Abstract

Schistosomiasis is a chronic and debilitating parasitic disease that has often been neglected because it is a disease of poverty, affecting poor rural communities in the developing world. This is not the case in the People's Republic of China (PRC), where the disease, caused by Schistosoma japonicum, has long captured the attention of the Chinese authorities who have, over the past 50–60 years, undertaken remarkably successful control programs that have substantially reduced the schistosomiasis disease burden. The Dongting Lake region in Hunan province is one of the major schistosome-endemic areas in the PRC due to its vast marshland habitats for the Oncomelania snail intermediate hosts of S. japonicum. Along with social, demographic, and other environmental factors, the recent completion and closure of the Three Gorges dam will most likely increase the range of these snail habitats, with the potential for re-emergence of schistosomiasis and increased transmission in Hunan and other schistosome-endemic provinces being a particular concern. In this paper, we review the history and the current status of schistosomiasis control in the Dongting Lake region. We explore the epidemiological factors contributing to S. japonicum transmission there, and summarise some of the key research findings from studies undertaken on schistosomiasis in Hunan province over the past 10 years. The impact of this research on current and future approaches for sustainable integrated control of schistosomiasis in this and other endemic areas in the PRC is emphasised.

Highlights

  • Schistosomiasis, caused by Schistosoma japonicum, disabled and killed millions of Chinese before the national control program for the People’s Republic of China (PRC) commenced in the 1950s

  • We explore the epidemiological factors contributing to S. japonicum transmission, and provide insight into future approaches for control that might lead to the elimination of schistosomiasis from this focus and other endemic areas in the PRC

  • Parasitological Methods The detection of eggs in faeces is diagnostic for schistosomiasis, and the Kato-Katz (KK) method, being simple, rapid, and inexpensive, has been used extensively in the Dongting Lake region to determine the burden of S. japonicum

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Summary

Methods

We conducted a thorough literature search in NCBI PubMed, the Chinese literature, and personal archives for research articles on schistosomiasis in the Dongting Lake region, with particular emphasis on research undertaken over the last 10 years. The article complements and extends our earlier review on the

Introduction
History of Schistosomiasis in the Dongting Lake Region
The Epidemiology of Schistosomiasis in the Dongting Lake Region
Estimated Number of Human Schistosomiasis Cases
Pathology and Morbidity due to Schistosomiasis in the Dongting Lake Region
Immunological Assays Various commercial immunodiagnostic kits based on serum
Live Snails Infected Snails
Chemotherapy and Treatment
Impact on Schistosome Transmission
Impact on Diagnosis
Impact on Treatment and Control
Schistosomiasis Control in the Dongting Lake Region
Vaccine Development Studies in the Dongting Lake Region
Findings
The Challenges Ahead
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