognition of the role of poverty in sustaining the panorama of endemic diseases has led to a deeper understanding of health-related poverty alleviation (King, 2010; Wang and Zhou, 2020). Meanwhile, political will, intersectoral collaboration and community participation will underpin the sustained commitment needed to achieve a working control strategy in P.R. China and elsewhere (Hotez, 2019; Nakagawa et al., 2015; Wang et al., 2008). The unfolding story of conquering the endemic helminthiases started with the elimination of lymphatic filariasis (Fang and Zhang, 2019), and other helminths are now being dealt with in a consorted manner (Fig. 1). As a consequence, we are witnessing the payoffs of this forward thinking in the form of novel ways of disease risk profiling, transmission control and different aspects of social and economic approaches, emphasising the importance of health promotion and education. The set of recommendations issuing from this special issue will no doubt further consolidate current control activities with the ultimate aim to eliminate all the main endemic helminthiases from P.R. China.

The purpose of this special issue was to investigate and update the current situation of the major helminthiases in P.R. China, including geographical distribution, epidemiological characteristics and risk factors. This is supported by the work of Chinese scientists in diverse areas of study, covering epidemiological assessment and disease burden estimates, progress in surveillance and public health responses, diagnostics, treatment, host-parasite interaction capacity building and international cooperation. The overarching theme concerns how laboratory and applied research are working hand-in-hand to produce and utilize control tools that contribute to the gaining and sustaining of control and eventually elimination of helminth infections in P.R. China.

Section snippets

General profile

Basic research facilitates discovery that leads to a deeper understanding of biology and disease mechanisms that, in turn, spurs innovation for development of novel tools for disease control and elimination. Applied research promotes the validation and application of improved tools, including diagnosis, drugs and vaccines. Together, these activities contribute to the advancement of control and elimination strategies, which play a key role in the decrease of helminth infections and interruption

Target helminths: a landscape of different distributions

From a historical point of view, the disease caused by the blood fluke Schistosoma japonicum ranks as the most important helminth infection in P.R. China (Chen et al., 2018; Li et al., 2017; Utzinger et al., 2005). High morbidity countered national development and the government continues giving control of schistosomiasis a high priority since the 1950s when an estimated 11–12 million people were affected (Utzinger et al., 2005). The main control strategy over time changed from snail control to

Concluding remarks

Infectious diseases of poverty currently affect 3 billion people worldwide and many of these diseases are due to helminths. Since they affect large populations in low- and middle-income countries and cause a considerable global burden, helminth infections constitute a major share of those listed by the World Health Organization (WHO) as neglected tropical diseases (NTDs) (GBD 2017 DALYs and HALE Collaborators, 2018; WHO 2020). Historically, P.R. China has been endemic for a large number of

Acknowledgement

We thank Mr. Alain Hollfelder for assistance with meta-data analysis of the 34 original articles of the current special issue of Acta Tropica pertaining to helminthiases in the People's Republic of China.

References (83)

  • B. Li

    Clonorchis sinensis ESPs enhance the activation of hepatic stellate cells by a cross-talk of TLR4 and TGF-β/Smads signaling pathway

    Acta Trop.

    (2020)
  • S.Z. Li et al.

    Changing trends of neglected tropical diseases in China

    Lancet Infect. Dis.

    (2017)
  • M. Liu et al.

    Trichinellosis in China: epidemiology and control

    Trends Parasitol.

    (2002)
  • R. Liu et al.

    Comparative serum metabolomics between SCID mice and BALB/c mice with or without Schistosoma japonicum infection: clues to the abnormal growth and development of schistosome in SCID mice

    Acta Trop.

    (2019)
  • J. Nakagawa et al.

    Towards effective prevention and control of helminth neglected tropical diseases in the Western Pacific Region through multi-disease and multi-sectoral interventions

    Acta Trop.

    (2015)
  • M.B. Qian et al.

    Clonorchiasis

    Lancet

    (2016)
  • M.B. Qian et al.

    Walk together to combat echinococcosis

    Lancet Infect. Dis.

    (2018)
  • M.B. Qian et al.

    Rapid screening of Clonorchis sinensis infection: performance of a method based on raw-freshwater fish-eating practice

    Acta Trop

    (2020)
  • Y.J. Qian et al.

    A path to cooperation between China and Mongolia towards the control of echinococcosis under the Belt and Road Initiative

    Acta Trop.

    (2019)
  • C. Qiu et al.

    Population genetics of Oncomelania hupensis snails, intermediate hosts of Schistosoma japonium, from emerging, re-emerging or established habitats within China

    Acta Trop.

    (2019)
  • Y. Ruan et al.

    Assessing competence for helminthiases: a lesson learnt from national contest of parasitic diseases in China in 2012–2016

    Acta Trop.

    (2019)
  • J. Shang et al.

    Molecular characterization of human echinococcosis in Sichuan, Western China

    Acta Trop.

    (2019)
  • M. Sudomo et al.

    Elimination of lymphatic filariasis in Southeast Asia

    Adv. Parasitol.

    (2010)
  • L.P. Sun et al.

    Approaches being used in the national schistosomiasis elimination programme in China: a review

    Infect. Dis. Poverty

    (2017)
  • C.L. Tang et al.

    Glutathione S-transferase influences the fecundity of Schistosoma japonicum

    Acta Trop.

    (2019)
  • H. Tian et al.

    Challenges in the control of soil-transmitted helminthiasis in Sichuan, Western China

    Acta Trop.

    (2019)
  • J. Utzinger et al.

    Progress in research, control and elimination of helminth infections in Asia

    Acta Trop.

    (2015)
  • L. Wang et al.

    Schistosomiasis control: experiences and lessons from China

    Lancet

    (2008)
  • L. Wang et al.

    Analysis of economic burden for patients with cystic echinococcosis in five hospitals in northwest China

    Trans. R. Soc. Trop. Med. Hyg.

    (2012)
  • L. Wang et al.

    Clinical and laboratory characterizations of hepatic capillariasis

    Acta Trop.

    (2019)
  • Y.P. Wang et al.

    The year 2020, a milestone in breaking the vicious cycle of poverty and illness in China

    Infect. Dis. Poverty

    (2020)
  • S.H. Xiao et al.

    Tribendimidine: a promising, safe and broad-spectrum anthelmintic agent from China

    Acta Trop.

    (2005)
  • S.H. Xiao et al.

    Advances with the Chinese anthelminthic drug tribendimidine in clinical trials and laboratory investigations

    Acta Trop.

    (2013)
  • J. Xu et al.

    Evolution of the national schistosomiasis control programmes in the People’s Republic of China

    Adv. Parasitol.

    (2016)
  • J.B. Xue et al.

    High-resolution remote sensing-based spatial modeling for the prediction of potential risk areas of schistosomiasis in the Dongting Lake area, China

    Acta Trop.

    (2019)
  • Z. Xunhui et al.

    DNA detection of Paragonimus westermani: diagnostic validity of a new assay based on loop-mediated isothermal amplification (LAMP) combined with a lateral flow dipstick

    Acta Trop.

    (2019)
  • X.J. Zeng et al.

    Effect of integrated control intervention on soil-transmitted helminth infections in Jiangxi province in southeast China

    Acta Trop.

    (2019)
  • H. Zhang et al.

    Development and application of anthelminthic drugs in China

    Acta Trop.

    (2019)
  • L.J. Zhang et al.

    The epidemiological status of schistosomiasis in P. R. China after the World Bank Loan Project, 2002–2017

    Acta Trop.

    (2019)
  • J. Zhao et al.

    The soluble worm antigens-specific antibodies used as biomarkers of Schistosoma japonicum in a low prevalence and intensity endemic area of Hubei, China

    Acta Trop.

    (2019)
  • C.M. Budke et al.

    Use of disability adjusted life years in the estimation of the disease burden of echinococcosis for a high endemic region of the Tibetan plateau

    Am. J. Trop. Med. Hyg.

    (2004)
  • Cited by (12)

    • More than seven decades of Acta Tropica: Looking back to move into the future

      2022, Acta Tropica
      Citation Excerpt :

      Fig. 3 shows the covers from nine special issues between 2010 and 2018. The special issue entitled “Helminthiases in the People's Republic of China: Status and prospects” (https://www.sciencedirect.com/journal/acta-tropica/special-issue/104FRZX54XH), published in 2020, summarised the progress in research of the main helminth infections in the People's Republic of China and discussed future prospects for gaining and sustaining control towards the final goal of breaking transmission, and hence, eliminating helminthiases (Brattig et al., 2020). It consists of 34 articles with a wide coverage that can be grouped into six domains: (i) epidemiological assessment and disease burden estimates; (ii) diagnostics and antigen characterisation; (iii) drug and vaccine development; (iv) host-parasite interactions and snail genetics; (v) surveillance and public health response; and (vi) capacity building and international cooperation.

    • Current status of human liver fluke infections in the Greater Mekong Subregion

      2021, Acta Tropica
      Citation Excerpt :

      Opisthorchiasis felineus is endemic in the Russian Federation, particularly Western Siberia and in Central-Eastern Europe (Armignacco et al., 2008; Fedorova et al., 2018; Fedorova et al., 2020; Keiser and Utzinger, 2005). It has been estimated up to 14 million people are infected with C. sinensis in China alone (Brattig et al., 2020; Furst et al., 2012; Lai et al., 2017). Recent national surveillance in 70 counties spread across 15 provinces of China in 2016 revealed an average of C. sinensis infection of 2.04%; 89.37% of the infected people were distributed in Jilin, Heilongjiang, Guangdong and Guangxi provinces (Zhu et al., 2020).

    View all citing articles on Scopus
    View full text