A multidisciplinary, integrated approach for the elimination of schistosomiasis: a longitudinal study in a historically hyper-endemic region in the lower reaches of the Yangtze River, China from 2005 to 2014

Abstract

BackgroundAlthough great success has been achieved, schistosomiasis remains a major public health concern in China, and the remaining core endemic regions are concentrated along the middle and lower reaches of the Yangtze River. In this longitudinal study, we evaluated the effectiveness of a multidisciplinary, integrated approach for schistosomiasis elimination in a historically hyper-endemic region in the lower reaches of the Yangtze River, China over the 10-year period from 2005 through 2014.MethodsA three-step roadmap for schistosomiasis elimination was designed in the study site, and multidisciplinary, integrated interventions were implemented by the health, agriculture, water resources development, land and resources, and forestry sectors from 2005 to 2014, including chemotherapy for infected individuals, health education, management of the source of Schistosoma japonicum infection, and intermediate host snail control. The annual number of schistosomiasis patients, S. japonicum infection in humans, bovines and Oncomelania hupensis snails, and water infectivity were observed to assess the effectiveness of the multidisciplinary, integrated approach for the elimination of schistosomiasis.ResultsThere was a tendency towards a gradual decline in both the number of schistosomiasis cases and the prevalence of S. japonicum human infection across the study period from 2005 through 2014. No S. japonicum human infection was detected since 2012, and no acute infection was seen since 2006. During the study period, no infection was found in bovines, and a 0.03% overall infection rate was observed in O. hupensis snails. Since 2009, no infected snails were identified, and the area of both snail habitats and infected snail habitats appeared a reduction over the study period. Following the 3-year multidisciplinary, integrated control, infection control was achieved, and transmission control was achieved after 6-year implementation, with all infected snails and water infectivity eliminated; in addition, the 10-year implementation resulted in interruption of schistosomiasis transmission in the study site in 2014.ConclusionsThe results of the present 10-year longitudinal study demonstrate that the multidisciplinary, integrated approach is effective for the elimination of schistosomiasis as a public health problem in the lower reaches of the Yangtze River, China.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-017-0270-x) contains supplementary material, which is available to authorized users.

Core components, concepts and strategies for parasitic and vector-borne disease elimination with a focus on schistosomiasis: A landscape analysis

“…Most of the identified articles that focus on strategies for implementation of interventions refer to the Chinese schistosomiasis control programme. They describe a combination of tools and comprehensive strategies [ 11 , 20 , 21 , 23 , 36 , 90 , 92 – 94 ] implemented through collaborations between multiple sectors but under central coordination [ 26 , 29 , 39 , 95 , 96 ]. This approach has been identified as important to reduce schistosomiasis japonica levels across P.R.…”

Assessment of Knowledge, Attitude and Practices and the analysis of Risk Factors regarding Schistosomiasis Among Fishermen and Boatmen in Dongting Lake Basin, P.R. China

“…The prevalence and intensity of infections with S. japonicum in humans has been reduced substantially, and the number of endemic provinces has decreased from 12 to seven [10,11]. Currently schistosomiasis is mainly endemic in areas surrounding Dongting Lake, Poyang Lake and beaches along the Yangtze River [12][13][14][15], with fishermen, boatmen and farmers being groups at high risk of infection and suffering the highest disease burden [16].…”

Temporal transcriptome change of Oncomelania hupensis revealed by Schistosoma japonicum invasion

“…Oncomelania hupensis (Gastropoda: Rissooidea), mainly distributed in China's Yangtze river basin and its south, is the only intermediate host of Schistosoma japonicum, which plays a key role in the transmission of schistosomiasis in China [2,3]. The number of Schistosomiasis patients and the burden of the disease have dramatically reduced since the establishment of People's Republic of China (P.R.C), together with the national schistosomiasis control strategy shift from the morbidity control strategy to an integrated strategy in 2004 [4][5][6]. However, the disease remains endemic in some regions and contributes to a major public health concern in China.…”