1. Introduction
Schistosomiasis, a water-borne parasitic disease that results from infection by trematode worms of the genus
Schistosoma, is prevalent in 78 tropical and sub-tropical countries worldwide. According to the World Health Organization (WHO), it affects more than 230 million people, with an estimated 700 million at risk [
1]. In 2020, WHO published a new “road map” targeting the elimination of schistosomiasis by 2030, but continued actions are required to reach this target [
2]. In the People’s Republic of China, Schistosomiasis japonica, caused by
S. japonicum, brought disability and death to millions of people, and had long been an important public health problem before the implementation of its national control plan [
3]. After more than 70 years of effort, seven out of twelve endemic provinces reached the criteria of transmission interruption [
4]. Jiangsu Province is one of the seven provinces which had met the criteria of transmission interruption by 2019. In Jiangsu Province, more than 90% of schistosomiasis endemic areas are located in marshland and lake regions distributed along the Yangtze River [
5]. Nanjing, Zhenjiang, and Yangzhou accounted for 72% of the intermediate host area in Jiangsu Province, and the annual number of monitored cases in these three cities exceeded 60% of the province in total [
6].
It is well known that
Oncomelania hupensis (
O. hupensis) is the unique intermediate host of
S. japonicum, whose geographical distribution correlates with that of schistosomiasis [
7]. In addition, the distribution of
O. hupensis is closely related to climate and geographical factors, especially temperature, humidity, altitude, and vegetation coverage [
8,
9,
10]. Some researchers have found that the distribution patterns of
O. hupensis could be predicted by some environmental factors, such as land surface temperature (LST) and normalized differential vegetation index (NDVI) [
11,
12]. Regression models have been widely used in studying the ecology of diseases, such as the spatial–temporal variance of distribution of
O. hupensis and its driving factors [
13,
14]. Geographically weighted regression (GWR) is one such regression model, which could be used to predict the results of unknown points by establishing a local regression equation of each point in the spatial range to explore the spatial change of the object in a certain scale and the relevant driving factors [
15,
16,
17]. Taking into account the influence of time dimension on diseases, the geographically and temporally weighted regression (GTWR) model integrates time and space dimensions, and has gradually been applied in the study of the spatial and temporal distribution of diseases and the analysis of relevant influencing factors [
18,
19,
20,
21].
Due to human mobility, floods, and other factors [
22,
23], the risk of schistosomiasis recurrence remains a potential threat and deserves unwavering attention. In recent years, with the proposal of the Yangtze River protection policy, the ecological environment around the river has gradually changed, day by day. For instance, because of the rising water level of the Yangtze River, over time, vegetation gradually grew in the demolished factory spaces along the river, which promoted snail propagation and diffusion; and restoration of the wetlands created conditions for snail breeding, and may even create a new snail source [
24,
25]. As a consequence, the change of geographical environment brings uncertainty to the recurrence of
Oncomelania snails. Under these circumstances, it is urgent to further explore the spatio–temporal distribution of
O. hupensis along the Jiangsu section of the Yangtze River and monitor the different determinants from recent years.
This study aimed to explore the spatio–temporal patterns of snail distribution and identify the dynamic determinants of the distribution of O. hupensis by the GTWR model along the Yangtze River in Jiangsu Province, so as to contribute to the national programs of control of schistosomiasis and other snail-borne diseases.
4. Discussion
This study was designed to explore the spatio–temporal pattern of snail distribution and identify the dynamic determinants of the distribution of O. hupensis by GTWR models along the Yangtze River in Jiangsu Province. We firstly analyzed the distribution of snail density in the whole study area and found that the areas with a high density of O. hupensis were mainly concentrated at the junction of Zhenjiang and Yangzhou, while there was a trend of cold spots gathering along the Yangtze River in Nanjing, in recent years. Based on RS data, seven influencing factor variables (NDVI, Dry, LST, RESI, DEM, Slope, and DIS) were screened, and a novel O. hupensis dataset along the Yangtze River in Jiangsu from 2017 to 2021 was developed by using GWR and GTWR models. Above all, the distribution of the determinants of the whole study area was obtained based on the GWR model. Further, we took Yangzhou as a test area to analyze the dynamic change of the average regression coefficients of each influencing factor in the GTWR model. Clearly, the fluctuation characteristics of environmental factors revealed that the environment had undergone significant annual changes from 2017 to 2021. Thus, different actions can be applied for different environments for the precise prevention and control of O. hupensis.
To our knowledge, the reproductive environment of
O. hupensis serves as the source factor that is responsible for the occurrence, prevalence, and transmission of schistosomiasis, which determine the probability of a regional schistosomiasis epidemic. Among previous studies, a popular research direction has been to analyze the spatial distribution pattern of schistosomiasis to detect the aggregation and aggregation areas of snails and the change of the distribution pattern over time. The geospatial distribution of
O. hupensis along the Yangtze River in Jiangsu in the current study was similar to those described in previous studies [
33,
34]. Our results showed that in the process of ecological protection and restoration in the Yangtze River Basin, due to the complex environment, suitable conditions for snail breeding in the beaches along the Yangtze River in Zhenjiang and Yangzhou tended to rebound, and the conditions allowed the snail life cycle to repeat, which indicates the difficulty of snail control. The main reasons for this are as follows. Firstly, the long coastline along the river makes the environment complex, and it is difficult to eliminate the snail. Secondly,
O. hupensis in the upper reaches of the Yangtze River was not effectively controlled, which led to the snail situations in the lower reaches of the Yangtze River [
35]. In addition, due to the limited development along the river, some breeding environments of
O. hupensis could not be effectively transformed [
36]. It should be noted that while monitoring large areas of historical snail environments closely, snails should also be prevented from spreading from the main branch of the Yangtze River to other tributaries. Although the snail density was not the highest in Nanjing along the Yangtze River, it should be noted that there exists a risk of
O. hupensis diffusion due to flood in 2020 [
37], so the surveillance of snails should be continued.
The influencing factors of the distribution of snails in Jiangsu Province agree with the results of other works carried out in marshland, including natural factors such as surface temperature, humidity, soil properties, and vegetation types, as well as human factors such as economic development, population level, and environmental management [
38,
39]. NDVI and LST are considered to be the most successful environmental factors for predicting snail habitat [
40,
41]. In this study, LST was the biggest determinant of snail density and was positively correlated with snail density overall. However, the performance of NDVI was not so satisfactory, ranking last among the seven factors. The influence of the distance to nearest river and dryness were second only to LST because one of the important characteristics of
O. hupensis is concentration in rivers or streams. The flow of water is determined by the elevation of the environment. Therefore, using the DEM to simulate the surface stream network and calculate slope data rapidly and accurately can provide important ecological indexes of
O. hupensis [
12]. However, Jiangsu is flat and consists of plains, waters, low mountains, and hills. Therefore, there is little difference in altitude between the study areas, which may be the reason why DEM and Slope were not as effective as others.
Based on spatial epidemiological methods, domestic and foreign scholars previously carried out spatial heterogeneity research on
O. hupensis and successfully understood its distribution law at different scales. Jun et al. [
38] used a spatial lag model to establish an epidemic risk description method based on land-use type, providing relative estimates of the impact of different land-use types on schistosomiasis prevalence in different regions. Yang et al. [
42] utilized a conditional autoregressive model to explore spatial autocorrelation, and combined the data with environmental factors such as LST and vegetation index to construct a Bayesian temporal and spatial model. Yuan et al. [
43] used a single-factor logistic regression model to determine the environmental factors related to the distribution of
O. hupensis in Hubei Province, and then identified the potential high-risk habitats within the spread area of the snail after the flood. These studies have one thing in common: the static influence factors of a time cross-section were selected to predict the distribution of
O. hupensis or schistosomiasis. However, the development and change of schistosomiasis was a long-term, spatio–temporal, and causal process, and the distribution characteristics, patterns, and trends of
O. hupensis varied greatly across different regions, times, and socio-economic attributes [
44,
45].
Geographically and temporally weighted regression is one method to deal with spatial non-stationary data, which can estimate local and global parameters and reflect the spatial effects of factors affecting schistosomiasis. GTWR models have been applied in the modeling of infectious diseases such as hemorrhagic fever of renal syndrome and hand–foot–mouth disease [
19,
46,
47], and they have good modeling accuracy in the study of chronic diseases such as chronic obstructive pulmonary disease [
32,
48]. After solving the GTWR model, a series of regression coefficients that vary with space and time can be obtained, which can construct a geographical heatmap over time and intuitively predict the spatio–temporal variation amplitude and direction of the determinants on the results. This study verified the feasibility and applicability of this model by fitting snail density along the Yangtze River in Jiangsu Province from 2017 to 2021.
For the snail density of the whole study area, the GWR model was better than the OLS and GTWR models in fitting, indicating that the dataset had significant spatial variation but no significant temporal non-stationary variation. From the data shown in
Figure 4, we found that the factor coefficients were usually of opposite sign in the main and tributaries of the Yangtze River, especially the branching channel in Nanjing. In Luhe district, LST had a positive effect on the upper reaches of
O. hupensis but the opposite effect on the lower reaches. DIS, Dry, DEM, and other environmental factors were also similar, which were closely related to the Yangtze River flood season. Previous studies found that snail diffusion in the Yangtze River Basin was related to river water velocity, discharge, water level, flooding time, and sediment erosion and deposition [
49]. Moreover, during the flood season, the water storage capacity of the tributaries increased, which greatly promoted the spread of
O. hupensis after the occurrence of flood disaster [
50]. The branching channels in Yangzhou and Zhenjiang also experienced a similar phenomenon, which is noteworthy.
The simulation effect of the global GTWR model was inferior to that of the GWR model because the influence factors of different regions differed greatly, which may reduce the estimation ability of the overall data.
Figure 5 shows that local R
2 was relatively high in Nanjing and Yangzhou. The results showed that the GTWR model had a strong ability to explain snail density in Yangzhou. In recent years, the snail area in Yangzhou was at a historically low level, and no positive snails were found. Nevertheless, the phenomenon of reoccurrence often occurred [
51]. Snail area in the river beach accounted for the largest proportion, which was where the snails were mainly distributed. Affected by the 2016 Yangtze River flood disaster, the snail situation in Yangzhou rose sharply, and the snail area increased significantly [
51]. Beyond these phenomena, the risk of schistosomiasis transmission still exists due to the fairly large water-level changes in the Yangtze River. The snail density in Yangzhou was a turning point in 2019, as many influencing factors fluctuated sharply and even changed their direction. The biggest possibility is that flooding increased the water level and width of the rivers; thus, the snail breeding sites near the river were immersed in water for a longer time, and their density decreased [
52]. Although the environmental variables we chose did not consider water level information, this study could indirectly prove that the environmental factors had a substantial impact on the snail distribution from the change trends of Dry and LST.
The Yangtze River Basin is the main area of the schistosomiasis epidemic. It is very important to balance schistosomiasis control while protecting the ecology of the Yangtze River [
25]. At present, there is a lack of research on the impact of the Yangtze River restoration project on infectious diseases. By using RS and the GIS, and constructing a GTWR model of the snail growth and decrease in the Yangtze River, we can identify the ecological factors closely related to snail distribution. Therefore, early prevention and control of schistosomiasis in high-risk areas can greatly improve the efficiency of surveillance. RS image data have been widely used to monitor schistosomiasis and the habitats of its intermediate host snails [
53,
54]. Different from Landsat-8 images with a spatial resolution of 30 m commonly used in previous research, this study extracted environmental indicators from Sentinel-2 images with a spatial resolution of 15 m. In addition, as the terrain of Jiangsu Province is flat and the elevation changes are not obvious, elevation and land use data with a resolution of 2 m were obtained in this study. All these were selected to improve the resolution of explanatory variables so as to improve the accuracy of model fitting. The original breeding sites of
O. hupensis are often affected by previous snail conditions and snail eradication, which will mask the intensity of spatial and temporal heterogeneity during model construction to some extent. The breeding sites of newly emerging or recurrent
O. hupensis are largely affected by environmental factors, so the variables screened in this study can have a better explanatory ability.
There are some disadvantages in this study that should be improved. First of all, the spatial resolution of some environmental data in the current study could limit the accuracy of the GTWR models, such as distance to rivers, GDP, and population density. Therefore, it is necessary to carry out further research to analyze the extent to which different scale impact factors can affect the accuracy of prediction results. Another limitation was the representativeness of variables. More factors should be considered to reflect the spatial and temporal characteristics of the snail in GTWR model, e.g., detailed water-level information and the snail-control pesticides used. These factors were not included because the related datasets were difficult to obtain. Moreover, the sampling of snails and environmental elements were conducted only in summer, and, as a result, we often analyzed the obtained data in a cycle unit of one year. In this study, only 5 years of snail data were selected, with the time period being too short to reflect temporal heterogeneity in some areas. Therefore, it is suggested to build a GTWR model on snail data over a longer time axis in the future.