Objective To analyze the spatial clustering of human schistosomiasis at the village level in key counties in Hubei Province, to provide scientific evidence for formulating strategies for human schistosomiasis prevention and control in the next stage. Methods Gong^'an County and Jiangling County in Hubei Province were selected as representative counties for this study. A town or village was set up as a research unit. Schistosomiasis cases of a positive fecal examination in 2015 and cases with positive detection for schistosomiasis serological antibody titer equal or above 80 in 2016-2018 were selected as research subjects in these two counties. The Kulldorff circular scan statistic was used for the spatial clustering analysis of human schistosomiasis infection status in the population. Results There was spatial clustering of positive schistosomiasis cases of fecal examination, at the level of a town or village in both counties in 2015. There was spatial clustering of positive human serological antibody detection at the level of town or village from 2016-2018. Eighty-six endemic villages in five towns in the northeast of Gong^'an County, along the Yangtze river,including Mahaokou Town, Zhakou Town, Yangjiachang Town, Jiazhuyuan Town and Douhuti Town, were the most prominent. There was no spatial clustering of positive results of human serological antibody detection at the town and village level in Jiangling County, in2017, while there was spatial clustering of human serological antibody detection in 2016 and 2018,respectively. Fifty-seven endemic villages in two towns (Puji Town and Xionghe Town) in the southwest of Jiangling County, along the Yangtze river,were the most prominent. Conclusion There were spatial clustering of human schistosomiasis epidemic at village level both in Gong^'an County and Jiangling County, Hubei Province. Compared with the previous studies, there was a trend of shrink and decline of clustering areas. Therefore, the current situation of the epidemic has put forward higher requirements for the implementation of precise prevention and control in the progress of schistosomiasis elimination work in various epidemic areas.

Objective To evaluate the effect of wild feces detection in Oncomelania hupensis environments on the surveil?lance of infection source of schistosomiasis,and find the weakness in schistosomiasis control in Hubei Province,so as to put for?ward the targeted strategies and measures. Methods Four environments with O. hupensis snails in endemic areas of Hubei Provinces,where human and livestock often haunted,were selected according to the river systems,namely the Juzhanghe River beach in Jingzhou City,Changjiang River beach in Jiayu County,Hanbei River beach in Tianmen City,and Changshou River beach in Zhongxiang City,then the snail survey and wild feces detection were implemented in the selected environments. Re?sults There were O. hupensis snails,livestock,wild feces of cattle or sheep as well as positive cattle feces found in all the 4 environments,and the positive rate of schistosome miracidium incubation was 47.62%. Conclusion The schistosome miracidi?um positive rate of wild feces of cattle is high in the environments with snails in endemic areas of Hubei Province ,which has high risk for schistosomiasis transmission.

Objective To analyze the construction and operation status of management system of laboratories of schistosomi?asis control institutions in Hubei Province,so as to provide the reference for the standardized detection and management of schis?tosomiasis laboratories. Methods According to the laboratory standard of schistosomiasis at provincial,municipal and county levels,the management system construction and operation status of 60 schistosomiasis control institutions was assessed by the acceptance examination method from 2013 to 2015. Results The management system was already occupied over all the labora?tories of schistosomiasis control institutions and was officially running. There were 588 non?conformities and the inconsistency rate was 19.60%. The non?conformity rate of the management system of laboratory quality control was 38.10%(224 cases)and the non?conformity rate of requirements of instrument and equipment was 23.81%(140 cases). Conclusion The management system has played an important role in the standardized management of schistosomiasis laboratories.

Objective To investigate the effect and current situation of the standardized construction of laboratories of schis?tosomiasis control institutions in Hubei Province,so as to provide the evidence for establishing and improving the quality control system of diagnosis of schistosomiasis after the transmission of schistosomiasis was under control. Methods According to the procedures of self?examination,field operation,and laboratory on?site,five laboratories were assessed,and all the results were analyzed comparatively. Results The average number of staffs were(7.00 ± 1.58)persons,and the staffs of the laboratories of the schistosomiasis control institutions with senior professional titles in the city level were more than that in the county level(t=5.563,P<0.05). The average space was(3.20±1.64)rooms,and the average area was(117.00±88.29)m2. The average score of field operation was(96.40 ± 4.49)points. The average score of laboratory on?site assessment was(106.6 ± 6.15)points. The highest and lowest of the laboratory on?site assessment scores were environment and facilities(19.60 ± 0.55)points and manage?ment system of laboratory quality control(15.70 ± 2.39)points(F=2.869,P<0.05),respectively. Conclusion The cultiva?tion of laboratory staff should be strengthened,and the diagnostic capacity should be maintained and improved. The laboratory quality control system should be paid more attention to,and the construction and management of schistosomiasis laboratories should be standardized.

Objective To assess the schistosomiasis endemic situation in the national surveillance sites in Hubei Province, so as to provide the evidence for the prevention and control of schistosomiasis. Methods According to the national surveillance protocol,a longitudinal surveillance of endemic situation of schistosomiasis was carried out in 16 national surveillance sites from 2005 to 2010. Results In general,the positive rates of IHA,Kato-Katz technique and infection rates of Schistosoma japonicum decreased from 15.67%,10.93%and 1.71%in 2005 to 10.48%,8.54%and 0.90%in 2010,and declined by 33.12%,22.70%and 47.95%,respectively. The infection rates of S. japonicum of the male were higher than that of the female,and the peak infec-tion rates were in the groups aged above 30 years. The endemic situation of fishermen and farmers were relatively serious. The in-fection rates of S. japonicum in cattle decreased from 11.69%in 2005 to 1.41%in 2010,and declined by 88.01%(χ2 =298.79, P<0.001). The areas with infected Oncomelania hupensis snails,the densities of living snails,the rates of infected snails and the densities of infected snails decreased by 90.88%,61.66%,80.00%and 92.00%,respectively. Conclusion The schistosomiasis endemic situation in the national surveillance sites in Hubei Province mitigates in 6 years,but the prevention is still a very daunt-ing task.

Objective To evaluate the effect of the Parasep? feces centrifuge tube method on detecting schistosome eggs. Methods A total of 803 residents aged from 6-65 years were selected in 2 schistosomiasis endemic villages Jiangling Coun-ty Hubei Province and their stool samples were collected and detected parallelly by the Kato-Katz technique nylon silk egg hatching method and Parasep? feces centrifuge tube method at the same time. Results Among the 803 people 15 cases were found of schistosome egg positive and the positive rate was 1.87%. The positive rates of the Kato-Katz technique nylon silk egg hatching method and Parasep? feces centrifuge tube method were 0.75% 1.49% and 1.12% respectively. The schistosome eggs got with the Parasep? feces centrifuge tube method were clear and easy to identify. Conclusion In low endemic areas of schistosomiasis the Parasep? feces centrifuge tube method can be used as schistosomiasis japonica etiology diagnosis method.

Objective To evaluate the efficacy of routinely used pattern for schistosomiasis diagnosis in lake and marshland regions. Methods A historically heavy endemic village of schistosomiasis named Jinggan Village from Jiangling County was se?lected for field survey. The residents aged 6?65 years were screened by indirect hemagglutination assay(IHA)and dipstick dye immunoassay(DDIA)in parallel. The serological positives were examined by Kato?Katz technique and miracidium hatching technique to determine the infection of schistosome. The consistency of the two serological methods was evaluated. In addition , the schistosome infection rates were estimated according to the 3 detection patterns namely IHA,DDIA,IHA+DDIA combined with the etiologic examination. Results A total of 530 individuals were examined by the serological tests. The positive rate of DDIA was 46.98%(249/530),significantly higher than that of IHA(28.49%,151/530)(χ2=59.55,P<0.01). Totally 279 in?dividuals were serological positives determined by IHA or DDIA,while 252 of them were detected by stool examination,and 22 cases were determined as parasitological positives,while 7 and 3 cases were diagnosed as antibody negatives by IHA and DDIA,respectively. The estimated infection rates determined by IHA,DDIA,IHA plus DDIA combined with stool examination were 3.14%,3.97%、4.60%,respectively. Conclusions Under the condition of endemic situation becoming more and more waning,the current routinely used pattern for schistosomiasis detection may lead to missed diagnosis. So,more sensitive and ef?fective diagnostic tools or appropriate detection patterns need to be explored.

Objective To evaluate the effects of the schistosomiasis control mode(“Hubei mode”)that includes“compre-hensive measures in a whole endemic county”,“co-action of Health Ministry and Province”and“replacing cattle with machine”in Hubei Province. Methods The data of schistosomiasis control in Hubei Province from 2008 to 2012 were collected and a data-base including the annual schistosome infections of human and cattle,acute schistosome infection,outbreak of schistosomiasis en-demic,schistosome infected Oncomelania hupensis snails,and other prevention indicators was established and analyzed by using SPSS. Results Compared with 2008,in 2012,the infection rates declined by 64.91%and 88.63%in human and cattle respec-tively. The area with snails decreased from 5 423.85 hm2 in 2008 to zero. There were no acute schistosomiasis patients and out-break of schistosomiasis endemic. Conclusion The schistosomiasis control mode(“Hubei mode”)is effective significantly.

Objective To understand the schistosomiasis endemic situation at a national surveillance site in Gong an Coun-ty Hubei Province. Methods According to The Scheme of Schistosomiasis Surveillance in China the schistosome infection rates of residents and cattle and the Oncomelaniahupensissnail status were investigated yearly in Zhangjiahu Village a nation-al surveillance site in Gong an County from 2004 to 2013. Results From 2004 to 2013 the human schistosome infection rates decreased from 10.66%to 0.58% and the cattle schistosome infection rates from 12.75%to 0. Meanwhile the snail areas and densities reduced and the schistosome infected snails were eliminated. Conclusion The schistosomiasis endemic situa-tion declined dramatically at the surveillance site and schistosomiasis is well-controlled.

Objective To understand the dynamic schistosomiasis situation in Hubei Province so as to provide the evidence for formulating the effective control strategy. Methods According to the Scheme of Schistosomiasis Surveillance in Hubei Province the 2009 edition 207 endemic villages were selected and investigated for the schistosome infections of residents and livestock and the distribution of Oncomelania hupensis snails. Results The average infection rates of residents and cattle were 0.35% and 0.15% respectively and the endemic situation of fishermen and farmers were relatively serious 0.44% and 0.42% respectively . The density of living snails was 0.30 snail/0.1m2 but no infected snails were found. Conclusion The en-demic situation of schistosomiasis in Hubei Province was stable in 2013 but the efforts for the infectious source control still should be strengthened.