2009, Volume 11, Issue 5
Strategic Study of CAE >> 2009, Volume 11, Issue 5
A new strategy to control transmission of Schistosoma japonicum
1. Ministry of Health of The People’s Republic of China, Beijing 100044, China;
2. National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China;
3. Jiangxi Provincial Institute of Parasitic Diseases, Nanchang 330046, China;
4. Jinxian Anti-schistosomiasis Station, Jinxian Jiangxi 331700, China;
5. Office for Schistosomiasis Control of Jiangxi Provincial Government, Nanchang 330003, China
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Abstract
Objective: To evaluate an integrated strategy for the national program on schistosomiasis control with emphasis on eliminating transmission of Schistosoma japonicum in marsh and lake region, since it is of difficulty to control the transmission of S. japonicum by using previous strategies in the region with the changes of environmental and social context in China. Methods: a comprehensive control strategy was evaluated in two intervention villages and two control villages along Poyang Lake in southeast of Jiangxi Province, where annual synchronous chemotherapy is routinely used. New interventions, implemented from 2005 through 2007, included removing cattle from snail-infested grasslands, providing farmers with mechanized farm equipment, improving sanitation by supplying tap water and building lavatories and latrines, providing boats with fecal-matter containers, and implementing an intensive health-education program. During the intervention period,changes were observed in S. japonicum infection in humans, measured the rate of infection in snails, and tested the infectivity of lake water in mice. Results After three transmission seasons, the rate of infection in humans decreased to less than 1.0 % in the intervention villages, from 11.3 % to 0.7 % in one village and from 4.0 % to 0.9 % in the other (P<0.001 for both comparisons). And the rate of infection in humans sustainably decreased to 0.2 % and 0 % after the fourth transmission seasons.The rate of infection in humans in control villages fluctuated but remained at baseline levels. In intervention villages, after four transmission seasons, the percentage of sampling sites with infected snails decreased from 2.2 % and 0.3 % to no infection in two marshlands, respectively (P<0.001 for both comparisons). The rate of infection in mice after exposure to lake water decreased from 79 % to no infection (P<0.001). Conclusions: A comprehensive control strategy based on interventions to reduce the rate of transmission of S. japonicum infection from cattle and humans to snails was highly effective. These interventions have been adopted as the national strategy to control schistosomiasis in China.
Keywords
schistosomiasis ; integrated control ; infectious agent ; pilot study
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References
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