BACKGROUND: After decades of praziquantel mass drug administration (MDA), several countries approach schistosomiasis elimination. Continuing MDA in largely uninfected populations no longer seems justified. Alternative interventions to maintain the gains or accelerate interruption of transmission are needed. We report results, strengths, and shortcomings of novel test-treat-track-test-treat (5T) interventions in low Schistosoma haematobium prevalence areas on Pemba, Tanzania.
METHODS: School- and household-based surveys were conducted in 2021 and 2022 to monitor the S. haematobium and microhematuria prevalence and assess the impact of interventions. In 2021, 5T interventions were implemented in 15 low-prevalence areas and included: (i) testing schoolchildren in primary and Islamic schools for microhematuria as a proxy for S. haematobium, (ii) treating positive children, (iii) tracking them to their households and to water bodies they frequented, (iv) testing individuals at households and water bodies, and (v) treating positive individuals. Additionally, test-and-treat interventions were implemented in the 22 health facilities of the study area.
RESULTS: The S. haematobium prevalence in the school-based survey in 15 low-prevalence implementation units was 0.5% (7/1560) in 2021 and 0.4% (6/1645) in 2022. In the household-based survey, 0.5% (14/2975) and 0.7% (19/2920) of participants were infected with S. haematobium in 2021 and 2022, respectively. The microhematuria prevalence, excluding trace results, in the school-based survey was 1.4% (21/1560) in 2021 and 1.5% (24/1645) in 2022. In the household-based survey, it was 3.3% (98/2975) in 2021 and 5.4% (159/2920) in 2022. During the 5T interventions, the microhaematuria prevalence was 3.8% (140/3700) and 5.8% (34/594) in children in primary and Islamic schools, respectively, 17.1% (44/258) in household members, and 16.7% (10/60) in people at water bodies. In health facilities, 19.8% (70/354) of patients tested microhematuria-positive.
CONCLUSIONS: The targeted 5T interventions maintained the very low S. haematobium prevalence and proved straightforward and feasible to identify and treat many of the few S. haematobium-infected individuals. Future research will show whether 5T interventions can maintain gains in the longer-term and expedite elimination.
BACKGROUND: ISRCTN, ISCRCTN91431493. Registered 11 February 2020, https://www.isrctn.com/ISRCTN91431493 .

Driven by international exchanges and climate changes, the invasion and spread of vector Anopheles mosquitoes posed a new challenge to achieving global malaria elimination. Taking the invasion of An. stephensi to exacerbate the malaria epidemic in Africa as an example, this article summarizes the current situation of global Anopheles invasion, and estimates the potential risk of vector Anopheles mosquitoes to unravel the difficulties and challenges in the global malaria elimination program, so as to provide insights into improved early earning and precision control of vector Anopheles mosquito invasion across the world.
［摘要］ 在国际交流与气候变化的驱动下, 媒介按蚊入侵与扩散 给全球疟疾消除目标的实现带来了新挑战。本文以斯氏按蚊入 侵加重非洲疟疾流行为例, 对全球按蚊入侵现状进行了梳理, 结 合媒介按蚊潜在入侵风险预估, 揭示全球疟疾消除的困难与挑 战, 为各国加强媒介按蚊入侵预警、媒介按蚊入侵的可持续精准 防控提供参考。.

The insecticide resistance is becoming increasingly severe in malaria vectors and has become one of the most important threats to global malaria elimination. Currently, malaria vectors not only have developed high resistance to conventional insecticides, including organochlorine, organophosphates, carbamates, and pyrethroids, but also have been resistant to recently used neonicotinoids and pyrrole insecticides. This article describes the current status of global insecticide resistance in malaria vectors and global insecticide resistance management strategies, analyzes the possible major challenges in the insecticide resistance management, and proposes the response actions, so as to provide insights into global insecticide resistance management and contributions to global malaria elimination.
［摘要］ 传疟媒介杀虫剂抗性问题日益严峻, 已成为全球消除疟 疾面临的最重要挑战之一。目前, 传疟媒介不仅对有机氯、有机 磷、氨基甲酸酯和拟除虫菊酯类等传统杀虫剂产生了高度抗性, 而且对近年来新使用的新烟碱类和吡咯类杀虫剂亦产生了抗性。 本文对当前全球传疟媒介杀虫剂抗性现状和相关抗性治理策略 进行了梳理, 并就杀虫剂抗性治理中存在的主要问题进行了分 析, 提出了下一步应对措施, 旨在为全球传疟媒介杀虫剂抗性治 理提供科学参考, 助力全球消除疟疾。.

The global malaria epidemic is still severe. Because of simple procedures, rapid detection and accuracy results, rapid diagnostic test (RDT) has become the most important and the most widely used diagnostic tool for malaria prevention and control. However, deletions in the RDT target Plasmodium falciparum histidine-rich protein 2/3 (Pfhrp2/3) genes may cause false-negative results of RDT, which has been included as one of the four biological threats to global malaria elimination. This article reviews the applications of RDT in the global malaria diagnosis, analyzes the threats and challenges caused by Pfhrp2/3 gene deletion, proposes methods for monitoring Pfhrp2/3 gene deletion, and summarizes the causes and countermeasures of negative RDT detections, so as to provide insights into consolidation of malaria elimination achievements in China and contributions to global malaria elimination.
［摘要］ 全球疟疾流行依然严峻, 疟疾快速诊断试纸条 (rapid diagnostic test, RDT) 操作简便、检测快速、结果准确, 已成为当前疟 疾防控中最重要和最广泛使用的诊断工具。但RDT靶标恶性疟 原虫富组氨酸蛋白2/3 (Plasmodium falciparum histidine-rich protein 2/3, Pfhrp2/3) 基因缺失可导致RDT产生假阴性检测结果, 被 WHO列为全球消除疟疾的四大生物学挑战之一。本文通过回顾 RDT在全球疟疾诊断中的应用, 分析Pfhrp2/3 基因缺失带来的威 胁与挑战、提出Pfhrp2/3 基因缺失的监测方法、总结RDT检测阴性 的原因与对策, 为巩固我国消除疟疾成果、助力全球消除疟疾提 供参考。.

Malaria is an infectious disease that seriously threatens human health. Currently, malaria control mainly depends on antimalarial chemotherapy. However, antimalarial drug resistance is becoming increasingly severe, which poses a great challenge to malaria control, notably treatment of Plasmodium falciparum malaria. To address this challenge, there is a need to facilitate development of novel antimalarial drugs and innovation of treatment strategies, as well as reinforce surveillance and research on antimalarial drug resistance. This article reviews the main categories and use guidelines of current antimalarial agents, summarizes the current status and monitoring methods of antimalarial drug resistance, and proposes the response to antimalarial drug resistance, so as to provide insights into the use of antimalarial drugs and response to antimalarial drug resistance, and contribute to global malaria elimination.
［摘要］ 疟疾是严重威胁人类健康的传染病之一, 目前疟疾 防控仍以药物治疗为主。然而, 抗疟药耐药性问题日益严峻, 给疟疾防控尤其是恶性疟治疗带来了严峻挑战。为应对这一 挑战, 需推动新型抗疟药物开发和治疗策略创新, 并加强抗疟 药耐药性监测与研究。本文梳理了当前抗疟药主要类别及使 用原则, 总结了抗疟药耐药性现状、监测手段及应对策略, 旨 在为抗疟药使用及耐药性应对提供科学参考、助力全球消除 疟疾。.

Malaria is one of the most serious mosquito-borne infectious diseases in the world. The global malaria control progress has stalled in recent years, which is largely due to the biological threats from the malaria pathogen Plasmodium and the vector Anopheles mosquitoes. This article provides an overview of biological threats to global malaria elimination, including antimalarial drug resistance, deletions in the malaria rapid diagnostic test target P. falciparum histidine-rich protein 2/3 (Pfhrp2/3) genes, vector insecticide resistance and emergence of invasive vector species, so as to provide insights into malaria and vector research and the formulation and adjustment of the malaria control and elimination strategy.
［摘要］ 疟疾是世界上危害最严重的蚊媒传染病之一。近年来, 全球疟疾防控进展迟缓, 重要原因之一是来自疟疾病原疟原虫和 传播媒介按蚊的生物学挑战。本文针对抗疟药耐药性、疟疾快速 诊断试纸条靶标恶性疟原虫富组氨酸蛋白2/3 (Plasmodium falciparum histidine-rich protein 2/3, Pfhrp2/3) 基因缺失、媒介杀虫剂抗 性及按蚊入侵等生物学挑战进行概述, 从而为当前疟疾及其媒介 相关研究提供参考, 亦为疟疾控制和消除策略的制订和调整提供 科学依据。.

To understand the progress of national schistosomiasis elimination program of China in 2023 and summarize the lessons and experiences, data on the endemic status of schistosomiasis and national schistosomiasis surveillance results in the People\'s Republic of China were collected and analyzed at a national level. By the end of 2023, Shanghai Municipality, Zhejiang Province, Fujian Province, Guangdong Province and Guangxi Zhuang Autonomous Region continued to consolidate the achievements of schistosomiasis elimination, and Sichuan and Jiangsu provinces maintained the criteria of transmission interruption, while Yunnan and Hubei provinces were identified to achieve the criteria of transmission interruption in 2020, and Anhui, Jiangxi and Hunan provinces achieved the criteria of transmission interruption in 2023. A total of 451 counties (cites, districts) were found to be endemic for schistosomiasis in China in 2023, including 26 250 endemic villages covering 73 034 500 residents at risk of infections. Among the 451 endemic counties (cities, districts), 78.49% (354/451) achieved the criteria of schistosomiasis elimination and 21.51% (97/451) achieved the criteria of transmission interruption, respectively. In 2023, a total of 4 216 643 individuals received immunological tests, with 47 794 sero-positives identified, and a total of 184 216 individuals received parasitological examinations, with 4 egg-positives detected. A total of 27 768 cases with advanced schistosomiasis were documented in China by the end of 2023. In 2023, 539 548 bovines were raised in schistosomiasis-endemic areas of China, and 125 440 bovines received immunological tests, with 124 sero-positives detected, while no egg-positives were identified among the 133 508 bovines receiving parasitological examinations. In 2023, snail survey was performed at an area of 641 339.53 hm2 and 184 819.77 hm2 snail habitats were identified, including 51.53 hm2 emerging snail habitats and 642.25 hm2 reemerging snail habitats. In 2023, there were 20 198 schistosomiasis patients receiving praziquantel chemotherapy, and 598 183 person-time individuals and 283 954 herdtime bovines were given expanded chemotherapy. In 2023, snail control with chemical treatment was performed in 116 347.95 hm2 snail habitats, and the actual area of chemical treatment was 65 690.89 hm2, while environmental improvements were performed in snail habitats covering an area of 1 334.62 hm2. The national schistosomiasis surveillance results showed that the mean prevalence of Schistosoma japonicum infections were both zero among humans and bovines in 2023, and no S. japonicum infection was detected in snails. These data demonstrated that transmission interruption of schistosomiasis had been achieved across all endemic provinces in China in 2023, and the endemic status of schistosomiasis tended to be stable, while advanced cases were predominant among all schistosomiasis cases. However, the areas of snail habitats remained high and cattle re-raising was very common in some regions. Intensified schistosomiasis surveillance and forecast and snail control in high-risk areas are needed.
［摘要］ 为了解全国血吸虫病消除工作进展、总结防治经验及存 在的问题, 本文对2023年全国血吸虫病疫情和监测结果进行了概 括分析。截至2023年底, 上海、浙江、福建、广东、广西等5个省 (直辖市、自治区) 继续维持血吸虫病消除状态, 四川、江苏省继续 维持传播阻断标准, 云南、湖北省于2020年达到传播阻断标准, 安 徽、江西、湖南省于2023年新达到传播阻断标准。2023年, 全国 共有451个血吸虫病流行县 (市、区) 、26 250个流行村, 流行村总 人口7 303.45万人; 451个流行县 (市、区) 中, 354个 (78.49%) 已达 到血吸虫病消除标准、97个 (21.51%) 已达到传播阻断标准。2023 年全国共开展居民血吸虫病免疫学检查4 216 643例, 阳性47 794 例; 开展病原学检查184 216例, 阳性4例; 全国尚存晚期血吸虫病 患者27 768例。2023年全国血吸虫病流行村现有存栏牛539 548 头, 累计开展免疫学检查查病125 440头, 阳性124头; 病原学检查查病133 508头, 未发现阳性。全国累计开展钉螺调查 641 339.53 hm2, 查出有螺面积184 819.77 hm2, 其中新发现有螺面积51.53 hm2、复现有螺面积642.25 hm2。2023年, 全国 累计治疗血吸虫病患者20 198例, 人群病原学扩大治疗598 183例·次, 牛病原学扩大治疗283 954头·次; 全国累计开展 药物灭螺116 347.95 hm2, 实际药物灭螺65 690.89 hm2, 环境改造灭螺1 334.62 hm2。2023年, 全国血吸虫病监测结果显 示人、畜血吸虫感染率均为0, 未发现感染性钉螺。疫情数据分析显示, 2023年全国所有流行省份均达到血吸虫病传播 阻断标准、疫情趋于稳定, 血吸虫病病例以晚期病例为主; 但钉螺面积居高不下, 部分地区牛复养现象严重。需继续加强 血吸虫病监测预警, 做好重点地区钉螺控制工作。.

Current industrial herbicides have a negative impact on the environment and have widespread resistance, so computational studies on their properties, elimination, and overcoming resistance can be helpful. On the other hand, developing new herbicides, especially bioherbicides, is slow and costly. Therefore, computational studies that guide the design and search for new herbicides that exist in various plant sources, can alleviate the pain associated with the many obstacles. This review summarizes for the first time the most recent studies on both aspects of herbicides over 10 years.

No vaccine has been more effective in reducing disease burden, especially in preventing child deaths, than measles-containing vaccine. The return on investment makes measles-containing vaccine one of the most cost-effective public health measures available. Exhaustive reviews of biological, technical, economic and programmatic evidence have concluded that measles can and should be eradicated, and by including rubella antigen in measles-containing vaccine, congenital rubella syndrome will also be eradicated. All World Health Organisation Regions have pledged to achieve measles elimination. Unfortunately, not all countries and global partners have demonstrated an appropriate commitment to these laudable public health goals, and the negative impact of the COVID-19 pandemic on coverage rates has been profound. Unsurprisingly, large disruptive outbreaks are already occurring in many countries with a global epidemic curve ominously similar to that of 2018/2019 emerging. The Immunization Agenda 2030 will fail dismally unless measles and rubella eradication efforts are accelerated. Over half of all member states have been verified to have eliminated rubella and endemic rubella transmission has not been re-established in any country to date. In 2023, 84 countries and areas were verified to have sustained elimination of measles. However, without a global target, this success will be difficult to sustain. Now is the time for a global eradication goal and commitment by the World Health Assembly. Having a galvanising goal, with a shared call for action, will demand adequate resourcing from every country government and global partners. Greater coordination across countries and regions will be necessary. Measles, rubella and congenital rubella syndrome eradication should not remain just a technically feasible possibility but rather be completed to ensure that future generations of children do not live under the shadow of preventable childhood death and lifelong disability.

Measles and rubella are vaccine-preventable viral diseases and can be prevented by safe, highly effective vaccination with measles- and rubella-containing vaccines. Given the myriad causes of febrile exanthems, laboratory surveillance for both measles and rubella is important to document the incidence of these diseases and to track the progress and maintenance of elimination in near- and post-elimination settings. Diagnostic challenges can hinder effective surveillance and classification challenges can hinder efforts to demonstrate achievement or maintenance of elimination. In this report, we review diagnostic and classification challenges for measles and rubella in near- and post-elimination settings.