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Previous Volume 360:121-128 January 8, 2009 Number 2 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Supplementary Material Perspective by King, C. H. Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

ABSTRACT

Background Schistosoma japonicum causes an infection involving humans, livestock, and snails and is a significant cause of morbidity in China.

Methods We evaluated a comprehensive control strategy in two intervention villages and two control villages along Poyang Lake in the southeastern province of Jiangxi, 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, we observed changes 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). The rate of infection in humans in control villages fluctuated but remained at baseline levels. In intervention villages, the percentage of sampling sites with infected snails decreased from 2.2% to 0.1% in one grassland area and from 0.3% to no infection in the other (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.

Source Information

From the Ministry of Health, Beijing (L.-D.W., L.-Y.W., G.X., Y.H.); Jiangxi Provincial Institute of Parasitic Diseases, Nanchang (H.-G.C., X.-J.Z.); the National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai (J.-G.G., X.-H.Wu, X.-H.Wang, X.-N.Z.); Jinxian Antischistosomiasis Station, Jinxian (X.-L.H.); Office for Schistosomiasis Control of Jiangxi Provincial Government, Nanchang (J.-J.X.); and the Bill and Melinda Gates Foundation, China Office, Beijing (D.P.C.) — all in China.

Address reprint requests to Dr. Zhou at the National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China, or at ipdzhouxn{at}sh163.net.

Full Text of this Article

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