{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T06:31:12Z","timestamp":1769149872393,"version":"3.49.0"},"reference-count":45,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T00:00:00Z","timestamp":1654732800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81973108"],"award-info":[{"award-number":["81973108"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018684","name":"National Health Commission of the People's Republic of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018684","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018684","name":"National Health Commission of the People's Republic of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018684","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004476","name":"Chinese Center for Disease Control and Prevention","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004476","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004476","name":"Chinese Center for Disease Control and Prevention","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004476","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background<\/jats:title><jats:p>Hookworm disease is endemic in China and is widespread globally. The disease burden to humans is great.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>The study described the national surveillance of hookworm implemented in 31 provinces\/autonomous regions\/municipalities (P\/A\/Ms) of China in 2019. Each P\/A\/M determined the number and location of surveillance spots (counties). A unified sampling method was employed, and at least 1000 subjects were investigated in each surveillance spot. The modified Kato-Katz thick smear method was employed for stool examination. Fifty samples positive with hookworm eggs were cultured in each surveillance spot to discriminate species between<jats:italic>A<\/jats:italic>.<jats:italic>duodenale<\/jats:italic>and<jats:italic>N<\/jats:italic>.<jats:italic>americanus<\/jats:italic>. Twenty-five soil samples were collected from each surveillance spot and examined for hookworm larva. The 2019 surveillance results were analyzed and compared with that of 2016\u20132018.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>A total of 424766 subjects were investigated in 31 P\/A\/Ms of China in 2019, and the overall hookworm infection rate was 0.85% (3580\/424766). The weighted infection and standard infection rates were 0.66% (4288357\/648063870) and 0.67% (4343844\/648063870), respectively. Sichuan province had the highest standard infection rate (4.75%) in 2019, followed by Chongqing (2.54%) and Hainan (2.44%). The standard infection rates of other P\/A\/Ms were all below 1%, with no hookworm detected in 15 P\/A\/Ms. The standard hookworm infection rate in the males and the females were 0.61% (2021216\/330728900) and 0.71% (2267141\/317334970), respectively, with a significant difference between different genders (<jats:inline-formula id=\"pntd.0010405.e001\"><jats:alternatives><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" id=\"pntd.0010405.e001g\" mimetype=\"image\" position=\"anchor\" xlink:href=\"info:doi\/10.1371\/journal.pntd.0010405.e001\" xlink:type=\"simple\"\/><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" display=\"inline\" id=\"M1\"><mml:mrow><mml:msup><mml:mi>\u03c7<\/mml:mi><mml:mn>2<\/mml:mn><\/mml:msup><\/mml:mrow><\/mml:math><\/jats:alternatives><\/jats:inline-formula>= 17.23,<jats:italic>P&lt;<\/jats:italic>0.0001). The highest standard hookworm infection rate (1.97%) was among age \u2265 60 years, followed by 45~59 years (0.77%), 15~44 years (0.37%), and 7~14 years (0.20%). The lowest standard infection rate was among the 0~6 years age group (0.12%). A significant difference was observed among different age groups (<jats:inline-formula id=\"pntd.0010405.e002\"><jats:alternatives><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" id=\"pntd.0010405.e002g\" mimetype=\"image\" position=\"anchor\" xlink:href=\"info:doi\/10.1371\/journal.pntd.0010405.e002\" xlink:type=\"simple\"\/><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" display=\"inline\" id=\"M2\"><mml:mrow><mml:msup><mml:mi>\u03c7<\/mml:mi><mml:mn>2<\/mml:mn><\/mml:msup><\/mml:mrow><\/mml:math><\/jats:alternatives><\/jats:inline-formula>= 2 305.17,<jats:italic>P&lt;<\/jats:italic>0.0001). The constitute ratio for<jats:italic>N<\/jats:italic>.<jats:italic>americanus<\/jats:italic>,<jats:italic>A<\/jats:italic>.<jats:italic>duodenale<\/jats:italic>, and coinfection was 78.70% (1341\/1704), 2.03% (346\/1704), and 1.00% (17\/1704), respectively. The detection rate of hookworm larva from soil was 3.45% (71\/2056).<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusion<\/jats:title><jats:p>The national surveillance showed that the hookworm infection rate has been decreasing annually from 2016 to 2019, and it is now below 1%. China has made significant progress in controlling hookworm. The national surveillance system is an important way to understand the endemic status and provide important information in this process and thus needs to be continually optimized.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pntd.0010405","type":"journal-article","created":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T17:47:46Z","timestamp":1654796866000},"page":"e0010405","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["National surveillance of hookworm disease in China: A population 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