China's new strategy to block Schistosoma japonicum transmission: experiences and impact beyond schistosomiasis

Authors: Wang, Long-De1; Guo, Jia-Gang2; Wu, Xiao-Hua2; Chen, Hong-Gen3; Wang, Tian-Ping4; Zhu, Shao-Ping5; Zhang, Zhi-Hai6; Steinmann, Peter; Yang, Guo-Jing7; Wang, Shi-Ping8; Wu, Zhong-Dao9; Wang, Li-Ying10; Hao, Yang10; Bergquist, Robert11; Utzinger, Jürg12; Zhou, Xiao-Nong2

Source: Tropical Medicine & International Health, Volume 14, Number 12, December 2009 , pp. 1475-1483(9)

Publisher: Blackwell Publishing

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Abstract:

Summary

Despite sustained efforts for its control made over the past 50+ years, the re-emergence of schistosomiasis in China was noted around the turn of the new millennium. Consequently, a new integrated strategy was proposed to stop the contamination of schistosome eggs to the environment, which emphasizes health education, access to clean water and adequate sanitation, mechanization of agriculture and fencing of water buffaloes, along with chemotherapy. Validation of this integrated control strategy in four pilot counties in the provinces of Anhui, Hubei, Hunan and Jiangxi revealed significant reductions in the rate of Schistosoma japonicum infection in humans and intermediate host snails. Importantly, this strategy showed an impact on diseases beyond schistosomiasis, signified by concomitant reductions in the prevalence of soil-transmitted helminth infections. In view of China's new integrated strategy for transmission control of schistosomiasis showing an ancillary benefit on other helminthic diseases, we encourage others to investigate the scope and limits of integrated control of neglected tropical diseases.

French
<title>Point de vue La nouvelle stratégie de la Chine pour bloquer la transmission de Schistosoma japonicum: expériences et impact au-delà de la schistosomiase</title>

La réémergence de la schistosomiase dans la République populaire de Chine a été notée au tournant du nouveau millénaire, en dépit des efforts de lutte soutenus réalisés depuis au moins les dernières 50 années. Par conséquent, une nouvelle stratégie intégrée a été proposée pour couper la contamination de l'environnement par les œufs de schistosomes, en mettant l'accent sur l'éducation sanitaire, l'accès à l'eau potable et un assainissement adéquat, la mécanisation de l'agriculture et la mise en enclos des buffles d'eau, en plus de la chimiothérapie. La validation de cette stratégie de lutte intégrée dans quatre comtés pilotes dans les provinces d'Anhui, de Hubei, de Hunan et de Jiangxi a révélé une diminution significative du taux d'infection par Schistosoma japonicum chez les humains et les mollusques hôtes intermédiaires. De façon importante, cette stratégie a montré un impact sur les maladies au-delà de la schistosomiase, signifiée par la réduction concomitante de la prévalence des infections par les helminthes transmises à partir du sol. Compte tenu de la nouvelle stratégie intégrée de la Chine pour lutter contre la transmission de la schistosomiase démontrant un bénéfice accessoire sur d'autres maladies à helminthes, nous encourageons d'autres études sur la portée et les limites de la lutte intégrée contre les maladies tropicales négligées.

Keywords: Schistosoma japonicum; soil-transmitted helminths; transmission; control; environmental management; water and sanitation; integration; China; Schistosoma japonicum; helminthes transmises à partir du sol; transmission; lutte; gestion environnementale; eau et assainissement; intégration; Chine; Schistosoma japonicum; helmintos transmitidos por la tierra; control; manejo medio ambiental; agua y salubridad; integración; China

Document Type: Research article

DOI: 10.1111/j.1365-3156.2009.02403.x

Affiliations: 1:  School of Public Health, Peking University, Beijing, China 2:  National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China 3:  Jiangxi Institute of Parasitic Diseases, Nanchang, China 4:  Anhui Institute of Parasitic Diseases, Wuhu, China 5:  Leading Office of Schistosomiasis Control of Anxian County, Anxian, China 6:  Leading Office of Schistosomiasis Control of Hanchuan County, Hanchuan, China 7:  Jiangsu Institute of Parasitic Diseases, Wuxi, China 8:  Department of Parasitology, Xiangya School of Medicine, Central South University, Changsha, China 9:  Department of Microbiology and Parasitology, Sun Yat-sen University of Medical Sciences, Guangzhou, China 10:  Ministry of Health, Beijing, China 11:  Ingerod 407, Brastad, Sweden 12:  Department of Public Health and Epidemiology, Swiss Tropical Institute, Basel, Switzerland

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