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Meta-Analysis
doi: 10.1051/parasite/2018058. Epub 2018 Nov 16.

Effectiveness of the new integrated strategy to control the transmission of Schistosoma japonicum in China: a systematic review and meta-analysis

Affiliations
Meta-Analysis

Effectiveness of the new integrated strategy to control the transmission of Schistosoma japonicum in China: a systematic review and meta-analysis

Chunyan Qian et al. Parasite.2018.

Abstract
in English, French

Since 2004, the national schistosomiasis control strategy in China has shifted from the morbidity control strategy (conventional strategy) to an integrated strategy (new strategy). We investigated the effectiveness of the new strategy and compared it against the conventional strategy. We retrieved from electronic databases the literature regarding the new strategy published from 2000 to 2017. The effect of the new or conventional strategy on infection by Schistosoma japonicum of humans and snails (Oncomelania hupensis) was evaluated with pooled log relative risk (logRR). A total of only eight eligible publications were included in the final meta-analysis. The results showed that implementation of the new strategy reduced the infection risk by 3-4 times relative to the conventional strategy. More specifically, the conventional strategy caused a reduction in both human (logRR = 0.56, 95% CI: 0.12-0.99) and snail infections (logRR = 0.34, 95% CI: -0.69-1.37), while the new strategy also significantly reduced both human (logRR = 1.89, 95% CI: 1.33-2.46) and snail infections (logRR = 1.61, 95% CI: 1.06-2.15). In contrast to the conventional strategy, the new strategy appeared more effective to control both human (logRR difference = 1.32, 95% CI: 0.78-1.86) and snail infections (logRR difference = 1.53, 95% CI: 0.76-2.31). Our data demonstrate that the new integrated strategy is highly effective to control the transmission of S. japonicum in China, and this strategy is recommended for schistosomiasis elimination in other affected regions across the world, with adaptation to local conditions.

Depuis 2004, la stratégie nationale de lutte contre la schistosomiase en Chine est passée d’une stratégie de contrôle de la morbidité (stratégie conventionnelle) à une stratégie intégrée (nouvelle stratégie). Nous avons examiné l’efficacité de la nouvelle stratégie et l’avons comparée à la stratégie conventionnelle. Nous avons extrait des bases de données électroniques la littérature concernant la nouvelle stratégie publiée de 2000 à 2017. L’effet de la stratégie nouvelle ou conventionnelle sur l’infection parSchistosoma japonicum des humains et des mollusques (Oncomelania hupensis) a été évalué avec le risque relatif de log groupé (logRR). Au total, seulement 8 publications éligibles ont été incluses dans la méta-analyse finale. Les résultats ont montré que la mise en œuvre de la nouvelle stratégie réduisait de 3 à 4 fois le risque d’infection par rapport à la stratégie conventionnelle. Plus spécifiquement, la stratégie conventionnelle a entraîné une réduction des infections humaines (logRR = 0.56, IC à 95 % : 0.12–0.99) et des infections des mollusques (logRR = 0.34, IC à 95 % : −0.69–1.37), tandis que la nouvelle stratégie a aussi réduit les infections humaines (logRR = 1.89, IC à 95 % : 1.33 à 2.46) et des mollusques (logRR = 1.61, IC à 95 % : 1.06 à 2.15). Contrairement à la stratégie conventionnelle, la nouvelle stratégie a semblé plus efficace pour contrôler à la fois les infections humaines (différence de logRR = 1.32, IC à 95 % : 0.78–1.86) et les infections des mollusques (différence de logRR = 1.53, IC à 95 % : 0.76–2.31). Nos données démontrent que la nouvelle stratégie intégrée est très efficace pour contrôler la transmission deS. japonicum en Chine et que cette stratégie est recommandée pour l’élimination de la schistosomiase dans d’autres régions touchées du monde, avec une adaptation aux conditions locales.

© C. Qian et al., published by EDP Sciences, 2018.

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Figures

Figure 1.
Figure 1.
Flowchart of study selection.
Figure 2.
Figure 2.
Funnel plot shows asymmetry for the studies included in this analysis. (A) the funnel plot of the studies reporting the effectiveness of the conventional strategy on the control of humanSchistosoma japonicum infection; (B) the funnel plot of the studies reporting the effectiveness of the conventional strategy on the control ofOncomelania hupensis snail infection; (C) the funnel plot of the studies reporting the effectiveness of the new strategy on the control of humanSchistosoma japonicum infection; (D) the funnel plot of the studies reporting the effectiveness of the new strategy on the control ofOncomelania hupensis snail infection; (E) the funnel plot of the studies comparing the effectiveness between the new strategy and the conventional strategy on the control of humanSchistosoma japonicum infection; (F) the funnel plot of the studies comparing the effectiveness between the new strategy and the conventional strategy on the control ofOncomelania hupensis snail infection.
Figure 3.
Figure 3.
Effectiveness of the conventional strategy on the control of humanSchistosoma japonicum infection (A) andOncomelania hupensis snail infection (B).
Figure 4.
Figure 4.
Effectiveness of the new strategy on the control of humanSchistosoma japonicum infection (A) andOncomelania hupensis snail infection (B).
Figure 5.
Figure 5.
Comparison of the conventional strategy versus the new strategy on the control of humanSchistosoma japonicum infection (A) andOncomelania hupensis snail infection (B).
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