Scabies, caused by the Sarcoptes scabiei var hominis mite burrowing into the skin, is a highly contagious disease characterized by intense nocturnal itching. Its global impact is considerable, affecting more than 200 million individuals annually and posing significant challenges to healthcare systems worldwide. Transmission occurs primarily through direct skin-to-skin contact, contributing to its widespread prevalence and emergence as a substantial public health concern affecting large populations. This review presents consensus-based clinical practice guidelines for diagnosing and managing scabies, developed through the fuzzy Delphi method by dermatology, parasitology, pediatrics, pharmacology, and public health experts. The presence of burrows containing adult female mites, their eggs, and excreta is the diagnostic hallmark of scabies. Definitive diagnosis typically involves direct microscopic examination of skin scrapings obtained from these burrows, although dermoscopy has become a diagnostic tool in clinical practice. Treatment modalities encompass topical agents, such as permethrin, balsam of Peru, precipitated sulfur, and benzyl benzoate. In cases where topical therapy proves inadequate or in instances of crusted scabies, oral ivermectin is recommended as a systemic treatment option. This comprehensive approach addresses the diagnostic and therapeutic challenges associated with scabies, optimizing patient care, and management outcomes.

Screening strategies for undiagnosed infections are fundamental for hepatitis C virus (HCV) elimination. We previously investigated HCV prevalence and screening strategies in an urban primary care setting. IV drug abuse, blood transfusion before 1992, immigration, or elevated ALT were identified as risk factors in a post hoc analysis and diagnosed 83% of unknown HCV-RNA-positive cases by screening only 26% of the population. We aimed to validate prospectively the proposed screening algorithm in two independent urban and rural cohorts and to analyse for potential differences.
Anti-HCV and ALT were included in a routine check-up together with a questionnaire covering risk factors. HCV-RNA was analysed in anti-HCV-positive individuals.
In urban and rural areas, 4323 and 9321 individuals were recruited. The anti-HCV prevalence was 0.56% and 0.49%, and 0.1% of patients were HCV-RNA-positive in both regions. Fifty-two anti-HCV positive patients including eight HCV-RNA-positive cases were unaware of the infection (number needed to screen to detect one unknown anti-HCV-positive individual: 262). At least one of the three aforementioned risk factors or elevated serum ALT was present in 3000 patients (22%). Restricting HCV screening to only those with risk factors, 52% and 75% of all anti-HCV and HCV-RNA-positive undiagnosed patients were identified (number needed to screen: 111).
We confirm prospectively the efficiency of a risk-based HCV screening. The risk-based algorithm should be evaluated in other countries with similarly low HCV prevalence as in Germany to achieve WHO HCV elimination goals.

Currently, the national schistosomiasis control program of China is moving from transmission interruption to elimination, and there are multiple challenges during the stage moving towards the progression of schistosomiasis elimination, including a high difficulty in shrinking snail-infested areas, unstable achievements for infectious source control, imperfect surveillance system and a reduction in schistosomiasis control and administration. Based on the core suggestions proposed in the 2022 WHO guideline on control and elimination of human schistosomiasis, recommendations on schistosomiasis surveillance system building, development of novel diagnostics, adjustment of the schistosomiasis control strategy and maintaining and improvements of the schistosomiasis control capability are proposed for the national schistosomiasis control program of China in the new era according to the actual status of schistosomiasis control in China. Formulation of the national schistosomiasis control strategy and goal from One Health perspective, verification of transmission interruption and elimination of schistosomiasis, precision implementation of schistosomiasis control interventions with adaptations to local circumstances, development and application of highly sensitive and specific diagnostics are recommended for elimination of schistosomiasis in China. In addition, the implementation of the 2022 WHO guideline on control and elimination of human schistosomiasis may guide the elimination of schistosomiasis in China.
［摘要］ 目前, 我国血吸虫病防治工作正处于从传播阻断迈向消除的关键阶段, 同时也面临进一步压缩钉螺面积难度 大、传染源控制成果不牢固、监测体系不完善、防治管理有所松懈等诸多问题和挑战。本文依据《WHO 控制和消除人体 血吸虫病指南》核心建议, 结合我国血吸虫病防治工作实际, 对新时期我国血吸虫病监测体系建设、检测新技术研发、防 治策略调整、防治能力维持和提高等提出了相应建议。要从全健康角度谋划我国血吸虫病防治策略和目标; 要适时对血 吸虫病传播阻断和消除进程开展验证; 要在充分评估的基础上因时因地调整防治策略, 精准实施血吸虫病防治措施; 要 重视和加强高敏感度、高特异度检测工具的开发和应用, 为消除血吸虫病提供技术支撑; 要借鉴和吸收《WHO 控制和消 除人体血吸虫病指南》精髓, 充分发挥其引导作用, 促进我国实现消除血吸虫病目标。.

Schistosomiasis is a parasitic disease that seriously hinders socioeconomic developments and threatens public health security. To achieve the global elimination of schistosomiasis as a public health problem by 2030, WHO released the guideline on control and elimination of human schistosomiasis on February, 2022, with aims to provide evidence-based recommendations for schistosomiasis morbidity control, elimination of schistosomiasis as a public health problem, and ultimate interruption of schistosomiasis transmission in disease-endemic countries. Following concerted efforts for decades, great achievements have been obtained for schistosomiasis control in China where the disease was historically highly prevalent, and the country is moving towards schistosomiasis elimination. This article reviews the successful experiences from the national schistosmiasis control program in China, and summarizes their contributions to the formulation and implementation of the WHO guideline on control and elimination of human schistosomiasis. With the progress of the \"Belt and Road\" initiative, the world is looking forward to more China\'s solutions on schistosomiasis control.
［摘要］ 血吸虫病是一种严重阻碍社会经济发展、威胁公共卫生安全的寄生虫病。为实现 2030 年全球消除作为一种公共卫生问题的血吸虫病, 2022 年 2 月 WHO 发布了《WHO 控制和消除人体血吸虫病指南》, 旨在为各国实现控制血吸虫病发病率、将其作为一种公共卫生问题消除及最终达到传播阻断提供循证建议。在历史上血吸虫病曾经严重流行的中国, 经过有效防控策略和措施的实施, 血吸虫病防控工作取得了重大成绩, 逐步迈向消除血吸虫病。本文回顾中国血吸虫病防控策略、防控关键技术和实践的成功经验, 贡献于《WHO 控制和消除人体血吸虫病指南》的制定与实施。随着“一带一路”倡议的深入推进, 世界也期待更多血吸虫病防控领域的“中国方案”。.

Preventive chemotherapy is one of the pivotal interventions for the control and elimination of schistosomiasis, which is effective to reduce the morbidity and prevalence of schistosomiasis. In order to promote the United Nations\' sustainable development goals and the targets set for schistosomiasis control in the Ending the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021-2030, WHO released the guideline on control and elimination of human schistosomiasis in 2022, with major evidence-based updates of the current preventive chemotherapy strategy for schistosomiasis. In China where great success has been achieved in schistosomiasis control, the preventive chemotherapy strategy for schistosomiasis has been updated several times during the past seven decades. This article reviews the evolution of the WHO guidelines on preventive chemotherapy and Chinese national preventive chemotherapy schemes, compares the current Chinese national preventive chemotherapy scheme and the recommendations for preventive chemotherapy proposed in the 2022 WHO guideline on control and elimination of human schistosomiasis, and proposes recommendations for preventive chemotherapy during the future implementation of the 2022 WHO guideline, so as to provide insights into schistosomiasis control among public health professionals engaging in healthcare foreign aid.
［摘要］ 预防性化疗是控制和消除血吸虫病的重要干预措施之一, 可显著降低发病率和感染率。为推进联合国可持续 发展目标和 WHO《结束忽视, 实现可持续发展目标：2021—2030 年被忽视热带病路线图》中设定的血吸虫病防控目标, 2022 年 WHO 发布了《WHO 控制和消除人体血吸虫病指南》, 基于循证医学证据对血吸虫病化疗策略进行了较大调整。作为血吸虫病防控进程较快的流行国家, 中国在 70 余年的血吸虫病防治历程中对化疗方案也进行了多次调整和修订。本文在回顾 WHO 和中国血吸虫病化疗策略演变过程的基础上, 对中国现行化疗方案和《WHO 控制和消除人体血吸虫病 指南》中的化疗建议进行了比较分析, 并对今后贯彻实施 WHO 指南的化疗策略提出相应建议, 为从事血吸虫病公共卫生 援外工作者和相关人员提供参考。.

On February 2022, WHO released the evidence-based guideline on control and elimination of human schistosomiasis, with aims to guide the elimination of schistosomiasis as a public health problem in disease-endemic countries by 2030 and promote the interruption of schistosomiasis transmission across the world. Based on the One Health concept, six evidence-based recommendations were proposed in this guideline. This article aims to analyze the feasibility of key aspects of this guideline in Chinese national schistosomiasis control program and illustrate the significance to guide the future actions for Chinese national schistosomiasis control program. Currently, the One Health concept has been embodied in the Chinese national schistosomiasis control program. Based on this new WHO guideline, the following recommendations are proposed for the national schistosomiasis control program of China: (1) improving the systematic framework building, facilitating the agreement of the cross-sectoral consensus, and building a high-level leadership group; (2) optimizing the current human and livestock treatments in the national schistosomiasis control program of China; (3) developing highly sensitive and specific diagnostics and the framework for verifying elimination of schistosomiasis; (4) accelerating the progress towards elimination of schistosomiasis and other parasitic diseases through integrating the national control programs for other parasitic diseases.
［摘要］ 2022 年 2 月, WHO 基于循证医学框架发布了《WHO控制和消除人体血吸虫病指南》 (以下简称 WHO 新指南), 以指导血吸虫病流行国家和地区控制和消除这一公共卫生问题、促进阻断血吸虫病传播。WHO 新指南以全健康理念为 基础, 提出了 6 项核心建议。本文旨在分析 WHO 新指南中的关键内容对我国血吸虫病防控工作的适用性, 阐释其对我 国血吸虫病防治工作后续发展的指导意义。目前, 我国血吸虫病防控体系在实施层面上已基本体现全健康理念及其组 成部分。基于WHO新指南, 针对我国血吸虫病防治工作提出如下建议：加强系统性框架建设, 推动跨部门共识的形成, 建立高级别领导小组; 优化现阶段我国血吸虫病防治策略中的人畜治疗措施; 开发高敏感度和高特异度的检测工具和消 除验证框架; 通过整合其他寄生虫病防治项目, 进一步推动血吸虫病和其他寄生虫病防控工作。.

Since 2015 when the transmission of schistosomiasis was controlled in China, the country has been moving towards elimination of schistosomiasis, with the surveillance-response as the main interventions for schistosomiasis control. During the period of the 13th Five-Year Plan, the transmission of schistosomiasis had been interrupted in four provinces of Sichuan, Jiangsu, Yunnan and Hubei and the prevalence of schistosomiasis has been at the historically lowest level in China. As a consequence, the goal set in The 13th Five-Year National Schistosomiasis Control Program in China is almost achieved. However, there are multiple challenges during the stage moving towards elimination of schistosomiasis in China, including the widespread distribution of intermediate host snails and complicated snail habitats, many types of sources of Schistosoma japonicum infections and difficulty in management of bovines and sheep, unmet requirements for the current schistosomiasis control program with the currently available tools, and vulnerable control achievements. During the 14th Five-Year period, it is crucial to consolidate the schistosomiasis control achievements and gradually solve the above difficulties, and critical to provide the basis for achieving the ultimate goal of elimination of schistosomiasis in China. Based on the past experiences from the national schistosomiasis control program and the challenges for schistosomiasis elimination in China, an expert consensus has been reached pertaining to the objectives, control strategy and measures for The 14th Five-Year National Schistosomiasis Control Program in China, so as to provide insights in to the development of The 14th Five-Year National Schistosomiasis Control Program in China.
［摘要］ 2015 年全国达到血吸虫病传播控制标准后, 进入以全面阻断血吸虫病传播为新目标、开展监测预警为主要干 预措施的新时期。“十三五” 时期, 四川、江苏、云南、湖北等 4 个血吸虫病防治重点省份先后达到血吸虫病传播阻断标准或通过国家血吸虫病传播阻断技术评估, 我国血吸虫病疫情处于历史最低水平, 流行程度进一步降低, 《“十三五” 全国血 吸虫病防治规划》既定目标基本实现。但日本血吸虫唯一中间宿主钉螺依然广泛存在且孳生环境复杂、血吸虫病传染源 种类多且牛羊等主要传染源管控困难、现有防治技术与当前防治需求不相适应、防治成果基础不牢等是我国血吸虫病消 除进程中面临的主要困难和挑战。“十四五” 时期是巩固我国血吸虫病防治成果、逐步解决上述困难的重要时期, 也是为 实现消除血吸虫病最终目标奠定基础的关键阶段。我们在认真总结前期血吸虫病防治经验和当前面临挑战基础上, 遵 循依法防治、科学防治和精准防治原则, 就《“十四五” 全国血吸虫病防治规划》中防治目标、防治策略、防治措施等方面达 成专家共识, 旨在为制定《“十四五” 全国血吸虫病防治规划》提供参考, 更好地发挥该规划对现场防治工作的政策指导和 引领作用。.

The guidelines, authored by a Task Force of experts in feline clinical medicine, are an update and extension of the AAFP-AAHA Feline Life Stage Guidelines published in 2010. The guidelines are published simultaneously in the Journal of Feline Medicine and Surgery (volume 23, issue 3, pages 211-233, DOI: 10.1177/1098612X21993657) and the Journal of the American Animal Hospital Association (volume 57, issue 2, pages 51-72, DOI: 10.5326/JAAHA-MS-7189). A noteworthy change from the earlier guidelines is the division of the cat\'s lifespan into a five-stage grouping with four distinct age-related stages (kitten, young adult, mature adult, and senior) as well as an end-of-life stage, instead of the previous six. This simplified grouping is consistent with how pet owners generally perceive their cat\'s maturation and aging process, and provides a readily understood basis for an evolving, individualized, lifelong feline healthcare strategy. The guidelines include a comprehensive table on the components of a feline wellness visit that provides a framework for systematically implementing an individualized life stage approach to feline healthcare. Included are recommendations for managing the most critical health-related factors in relation to a cat\'s life stage. These recommendations are further explained in the following categories: behavior and environmental needs; elimination; life stage nutrition and weight management; oral health; parasite control; vaccination; zoonoses and human safety; and recommended diagnostics based on life stage. A discussion on overcoming barriers to veterinary visits by cat owners offers practical advice on one of the most challenging aspects of delivering regular feline healthcare.

The availability of pangenotypic direct-acting antivirals for treatment of hepatitis C (HCV) has provided an opportunity to simplify patient pathways. Recent clinical practice guidelines have recognised the need for simplification to ensure that elimination of HCV as a public health concern remains a priority. Despite the move towards simplified treatment algorithms, there remains some complexity in the recommendations for the management of genotype 3 patients with compensated cirrhosis. In an era where additional clinical trial data are not anticipated, clinical guidance should consider experience gained in real-world settings. Although more experience is required for some pangenotypic therapeutic options, on the basis of published real-world data, there is already sufficient evidence to consider a simplified approach for genotype 3 patients with compensated cirrhosis. The coronavirus disease 2019 (COVID-19) pandemic has highlighted the need to minimise the need for complex patient pathways and clinical practice guidelines need to continue to evolve in order to ensure that patient outcomes remain optimised.

BACKGROUND: Achievement of the elimination target for mother-to-child transmission (MTCT) of HIV in selected countries has increased hope to end the HIV epidemic in children across the world. However, MTCT rates remain well above the 5% elimination target in most sub-Saharan Africa countries. These countries require innovative strategies to scale-up their interventions to end paediatric HIV. We describe how the Elizabeth Glaser Paediatric AIDS Foundation (EGPAF) consortium and the Children\'s Investment Fund Foundation (CIFF) used the critical path method to facilitate rapid expansion and optimization of 2010 and 2013 WHO PMTCT guidelines to reduce Zimbabwe\'s MTCT rate from 22% in 2010 to 6.4% in 2015.
METHODS: We analysed activities implemented and PMTCT programme data for the period before and during the EGPAF-CIFF project. The critical path method involved a cycle of collecting and analysing quarterly PMTCT indicator data and planning and implementing targeted activities to improve the PMTCT indicators. We performed a graphical trend analysis of data that measured availability of PMTCT services. Using Pearson\'s Chi2 test, we compared results of PMTCT uptake indicators at the start and end of the EGPAF-CIFF project and used regression discontinuity analysis to assess effectiveness of activities implemented to improve the PMTCT service uptake indicators.
RESULTS: Zimbabwe rolled out WHO 2010 and 2013 PMTCT guidelines in less than 1 year during the EGPAF-CIFF project, yet it took more than 4 years to roll-out previous guidelines. All PMTCT indicators increased significantly (p < 0.001) comparing the five-year periods before and during the EGPAF-CIFF project. Critical path activities implemented increased five of the seven PMTCT uptake indicators.
CONCLUSIONS: Zimbabwe rapidly rolled-out and optimised new WHO PMTCT guidelines and drastically reduced its MTCT rate using the critical path method. We recommend wider use of the critical path method in public health programmes.