Schistosomiasis Research in the Dongting Lake Region and Its Impact on Local and National Treatment and Control in China

Abstract

Schistosomiasis is a chronic and debilitating parasitic disease that has often been neglected because it is a disease of poverty, affecting poor rural communities in the developing world. This is not the case in the People's Republic of China (PRC), where the disease, caused by Schistosoma japonicum, has long captured the attention of the Chinese authorities who have, over the past 50–60 years, undertaken remarkably successful control programs that have substantially reduced the schistosomiasis disease burden. The Dongting Lake region in Hunan province is one of the major schistosome-endemic areas in the PRC due to its vast marshland habitats for the Oncomelania snail intermediate hosts of S. japonicum. Along with social, demographic, and other environmental factors, the recent completion and closure of the Three Gorges dam will most likely increase the range of these snail habitats, with the potential for re-emergence of schistosomiasis and increased transmission in Hunan and other schistosome-endemic provinces being a particular concern. In this paper, we review the history and the current status of schistosomiasis control in the Dongting Lake region. We explore the epidemiological factors contributing to S. japonicum transmission there, and summarise some of the key research findings from studies undertaken on schistosomiasis in Hunan province over the past 10 years. The impact of this research on current and future approaches for sustainable integrated control of schistosomiasis in this and other endemic areas in the PRC is emphasised.

Assessing the influence of water level on schistosomiasis in Dongting Lake region before and after the construction of Three Gorges Dam

“…In this study site, the start and termination of the World Bank Loan Project McManus et al 2011) and the policy of BReturn Land to Lake^ (Li et al 2007;McManus et al 2010) were considered as factors that greatly influenced the schistosomiasis infection rate. Meanwhile, China redefined its top priorities in communicable disease control in 2004 (Utzinger et al 2005;Zhou et al 2005), and schistosomiasis has been moved up as one of the top public-health priorities and is now in the same league as HIV/AIDS, tuberculosis, and hepatitis B (Wang et al 2008).…”

“…Moreover, schistosomiasis infection is transmitted through humans and other mammalian hosts that contact cercariae released by snails when they are exposed to infested water (Li et al 2007). The Dongting Lake region, which is located in the middle and lower reaches of the Yangtze River, is one of the major and typical lake and marshland areas in China where schistosomiasis is endemic (Yu et al 2002;McManus et al 2011). The epidemiology of schistosomiasis transmission in the lake can be attributed to the complex interaction between the dynamics of water level in the lake, infected snails, and human behavior patterns (Li et al 2000).…”

“…The epidemiology of schistosomiasis transmission in the lake can be attributed to the complex interaction between the dynamics of water level in the lake, infected snails, and human behavior patterns (Li et al 2000). Schistosomiasis infection in the lake reaches its peak when the water level rises in summer from May to early July and falls in autumn from October to November (McManus et al 2011).…”

“…Thus, the potential influence on the distribution of Oncomelania hupensis and transmission of S. japonicum in the vicinity of TGD and downstream Yangtze regions attracted research attention worldwide (Maszle et al 1998;Zheng et al 2002;Engels et al 2005;Minter 2005;Zhu et al 2008;McManus et al 2010). Most researchers reported that the construction and operation of the TGD would expand the O. hupensis habitat and increase the spread of S. japonicum (Li et al 2000(Li et al , 2007Ross et al 2001;Zheng et al 2002;Zhu et al 2008;McManus et al 2010McManus et al , 2011. However, the current investigations are mainly predictive research or preliminary theoretical analysis (Li et al 2007;Zhu et al 2008).…”

Urine Turbidity and Microhaematuria as Rapid Assessment Indicators for <i>Schistosoma haematobium</i> Infection among School Children in Endemic Areas

“…Young individuals are mostly infected with peak prevalence and intensity of infection in the age group 11-15 years (Biu et al, 2009;Sarkinfada et al, 2009). Reports have established that both natural (McManus et al, 2011) and artificial water bodies (Duwa and Oyeyi, 2009) are transmission foci of the parasite.…”