Neglected tropical diseases in the People’s Republic of China: progress towards elimination

Abstract

Since the founding of the People's Republic of China in 1949, considerable progress has been made in the control and elimination of the country's initial set of 11 neglected tropical diseases. Indeed, elimination as a public health problem has been declared for lymphatic filariasis in 2007 and for trachoma in 2015. The remaining numbers of people affected by soil-transmitted helminth infection, clonorchiasis, taeniasis, and echinococcosis in 2015 were 29.1 million, 6.0 million, 366 200, and 166 100, respectively. In 2017, after more than 60 years of uninterrupted, multifaceted schistosomiasis control, has seen the number of cases dwindling from more than 10 million to 37 600. Meanwhile, about 6000 dengue cases are reported, while the incidence of leishmaniasis, leprosy, and rabies are down at 600 or fewer per year. Sustained social and economic development, going hand-in-hand with improvement of water, sanitation, and hygiene provide the foundation for continued progress, while rigorous surveillance and specific public health responses will consolidate achievements and shape the elimination agenda. Targets for poverty elimination and strategic plans and intervention packages post-2020 are important opportunities for further control and elimination, when remaining challenges call for sustainable efforts.

The year 2020, a milestone in breaking the vicious cycle of poverty and illness in China

“…Out-of-pocket payments trap poor and near-poor households in a vicious cycle due to large personal expenditures leading to impoverishment and worse health, particularly in the LMICs where social health insurance schemes are generally lacking. Besides the NCDs and major infectious diseases, the NTDs constitute a group of diseases in tropical environments closely associated with poverty proliferation [9,17]. Although many countries have made progress in the elimination of NTDs, an estimated 1.5 billion people in 2016 still require treatment and care due to affliction with one or more NTDs, among them about 400 million (27%) in low-income countries [4], emphasizing the worldwide presence of poverty and inequality.…”

“…However, this kind of poverty-related lack of proper care is still a challenge in China and to eliminate infectious diseases among the poor and improve their accessibility and affordability with respect to disease prevention, treatment and rehabilitation services will take more time [25]. For example, the results from three rounds of a national survey of important parasitic diseases showed that with the economic development, the average prevalence rate of soil-transmitted helminthiasis dropped from 59.8% in 1991 to 19.6% in 2003, and continued down to 4.8% in 2013 [9]. Another example is malaria, a disease with high mortality that traps households in poverty in many countries with a high burden of this infection [26][27][28], where Chinese evidence shows a significant Spearman's rank correlation coefficient correlations between poverty and incidence of malaria (0.88, P < 0.01), as well as between poverty and epidemic hemorrhagic fever (0.89, P < 0.01) for the years 1990-2018 [15,[29][30][31] (Fig.…”

“…Not that long ago, China had the world's biggest poor population, but has made spectacular progress in reducing health-related poverty [8] and became already the first country to meet the MDG targets for reduction of the number of poor people by 2015 [9]. Over 700 million people, amounting to 70% of the world's total poor, have been lifted above China's national poverty line since 1978, the time when the country opened up and started economic reform [10].…”

Assessment of China’s Contribution in Regional Network for Asian Schistosomiasis: A Questionnaire Survey

“…In order to lift the impact of RNAS+, as a platform for exchange and dissemination of information on schistosomiasis and other zoonotic helminthiasis control, which breaks the geographic borders to encouraging the collaboration and communication among scientists and decision-makers [24], several ways to enhance China's contribution to RNAS + development in future were suggested. First, China has made great progress in Schistosomiasis control in the past 70 years [25][26], continuing seeking out professional integrating points to share China's experiences and enhance the cooperation within member countries is still the signi cant issue [27][28]. Second, capacity building is needed by RNAS + members, China can continue to support the annual workshops and technical trainings as well as collaboration research [29][30].…”

Familial assimilation in transmission of raw-freshwater fish-eating practice leading to clonorchiasis

“…The dietary habit of ingesting raw freshwater fish could date back to one century ago there [12]. Following the development of aquaculture, the endemicity is worsen in some areas because of the more accessibility to freshwater fish [13,14]. The epidemiology of clonorchiasis is characterized by the increasing prevalence and intensity by ages and higher prevalence and intensity in males compared to females [7,11,13].…”