Epidemiological and clinical characteristics of newly reported advanced schistosomiasis patients in Jiangxi Province from 2019 to 2022

doi:10.12140/j.issn.1000-7423.2026.01.002

Abstract

Abstract:

Objective To analyze the epidemiological and clinical characteristics of newly reported advanced schistosomiasis (AS) cases in Jiangxi Province from 2019 to 2022, so as to provide insights into optimization of the AS control strategy. Methods The epidemiological and clinical characteristics of newly reported AS patients in Jiangxi Province from 2019 to 2022 were collected by means of a retrospective review, medical record inquiry, and questionnaire surveys, including demographics, history of case diagnosis and treatment, comorbidities and complications, laboratory tests (routine blood tests, blood biochemical tests, coagulation functions, and hepatic fibrosis markers) and ultrasound examinations. All data were input into Microsoft Excel 2016, and all statistical analyses were performed with SPSS 25.0. The χ² test was used for comparisons between groups. Results A total of 518 newly reported AS cases were recorded in Jiangxi Province from 2019 to 2022, and 488 cases were included in this analysis. These AS cases were predominantly found in Shangrao City (45.2%, 234/518), Jiujiang City (31.1%, 161/518), Nanchang City (14.1%, 73/518) and Yichun City (9.6%, 50/518), and the majority of these cases were male (62.5%, 305/488). The subjects had a mean age of (66.61 ± 9.84) years, including 82.2% (401/488) at ages of 60 years and older, 88.5% (432/488) with an educational level of primary school and below, and 77.1% (376/488) with an occupation of farmer. Ascites subtype was the predominant clinical subtype (75.4%, 368/488), and 23.6% (115/488) of the subjects were comorbid with other diseases, with hypertension as the most common comorbidity (41 cases), followed by diabetes mellitus (14 cases). Of all cases, 13.1% (64/488) had complications, with upper gastrointestinal bleeding as the predominant complication (53 cases), and the proportions of etiological treatment and antifibrotic therapy were 91.4% (446/488) and 82.6% (403/488). Laboratory tests showed the highest incidence of abnormal platelet counts in blood cell analysis (59.1%, 117/198), and there was a significant difference in the incidence of abnormal platelet counts among subjects with different clinical subtypes of AS (χ² = 12.398, P < 0.05). Regarding liver function parameters, the highest incidence of abnormal albumin was detected (70.7%, 140/198), and regarding hepatic fibrosis markers, the highest incidence of abnormal procollagen typeⅢ (PCⅢ) was recorded (56.6%, 112/198), with a 58.9% (96/163) incidence of abnormal PCⅢ seen among ascites-subtype cases. Regarding coagulation function indicators, thrombin time prolongation was the most common coagulation disorder (52.5%, 104/198), and the proportion of abnormal activated partial thromboplastin time varied in clinical subtypes (χ² = 13.696, P < 0.05). Ultrasound examinations showed grade Ⅲ hepatic parenchymal fibrosis among 89.2% (415/465) of subjects, 69.9% (325/465) among subjects with ascites, and 62.2% (289/465) among subjects with the inner diameter of main portal vein of > 13 mm. Conclusion Elderly men are predominant among newly reported AS cases in Jiangxi Province, and ascites subtype is the predominant clinical subtype, with hypertension and diabetes mellitus as common comorbidities. Despite multiple etiological and antifibrotic treatments given among selected patients, AS remained to progress to advanced stage, suggesting the need to strengthen early monitoring and interventions among patients with comorbid metabolic diseases to slow down disease progression.

Key words: Newly reported cases, Advanced schistosomiasis, Jiangxi Province, Epidemiology, Clinical characteristics

CLC Number:

R532.21

GONG Zhihong, YUAN Min, XIE Huiqun, XU Yun, ZHOU Feng, LUO Anqi, LIU Junpu, HU Fei, LIN Dandan, LI Yifeng. Epidemiological and clinical characteristics of newly reported advanced schistosomiasis patients in Jiangxi Province from 2019 to 2022[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2026, 44(1): 8-14.

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References 33

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特征 Characteristic	例数 No. cases	构成比/% Composition ratio/%
性别 Sex
男 Male	305	62.5
女 Female	183	37.5
年龄组 Age group
< 30	2	0.4
30~59	85	17.4
≥ 60	401	82.2
文化程度 Educational level
文盲 Illiteracy	195	39.9
小学 Primary school	237	48.6
中学及以上 Secondary and above	56	11.5
职业 Occupation
农民 Peasants	376	77.1
家务 domestic work	62	12.7
半农半渔 Half farmer and half fisherman	27	5.5
民工、教师及其他 Civilian workers, teachers and others	23	4.7

临床类型 Clinical type	检测例数 No. cases tested	异常例数（占比/%）No. abnormal cases (Proportion/%)
临床类型 Clinical type	检测例数 No. cases tested	白细胞计数 WBC	红细胞计数 RBC		血小板计数 PLT
腹水型 Ascites type	163	92（56.4）		60（36.8）		92（56.4）
结肠增殖型 Colonic proliferative type	6	2（2/6）		1（1/6）		1（1/6）
巨脾未切 Megasplenic type without splenectomy	18	12（12/18）		12（12/18）		16（16/18）
巨脾已切 Megasplenic type with splenectomy	11	6（6/11）		0（0）		8（8/11）
合计 Total	198	112（56.6）		73（36.9）		117（59.1）

临床分型 Clinical type	检测例数 No. cases tested	异常例数（占比/%）No. abnormal cases (Proportion/%)
临床分型 Clinical type	检测例数 No. cases tested	丙氨酸转氨酶 ALT	天冬氨酸转氨酶 AST	γ-谷氨酰转肽酶 γ-GT	总胆红素TBIL	直接胆红素 DBIL	白蛋白 ALB	球蛋白GLB
腹水型 Ascites type	163	31（19.0）	67（41.1）	69（42.3）	40（24.5）	47（28.8）	118（72.4）	21（12.9）
结肠增殖 Colonic proliferative type	6	1（1/6）	2（2/6）	3（3/6）	0（0）	0（0）	2（2/6）	2（2/6）
巨脾未切 Megasplenic type without splenectomy	18	3（3/18）	5（5/18）	6（6/18）	3（3/18）	6（6/18）	12（12/18）	2（2/18）
巨脾已切 Megasplenic type with splenectomy	11	1（1/11）	2（2/11）	2（2/11）	4（4/11）	3（3/11）	8（8/11）	4（4/11）
合计 Total	198	36（18.2）	76（38.4）	80（40.4）	47（23.7）	56（28.3）	140（70.7）	29（14.6）

临床分型 Clinical type	检测例数 No. cases tested	异常例数（占比/%）No. abnormal cases (Proportion/%)
临床分型 Clinical type	检测例数 No. cases tested	透明质酸 HA	层粘连蛋白 LN	Ⅲ型前胶原 PCⅢ	Ⅳ型胶原 Ⅳ-C
腹水型 Ascites type	163	71（43.6）	8（4.9）	96（58.9）	20（12.3）
结肠增殖型 Colonic proliferative type	6	1（1/6）	0（0）	1（1/6）	0（0）
巨脾未切 Megasplenic type without splenectomy	18	8（8/18）	10（10/18）	11（11/18）	4（4/18）
巨脾已切 Megasplenic type with splenectomy	11	8（8/11）	2（2/11）	4（4/11）	1（1/11）
合计 Total	198	88（44.4）	20（10.1）	112（56.6）	25（12.6）

临床分型 Clinical type	检测例数 No. cases tested	异常例数（占比/%）No. abnormal cases (Proportion/%)
临床分型 Clinical type	检测例数 No. cases tested	PT	APTT	TT	FIB	AFP
腹水型 Ascites type	163	25（15.3）	24（14.7）	84（51.5）	28（17.2）	5（3.1）
结肠增殖型 Colonic proliferative type	6	0（0）	0（0）	2（2/6）	0（0）	0（0）
巨脾未切 Megasplenic type without splenectomy	18	2（2/18）	2（2/18）	12（12/18）	3（3/18）	4（4/18）
巨脾已切 Megasplenic type with splenectomy	11	0（0）	0（0）	6（6/11）	0（0）	1（1/11）
合计 Total	198	27（13.6）	26（13.1）	104（52.5）	31（15.7）	10（5.1）