Establishing and applying a schistosomiasis early warning index (SEWI) in the lower Yangtze River Region of Jiangsu Province, China.

BACKGROUND: China has made remarkable progress in schistosomiasis control over the past decades. Transmission control has replaced morbidity control as the country moves towards the goal of elimination and the current challenge is to find a sensitive measure capable of gauging transmission risk in l...

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Main Authors: Kun Yang, Jun-Fang Xu, Jian-Feng Zhang, Wei Li, Jian He, Song Liang, Robert Bergquist
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2014-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC3976384?pdf=render
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author Kun Yang
Jun-Fang Xu
Jian-Feng Zhang
Wei Li
Jian He
Song Liang
Robert Bergquist
author_facet Kun Yang
Jun-Fang Xu
Jian-Feng Zhang
Wei Li
Jian He
Song Liang
Robert Bergquist
author_sort Kun Yang
collection DOAJ
description BACKGROUND: China has made remarkable progress in schistosomiasis control over the past decades. Transmission control has replaced morbidity control as the country moves towards the goal of elimination and the current challenge is to find a sensitive measure capable of gauging transmission risk in low-prevalence areas. The study aims to develop a Schistosomiasis Early Warning Index (SEWI) and demonstrate its use in Jiangsu Province along the lower Yangtze River. METHODOLOGY/PRINCIPAL FINDINGS: The Delphi approach, a structured communication technique, was used to develop the SEWI. Two rounds of interviews with 30 public health experts specialized in schistosomiasis control were conducted using 40 indicators that reflected different aspects of schistosomiasis transmission and control. The necessity, feasibility, and sensitivity of each indicator were assessed and the weight value of each indicator determined based on these experts' judgment. The system included 3 first-order indicators, 7 second-order indicators, and 30 third-order indicators. The 3 first-order indicators were endemic status, control measures, social and environmental factors, with the weight values 0.366, 0.343 and 0.291, respectively. For the 7 second-order indicators, the highest weight value was for control measures for snails (0.175) and the lowest for transmission route (0.110). We estimated and mapped the SEWI for endemic areas at the county scale in Jiangsu Province finding that the majority of the endemic areas were characterized as medium transmission risk (SEWI risk values between 0.3 and 0.6), while areas where transmission interruption had been officially declared showed SEWI values <0.30. A few isolated areas (e.g. endemic islands in the Yangtze River) produced SEWI values >0.60. These estimates are largely in agreement with the endemicity levels based on recent epidemiological surveys. CONCLUSIONS/SIGNIFICANCE: The SEWI should be useful for estimation of schistosomiasis transmission surveillance, particularly with reference to the elimination of the disease in China.
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spelling doaj.art-5d67ea81233d410ea53ffa6651cc0ec52022-12-21T23:41:46ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0194e9401210.1371/journal.pone.0094012Establishing and applying a schistosomiasis early warning index (SEWI) in the lower Yangtze River Region of Jiangsu Province, China.Kun YangJun-Fang XuJian-Feng ZhangWei LiJian HeSong LiangRobert BergquistBACKGROUND: China has made remarkable progress in schistosomiasis control over the past decades. Transmission control has replaced morbidity control as the country moves towards the goal of elimination and the current challenge is to find a sensitive measure capable of gauging transmission risk in low-prevalence areas. The study aims to develop a Schistosomiasis Early Warning Index (SEWI) and demonstrate its use in Jiangsu Province along the lower Yangtze River. METHODOLOGY/PRINCIPAL FINDINGS: The Delphi approach, a structured communication technique, was used to develop the SEWI. Two rounds of interviews with 30 public health experts specialized in schistosomiasis control were conducted using 40 indicators that reflected different aspects of schistosomiasis transmission and control. The necessity, feasibility, and sensitivity of each indicator were assessed and the weight value of each indicator determined based on these experts' judgment. The system included 3 first-order indicators, 7 second-order indicators, and 30 third-order indicators. The 3 first-order indicators were endemic status, control measures, social and environmental factors, with the weight values 0.366, 0.343 and 0.291, respectively. For the 7 second-order indicators, the highest weight value was for control measures for snails (0.175) and the lowest for transmission route (0.110). We estimated and mapped the SEWI for endemic areas at the county scale in Jiangsu Province finding that the majority of the endemic areas were characterized as medium transmission risk (SEWI risk values between 0.3 and 0.6), while areas where transmission interruption had been officially declared showed SEWI values <0.30. A few isolated areas (e.g. endemic islands in the Yangtze River) produced SEWI values >0.60. These estimates are largely in agreement with the endemicity levels based on recent epidemiological surveys. CONCLUSIONS/SIGNIFICANCE: The SEWI should be useful for estimation of schistosomiasis transmission surveillance, particularly with reference to the elimination of the disease in China.http://europepmc.org/articles/PMC3976384?pdf=render
spellingShingle Kun Yang
Jun-Fang Xu
Jian-Feng Zhang
Wei Li
Jian He
Song Liang
Robert Bergquist
Establishing and applying a schistosomiasis early warning index (SEWI) in the lower Yangtze River Region of Jiangsu Province, China.
PLoS ONE
title Establishing and applying a schistosomiasis early warning index (SEWI) in the lower Yangtze River Region of Jiangsu Province, China.
title_full Establishing and applying a schistosomiasis early warning index (SEWI) in the lower Yangtze River Region of Jiangsu Province, China.
title_fullStr Establishing and applying a schistosomiasis early warning index (SEWI) in the lower Yangtze River Region of Jiangsu Province, China.
title_full_unstemmed Establishing and applying a schistosomiasis early warning index (SEWI) in the lower Yangtze River Region of Jiangsu Province, China.
title_short Establishing and applying a schistosomiasis early warning index (SEWI) in the lower Yangtze River Region of Jiangsu Province, China.
title_sort establishing and applying a schistosomiasis early warning index sewi in the lower yangtze river region of jiangsu province china
url http://europepmc.org/articles/PMC3976384?pdf=render
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