Schistosomiasis control in China: the impact of a 10-year World Bank Loan Project (1992-2001)

• Published in: Bulletin of the World Health Organization Vol. 83; no. 1; pp. 43 - 48
• Main Authors: CHEN XIANYI, WANG LIYING, CAI JIMING, ZHOU XIAONONG, ZHENG JIANG, GUO JIAGANG, WU XIAOHUA, ENGELS, D, CHEN MINGGANG
• Format: Journal Article
• Language: English
• Published: Genève Organisation mondiale de la santé 2005; World Health Organization; The World Health Organization
• Subjects: Animals; Biological and medical sciences; Buffalo; Buffaloes - parasitology; Cancer; Cattle; Cattle - parasitology; Chemotherapy; China; China (People's Republic); China - epidemiology; Control; Disease control; Disease prevention; Diseases caused by trematodes; Drug therapy; Endemic Diseases - prevention & control; Environmental aspects; Epidemiology; Evaluation; General aspects; Health aspects; Health conditions; Health Education; Health Policy & Services; Helminthic diseases; Humans; Infection control; Infections; Infectious diseases; International Bank for Reconstruction and Development; Livestock; Medical sciences; Medical treatment; Miscellaneous; Molluscacides - therapeutic use; Mollusks; Morbidity; Operations research; Parasitic diseases; Patient outcomes; Population Surveillance; Prevention; Program Evaluation; Programmes; Provinces; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Schistosoma; Schistosoma japonicum - drug effects; Schistosoma japonicum - isolation & purification; Schistosomiases; Schistosomiasis; Schistosomiasis japonica - drug therapy; Schistosomiasis japonica - epidemiology; Schistosomiasis japonica - prevention & control; Schistosomiasis japonica/prevention and control; Snails; Snails - parasitology; Statistics; United Nations; World Bank; Asia; China; Infection; Human; Sanitary program; Schistosomiasis; Trematode disease; Tropical medicine; Parasitosis; Eradication; Helminthiasis; Public health; Esquistosomiasis japónica; Schistosomiasis japonica; Banque Mondiale; Evaluación de programas; World Bank; China; Evaluation programme; Banco Mundial; Program evaluation; Schistosomiase artérioveineuse; Chine
• ISSN: 0042-9686; 1564-0604
• DOI: 10.1590/S0042-96862005000100013

China has been carrying out large-scale schistosomiasis control since the mid-1950s, but in the early 1990s, schistosomiasis was still endemic in eight provinces. A World Bank Loan Project enabled further significant progress to be made during the period 1992-2001. The control strategy was focused on the large-scale use of chemotherapy -- primarily to reinforce morbidity control -- while at the same time acting on transmission with the ultimate goal of interrupting it. Chemotherapy was complemented by health education, chemical control of snails and environmental modification where appropriate. A final evaluation in 2002 showed that infection rates in humans and livestock had decreased by 55% and 50%, respectively. The number of acute infections and of individuals with advanced disease had also significantly decreased. Although snail infection rates continued to fluctuate at a low level, the densities of infected snails had decreased by more than 75% in all endemic areas. The original objectives of the China World Bank Loan Project for schistosomiasis control had all been met. One province, Zhejiang, had already fulfilled the criteria for elimination of schistosomiasis by 1995. The project was therefore a success and has provided China with a sound basis for further control.