Epidemiological Transition and Spatial Expansion of Mountain-Type Zoonotic Visceral Leishmaniasis — China, 2010–2024

Lulu Huang¹; Yanfeng Gong²; Zhengbin Zhou¹; Jingshu Liu¹; Peijun Zhang³; Shizhu Li¹^,#

1. National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Chinese Center for Tropical Diseases Research; NHC Key Laboratory of Parasite and Vector Biology; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, China;

2. School of Public Health, Fudan University, Shanghai, China;

3. Yangquan Center for Disease Control and Prevention, Yangquan City, Shanxi Province, China.

^# Corresponding author: Shizhu Li, lisz@chinacdc.cn.

MT-ZVL has re-emerged in China with shifting demographic patterns and expanding geographical distribution. This study aimed to characterize its epidemiological and spatial-temporal dynamics to guide targeted control strategies. Case data from 2010–2024 were analyzed using χ² tests and proportional analyses. Temporal trends were assessed by Joinpoint regression, projections by ARIMA models, spatial clustering and directional tendency by Moran’s I and SDE analyses. A total of 2,260 cases were reported, showing a bimodal age distribution (<5 years and 60–75 years) with marked male predominance and a shifting occupational risk toward adults. Affected counties expanded from 19 to 69 and after a decline in 2010–2015, incidence increased and spread eastward during 2015–2024, with projections indicating continued growth by 2030 without strengthened control. MT-ZVL in China shows expanding risk areas and changing occupational patterns, highlighting the need for strengthened surveillance and targeted control interventions in the regions.

犬源型内脏利什曼病的时空流行特征及空间分布格局演变 — 中国，2010–2024年

黄璐璐¹；公衍峰²；周正斌¹；刘婧姝¹；张佩君³；李石柱¹^,#

¹ 中国疾病预防控制中心寄生虫病预防控制所（国家热带病研究中心）；国家卫生健康委员会寄生虫病原与媒介生物学重点实验室；世界卫生组织热带病合作中心；科技部国家级热带病国际联合研究中心传染病溯源预警与智能决策全国重点实验室，上海，中国；
² 复旦大学公共卫生学院，上海，中国；

³ 山西省阳泉市疾病预防控制中心，阳泉市，山西省，中国。

^# 通信作者: 李石柱, lisz@chinacdc.cn。

犬源型内脏利什曼病（MT-ZVL）近年来在我国呈现复燃趋势，其人群特征发生变化，地理分布范围持续扩大。本研究旨在刻画MT-ZVL的流行病学特征及时空变化规律，为制定有针对性的防控策略提供科学依据。收集并分析2010—2024年病例数据，采用χ²检验和构成比分析进行描述性统计。通过Joinpoint回归分析发病时间趋势，利用ARIMA模型对未来发病趋势进行预测，并采用Moran’s I指数和标准差椭圆（SDE）分析方法评估疫情的空间聚集性及疫情扩散的方向性特征。研究期间共报告MT-ZVL病例2,260例，年龄分布呈明显的双峰特征（<5岁和60–75岁），男性发病显著高于女性，职业高风险群体逐渐向成年人群体转变。受影响县（区）数由19个增加至69个。发病率在2010—2015年下降后，于2015—2024年再次上升，并呈现明显向东扩展的趋势。预测结果显示，如不加强防控措施，到2030年发病仍可能持续增长。我国MT-ZVL呈现风险区域不断扩大及职业人群构成变化的流行特征，提示亟需加强监测体系建设，并在重点地区实施更加精准和有针对性的综合防控干预措施。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2026.017

Effectiveness of an Integrated One Health Intervention on Schistosoma japonicum Infection in Wild Rodents — Anhui Province, China, 2023–2024

Suying Guo¹, Chao Lyu¹, Lijuan Zhang¹, Wangping Deng¹, Jing Xu^1,2,#, Shizhu Li¹, Xiaonong Zhou^1,2

1. National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases; Key Laboratory on Parasite and Vector Biology, Ministry of Health; WHO Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, China;

2. School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

^# Corresponding author: Jing Xu, xujing@nipd.chinacdc.cn.

Wild rodents serve as important reservoir hosts of Schistosoma japonicum in certain endemic regions. Although a One Health strategy integrating human, animal, and environmental health measures has been proposed, evidence demonstrating its effectiveness in reducing wildlife reservoir infection remains limited. A preplanned intervention study was conducted from 2022 to 2024 across 12 villages in two endemic counties of Anhui Province. Villages were assigned to receive either routine control measures or an enhanced One Health intervention package that included deratization, drone-based surveillance, microenvironment modification, and health education. Annual rodent surveys were conducted using trap-night methods, and multiple diagnostic tests were employed to detect S. japonicum infection. A total of 2,084 rodents were captured and examined. The S. japonicum infection rate in intervention villages decreased from 69.15% (278/402) at baseline to 22.09% (146/661) after two years of intervention (χ²=230.950, P<0.01), whereas the infection rate in control villages increased from 39.07% (143/366) to 45.65% (299/655) (χ²=4.138, P=0.04). Adjusted analysis demonstrated an 88.5% reduction in infection odds within the intervention group [adjusted odds ratio (aOR)=0.115, 95% confidence interval (CI): 0.078, 0.172]. A comprehensive One Health intervention package is significantly associated with reduced S. japonicum infection in wild rodents. Integrating rodent-targeted measures into schistosomiasis control programs may substantially decrease transmission risk and accelerate progress toward nationwide schistosomiasis elimination.

野生啮齿动物日本血吸虫感染全健康综合干预措施效果评价 — 安徽省，中国， 2023–2024年

郭苏影¹，吕超¹，张利娟¹，邓王平¹，许静^1,2,#，李石柱¹，周晓农^1,2

1. 中国疾病预防控制中心寄生虫病预防控制所（国家热带病研究中心）；传染病溯源预警与智能决策全国重点实验室；国家卫生健康委员会寄生虫病原与媒介生物学重点实验室；世界卫生组织热带病合作中心；科技部国家级热带病国际联合研究中心，上海，中国；

2. 全球健康学院，上海交通大学医学院-国家热带病研究中心，上海，中国。

^# 通信作者：许静，xujing@nipd.chinacdc.cn。

在部分流行区，野生啮齿动物是日本血吸虫的重要保虫宿主。尽管目前已有整合了人类、动物和环境健康措施的全健康策略，但其在降低野生动物保虫宿主感染有效性上的证据仍然有限。2022–2024年，在安徽省2个流行县的12个村开展了干预的预实验研究。村庄被分成常规防控措施和强化的全健康干预措施两组，全健康干预措施包括灭鼠、无人机监测、小环境改造和健康教育。每年采用夹夜法进行野生啮齿动物调查，并采用多种诊断方法检测其日本血吸虫感染情况。共捕获并检测2084只啮齿动物。干预村的日本血吸虫感染率从基线的69.15%（278/402）降至干预两年后的22.09%（146/661）（χ²=230.950，P<0.01），而对照村的感染率从39.07%（143/366）升至45.65%（299/655）（χ²=4.138，P=0.04）。调整分析显示，干预组的感染概率降低了88.5% [校正比值比（adjusted odds ratio, aOR）=0.115，95%置信区间（confidence interval , CI）：0.078，0.172]。全健康综合干预措施与野生啮齿动物日本血吸虫感染率的降低显著相关。将针对啮齿动物的措施纳入到血吸虫病控制规划中可能会大幅降低传播风险，并加快全国消除血吸虫病的进程。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2026.018

Knowledge, Attitudes, and Practices of Dog Owners Toward a Smart Health Education Pillbox for Controlling Echinococcosis — Western China, 2023–2024

Shijie Yang¹; Chenqing Sun¹; Ning Xiao¹; Shizhu Li¹; Shuai Han¹; Liying Wang¹; Ying Wang¹; Jiangshan Zhao²; Shanglin Wu³; Xiao Ma⁴; Yu Feng⁵; Benfu Li⁶; Tongmin Wang⁷; Kaisaier Tuerxunjiang²; Xiaonong Zhou^1,#

1. National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Health Commission Key Laboratory on Parasite and Vector Biology, WHO Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, China;

2. Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi City, Xinjiang Uygur Autonomous Region, China;

3. Ningxia Hui Autonomous Region Center for Disease Control and Prevention, Yinchuan City, Ningxia Hui Autonomous Region, China;

4. Qinghai Institute for Endemic Disease Prevention and Control, Xining City, Qinghai Province, China;

5. Department of Parasitic Diseases, Gansu Center for Disease Control and Prevention, Lanzhou City, Gansu Province, China;

6. Yunnan Institute of Parasitic Diseases, Kunming City, Yunnan Province, China;

7. Center for Disease Control and Prevention of Xinjiang Production and Construction Corps, Urumqi City, Xinjiang Uygur Autonomous Region, China.

^# Corresponding author: Xiaonong Zhou, zhouxn1@chinacdc.cn.

Echinococcosis, a neglected zoonotic disease, imposes a substantial global health burden. Enhancing health literacy and facilitating practice changes among pastoral communities through innovative technological interventions are essential for reducing disease transmission and impact. We evaluated the effectiveness of the SHEP on the knowledge, attitudes, and practices (KAP) of dog owners in controlling echinococcosis. We conducted a cluster-randomized trial among 2,700 dog owners across nine endemic counties in western China, selecting two townships per county. Within each township, 150 enrolled dog owners were randomly allocated in equal numbers to either the Smart Health Education Pillbox (SHEP) or routine health education (RHE) group. Data were collected through a validated online questionnaire (Cronbach's α=0.85) distributed via the Wenjuanxing platform. Primary outcomes included knowledge, attitude, and practice rates, as well as practice conversion efficiency. Statistical analyses were performed to calculate absolute risk reduction (ARR), relative risk (RR), relative risk reduction (RRR), protective efficacy (1/RR), and conversion efficiency index (η). Implementation of the SHEP significantly enhanced dog owners' knowledge, attitudes, and practices by 6.78%, 3.30%, and 7.50%, respectively, while reducing misconceptions, negative attitudes, and improper practices by 43.92%, 28.60%, and 13.74% compared to RHE (all P<0.001). The intervention demonstrated protective efficacy ratios of 1.82, 1.40, and 1.16 across these domains and increased the overall conversion efficiency index by 7.88% (all P<0.001). The SHEP represents a superior intervention for improving echinococcosis-related knowledge, attitudes, and practices (KAP), demonstrating particular strength in enhancing knowledge-to-practice conversion. As an innovative solution addressing health education challenges in plateau pastoral areas, the SHEP is recommended for integration into the national echinococcosis control program.

棘球蚴病防控中智能健康科普药盒对犬主人知信行影响研究 — 西部地区，中国，2023–2024年

杨诗杰¹，孙晨清¹，肖宁¹，李石柱¹，韩帅¹，王立英¹，王莹¹，赵江山²，吴尚林³，马霄⁴，冯宇⁵，李奔福⁶，王童敏⁷，开赛尔∙吐尔逊江²，周晓农^1,#

1. 寄生虫病预防控制所，中国疾病预防控制中心（国家热带病研究中心），传染病溯源预警与智能决策全国重点实验室，国家卫生健康委员会寄生虫与媒介生物学重点实验室，世界卫生组织热带病合作中心，科技部国家热带病国际研究中心，上海，中国；

2. 新疆维吾尔自治区疾病预防控制中心，乌鲁木齐市，新疆维吾尔自治区，中国；

3. 宁夏回族自治区疾病预防控制中心，银川市，宁夏回族自治区，中国；

4. 青海省地方病预防控制所，西宁市，青海省，中国；

5. 寄生虫病预防控制所，甘肃省疾病预防控制中心，兰州市，甘肃省，中国；

6. 云南省寄生虫病防治所，昆明市，云南省，中国；

7. 新疆生产建设兵团疾病预防控制中心，乌鲁木齐市，新疆维吾尔自治区，中国。

^# 通信作者：周晓农, zhouxn1@chinacdc.cn。

新技术对提高牧区居民的健康素养、促进行为改变和减少疾病传播至关重要。本文评价智能健康科普药盒对犬主人防控棘球蚴病知识态度和行为（KAP）影响，为精准化健康教育提供依据。在中国西部九个流行县中对 2700 名养犬者进行了整群随机试验，通过问卷星平台分发的在线验证问卷收集数据。测量的结果包括知识、态度和实践率，以及实践转化效率。计算绝对风险降低（ARR）、相对风险（RR）、相对风险降低（RRR）、保护效力（1/RR）和转化效率指数（η）。与常规健康教育相比，应用智能健康科普药盒显著提高了犬主的知识、态度和实践水平，分别提高了 6.78%、3.30% 和 7.50%，同时减少了错误观念、负面态度和不当行为，分别降低了 43.92%、28.60% 和 13.74%（P < 0.001）。在这些领域分别显示出 1.82、1.40 和 1.16 倍的保护效力，使总体转化效率指数提高了 7.88%（所有 P < 0.001）。智能健康科普药盒为高原牧区的健康教育难题提供了一种创新的解决方案。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2026.019

Attitudes as a Critical Mediator Between Schistosomiasis Knowledge and Practices Among Students, With Implications for Behavior Change Interventions — Pemba Island, Zanzibar, Tanzania, 2024

Xiaojing Li^1,2,&; Mingzhen He^3,&; Yi Wang²; Saleh Juma Mohammed⁴; Xiangyu Zhou⁵; Xinyao Wang²; Mchanga Mohd Suleiman⁴; Mayda Salim Hamad⁴; Mgeni Abdalla Khamis⁴; Khamis Seif Khamis⁴ and Yuzheng Huang^1,2,#

1. Nanjing Medical University School of Public Health, Nanjing City, Jiangsu Province, China;

2. Jiangsu Institute of Parasitic Diseases, Wuxi City, Jiangsu Province, China;

3. Changzhou Center for Disease Control and Prevention, Changzhou City, Jiangsu Province, China;

4. Office of Neglected Tropical Diseases, Ministry of Health, Pemba, Tanzania;

5. Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan City, Hubei Province, China.

^& Joint first authors.

^# Corresponding authors: Yuzheng Huang, huangyuzheng@jipd.com.

To assess the mediating role of attitudes in the knowledge-practice pathway, a school-based cross-sectional study (N=390) was conducted on Pemba Island, Zanzibar, Tanzania (Jan–Mar 2024), combining KAP surveys with urinary egg detection. Regression and mediation analyses identified influencing factors and quantified mediation effects. Results showed a 12.05% infection rate. Mean scores were 6.89±1.50 (knowledge, out of 10), 41.40±9.77 (attitudes, out of 55), and 19.28±2.78 (practices, out of 30). Sex, grade, tap water access, and water contact opportunities were significant factors (P<0.05). Critically, attitudes mediated 68.35% of knowledge’s total effect on practices. These findings underscore that effective behavior change interventions in schistosomiasis-endemic areas must prioritize attitude transformation through community health volunteer-led interactive education (e.g., peer role-playing) integrated with WASH improvements, rather than relying solely on knowledge dissemination.

血吸虫病知识与行为间态度的关键中介作用及对行为改变干预的启示 — 奔巴岛，桑给巴尔，坦桑尼亚，2024年

李晓静^1,2,&；何明祯^3,&；王依²；Saleh Juma Mohammed⁴；周翔宇⁵；王鑫瑶²；Mchanga Mohd Suleiman⁴；Mayda Salim Hamad⁴；Mgeni Abdalla Khamis⁴；Khamis Seif Khamis⁴；黄玉政^1,2,#

1. 南京医科大学公共卫生学院，南京市，江苏省，中国；

2. 江苏省血吸虫病防治研究所，无锡市，江苏省，中国；

3. 常州市疾病预防控制中心，常州市，江苏省，中国；

4. 坦桑尼亚桑给巴尔卫生部被忽视热带病办公室，奔巴，坦桑尼亚；

5. 华中科技大学同济医学院附属同济医院检验科，武汉市，湖北省，中国。

^& 共同第一作者。

^# 通信作者：黄玉政，huangyuzheng@jipdd.com。

为评估态度在“知识-行为”路径中的中介作用，本研究于2024年1月至3月在坦桑尼亚桑给巴尔奔巴岛开展了一项以学校为基础的横断面研究（N=390），结合知识、态度和行为（KAP）问卷调查和尿液血吸虫虫卵检测。通过回归分析和中介效应分析识别影响因素并量化中介作用。结果显示，血吸虫感染率为12.05%。知识、态度和行为平均得分分别为6.89±1.50（满分10分）、41.40±9.77（满分55分）和19.28±2.78（满分30分）。性别、年级、自来水获取情况及水接触机会是显著影响因素（P<0.05）。关键发现是，态度在知识对行为的影响中起关键中介作用，中介效应占比达68.35%。这些发现强调，在血吸虫病流行区，有效的行为改变干预必须优先通过社区健康志愿者主导的互动式教育（如同伴角色扮演）并结合水、环境卫生和个人卫生（WASH）改善来实现态度转变，而非仅仅依赖知识传播。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2026.020

First Imported Case of Cerebral Schistosomiasis Mansoni — China, May 2025

Weiqi Chen¹; Yalan Zhang¹; Xiaohui Ma¹; Tiantian Jiang¹; Dongyang Zhao¹; Yan Deng^1,#

1. Henan Center for Disease Control and Prevention, Henan Medical Key Laboratory for Pathogeny and Vector of Parasitosis, Provincial Key Laboratory for Infectious Disease Prevention and Control, Henan Province, China.

^# Corresponding authors: Yan Deng, sunnydeng310@163.com.

To report the first imported case of cerebral schistosomiasis mansoni in China and highlight the public health risks posed by this disease. We conducted an epidemiological investigation, performed laboratory testing of clinical samples, and collected diagnostic and treatment data. The infection source was determined through comprehensive analysis of epidemiological history, clinical manifestations, and laboratory findings. Before returning to China, the patient had resided for nearly 10 years in schistosomiasis-endemic regions, including Angola and the Democratic Republic of the Congo (DRC), where mountain spring water was used for drinking and daily activities. One month before returning to China, the patient developed central nervous system symptoms, including limb weakness and slowed reactions. Laboratory testing revealed markedly elevated eosinophil (EOS) levels, with both percentage (25.0%) and absolute count (3.30×10⁹/L) exceeding normal ranges. High-throughput sequencing (HTS) of blood samples identified Schistosoma mansoni DNA sequences, and microscopic stool examination detected S. mansoni eggs. China is not an endemic area for S. mansoni. This study reports the first imported case of cerebral schistosomiasis mansoni in China. With the continuous emergence of imported S. mansoni cases and the gradual expansion of intermediate host breeding grounds, we should actively monitor the potential risk of local transmission occurring in China. Enhanced protective awareness among international travelers and strengthened public health surveillance are essential measures to counter the threat posed by imported cases.

首例输入性脑型曼氏血吸虫病病例 — 中国，2025年5月

陈伟奇¹；张雅兰¹；马晓会¹；蒋甜甜¹；赵东阳¹；邓艳^1,#

1. 河南省疾病预防控制中心，河南省寄生虫病原与媒介医学重点实验室，河南省传染病病原生物重点实验室，中国，河南省，郑州市。

^# 通信作者：邓艳，sunnydeng310@163.com。

报告中国首例输入性脑型曼氏血吸虫病病例，并强调该疾病对公共卫生的威胁。我们开展了流行病学调查，对临床样本进行了实验室检测，并收集了临床诊治疗资料。通过对流行病学史、临床表现及实验室结果的综合分析，确定了感染来源。病例回国前有在安哥拉、刚果金等曼氏血吸虫病流行区近10年的旅居史，期间以山泉水作为饮用水和日常生活用水。回国前的1个月，病例出现肢体无力、反应迟钝等中枢神经系统症状。实验室检测显示嗜酸性粒细胞（EOS）水平显著升高，其百分比（25.0%）和绝对计数（3.30×10⁹/L）均超出正常范围。血液样本的高通量测序（HTS）检出曼氏血吸虫DNA序列，粪便中检出曼氏血吸虫虫卵。中国并非曼氏血吸虫的流行区。本研究报道了中国首例境外输入性脑型曼氏血吸虫病病例。随着输入性曼氏血吸虫病例的持续出现和中间宿主孳生地的逐步扩大，我们应积极关注中国境内发生本地传播的潜在风险。提高国际旅行者的防护意识，加强公共卫生监测，是应对输入性病例威胁的关键措施。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2026.021