Abstract
BackgroundSchistosomiasis remains a major public health problem in China. The major endemic foci are the lake and marshland regions of southern China, particularly the regions along the middle and lower reach of the Yangtze River in four provinces (Hubei, Hunan, Jiangxi, and Anhui). The purpose of our study is to assess the effect of a new integrated strategy emphasizing infection source control to curb schistosomiasis in marshland regions.MethodsIn a longitudinal study, we implemented an integrated control strategy emphasizing infection source control in 16 villages from 2005 through 2012 in marshland regions of Hubei province. The interventions included removing cattle from snail-infested grasslands, providing farmers with mechanized farm equipment, improving sanitation by supplying tap water, building lavatories and latrines, praziquantel chemotherapy, controlling snails, and environmental modification.ResultsFollowing the integrated control strategy designed to reduce the role of bovines and humans as sources of Schistosoma japonicum infection, the prevalence of human S. japonicum infection declined from 1.7% in 2005 to 0.4% in 2012 (P<0.001). Reductions were also observed in both sexes, across all age groups, and among high risk occupations. Moreover, the prevalence of bovine S. japonicum infection decreased from 11.7% in 2005 to 0.6% in 2012 (P<0.001). In addition, all the 16 villages achieved the national criteria of infection control in 2008.ConclusionOur findings indicate that the integrated strategy was likely effective in controlling the transmission of S. japonicum in marshland regions in China.
Highlights
Schistosomiasis is one of the most prevalent parasitic diseases in the world [1]
S. japonicum eggs were identified in a male corpse dating back to the Western Han dynasty some 2100 years ago that was exhumed in Jianglin Hsien, Hubei Province in 1975 [5]
The 16 counties were first randomly selected from 63 counties; 16 towns were randomly selected from 16 counties; 16 schistosomiasis-endemic villages were randomly selected from the 16 towns
Summary
Schistosomiasis is one of the most prevalent parasitic diseases in the world [1]. The global prevalence is currently estimated to be 207 million cases, with another 779 million people at risk of infection in 76 countries and territories [2,3]. Documented evidence indicates that Schistosoma japonicum has been endemic for a long time in China [4]. Schistosomiasis is mainly endemic today in lake and marshland areas (Hubei, Hunan, Jiangxi, Anhui, and Jiangsu provinces) and in hilly and mountainous regions (Sichuan and Yunnan provinces) in China [7]. Since 2005, integrated strategy emphasizing infection source control and mollusciciding were added to chemotherapy of humans. The major endemic foci are the lake and marshland regions of southern China, the regions along the middle and lower reach of the Yangtze River in four provinces (Hubei, Hunan, Jiangxi, and Anhui). The purpose of our study is to assess the effect of a new integrated strategy emphasizing infection source control to curb schistosomiasis in marshland regions
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