Schistosomiasis In China

       University of California, Berkeley

Environmental Change and Parasite Diffusion

Hydrological Modeling
Intermediate Host Snail Dynamics
Landscape Genetics
Sociometrics
Statistical and Mathematical Modeling

Schistosomiasis has long been associated with engineered environmental changes, particularly dam construction. The construction of the Aswan Dam in Egypt, the Tigay in Ethiopia, the Kossou and Taabo in Cote d’Ivoire, the Diama in Senegal and Manantali in Mali have all led to major outbreaks of schistosomiasis. While it is clear that schistosomiasis transmission exhibits a strong response to environmental change, the underlying mechanisms shaping this relationship are unclear. We argue that transmission prediction, and ultimately prevention, requires a more sophisticated understanding of the mechanisms that alter transmission within a changing environment.

This project, supported by the NSF Ecology of Infectious Diseases program, aims to answer two open questions about the epidemiology of human parasites: how do parasites spread, and how does environmental change influence parasite spread? In western China, little is known about the relative importance of the transport of snail and S. japonicum larvae through waterways in relation to other potential modes of schistosome spread, such as human and domestic animal movement. With respect to the S. japonicum parasite, we term these flows parasite diffusion, using the phrase to encompass all diffusive pathways along which parasites are transported into new and existing locales.

From our environmental change research we hope to answer the following questions:

 

      1)     What is the relative importance of these diffusion pathways in spreading parasites to new areas, or sustaining the parasite in endemic environments?

      

      2)     How can anthropogenic change modify diffusion parameters, and thereby influence transmission?

 

This project brings together leading experts in molecular ecology, schistosome genetics and environmental and epidemiological modeling to comprehensively examine the diffusion pathways that carry S. japonicum between and among human populations in twenty-one villages in western China.

Hydrological Modeling

Hydrological variability has been raised as a key factor in modifying vector-borne disease transmission under climate change scenarios. In Western China, the water-based free-living stages and aquatic intermediate host of S. japonicum have led us to focus on hydrological corridors, including streams, rivers and irrigation canals, and their impedances, such as weirs or dams, as key pathways by which parasites can diffuse.  Our aim is to integrate dispersal characteristics of snails and parasites, habitat quality estimators, and GIS-based hydrologic pathways into a least-cost model to estimate the most probable dispersal paths between each pair of villages, and to quantify the degree to which landscape features facilitate or impede snail migration and parasite diffusion. 

Examples of questions we hope to answer are:

          1) Does the dominant direction of parasite diffusion follow a hydrological gradient?

          2) Is there a positive correlation between gradient in a watershed and snail genetic heterogeneity?

          3) Is contemporary dispersal among snail populations unidirectional along the path of hydrological flow?  

(Top)  |  Methods: GIS/RS, Hydrology

Intermediate Host Snail Dynamics

Within intermediate snail hosts, parasites are conveyed among and between aquatic and riparian habitats.  Much of our previous work has focused on characterizing the response of snail population dynamics to environmental factors (e.g. temperature, precipitation). We use traditional (mark-recapture) and molecular (AFLP markers) methods to estimate key population parameters and quantify dispersal among and between sites. We recognize that traditional and molecular methods measure somewhat different quantities and can disagree. Thus, we are employing the simultaneous application of both direct and indirect methods following the mass mark-recapture work of Remais et al. (2007) and the AFLP markers developed by Wilke and Davis (2006). Direct estimates of bidirectional dispersal will be used to validate the indirect methods in a subset of study villages. Also to be collected in the current study is the infection status, sex and age of each collected snail.

With these data, we can potentially answer the following questions:

      1) What characteristics (age, sex, infection status) are dominant among migrant snails vs. non-migrants?

      2) What is the relationship between snail genetic heterogeneity and susceptibility?

      3) Between susceptibility and isolation?

(Top)   |  Methods: Molecular Detection / Cercariometry , Genetic analysis

Landscape Genetics

Landscape genetics is an emerging field integrating landscape ecology, population genetics, and spatial statistics to better understand how physical, biological, and chemical variation shape genetic diversity and structure.  We are currently applying landscape genetic tools to model the influence of environmental variables such as riparian habitat quality, topography, and hydrology on snail migration and parasite diffusion, as measured using genetic assignment techniques. Correlations between fine-scale genetic patterns and environmental variables are being explored through the use of a GIS-based predictive hydrological platform, which allows us to model the dispersal pathways of parasites and intermediate hosts, using the results of fully Bayesian assignment tests, topographic barriers, hydrologic pathways, and land use as model inputs.

(Top)   |  Methods: Genetic analysis, hydrology, GIS/RS

Sociometrics

The movements of human and animal hosts are being reconstructed using a social network parameterized using sociometric surveys of study participants and animal host tracking. We also classify, through interviews and using extensive field surveys and existing maps, the ease (or difficulty) of movement between villages by systematically documenting the presence of roads, footpaths, public transportation and the length (in time and distance) of common between-village trips.

(Top)   |  Methods: GIS/RS

Statistical and Mathematical Modeling

We use statistical and mathematical models to achieve mechanistic insights into how environmental change can modify parasite mobility, thereby altering transmission. We regard the model as a platform for the synthesis of general knowledge of the mechanisms of disease transmission, quantitative estimates of biological parameter values, and the local factors influencing transmission. To date, we have utilized a variant of the Anderson-May model of schistosomiasis transmission, a compartmental differential equation model modified to allow for multiple risk groups. An extension of this form would be a stochastic compartmental model, where the risk group structure would be maintained with each compartment being comprised of a number of identical individuals. The static representation of the aggregation of parasites in humans in this model poses some limitations, and thus the predictive modeling carried out in the present study will exploit the utility of stochastic models for incorporating rare transmission events. Our general approach given any model framework is to simulate transmission at the village scale, with villages within and between watersheds exchanging parasites through the major diffusion pathways. Our primary modeling outcomes are infection intensity in humans and infected and uninfected snail densities.

To incorporate spatial structure with respect to both the exposure process and snail dynamics, we are currently exploring several model types, with our primary interest in reaction-diffusion network models, which have a long history of application to island models of metapopulation dynamics. Theoretical explorations with a stochastic, individual-based model can provide insight about the transmission relevance of the introduction of an infected host, as well as answer questions related to parasite population viability:

          1) Can one infected water-buffalo, alone (given their size and typically high worm burden), initiate and sustain transmission in a new environment?

          2) What is the impact on transmission of rare diffusion events, such as long-distance snail dispersal?

          3) Given the measured pathways, what influence does diffusion have in preventing disease eradication? That is, how does diffusion influence parasite population viability?

(Top)  |  Methods: Disease Modeling