title: A strategy to control transmission of Schistosoma japonicum in China.
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.
authors.affiliation: Ministry of Health, Beijing, China.
authors.forename: Long-De
authors.initials: LD
authors.lastname: Wang
authors.forename: Hong-Gen
authors.initials: HG
authors.lastname: Chen
authors.forename: Jia-Gang
authors.initials: JG
authors.lastname: Guo
authors.forename: Xiao-Jun
authors.initials: XJ
authors.lastname: Zeng
authors.forename: Xian-Lin
authors.initials: XL
authors.lastname: Hong
authors.forename: Ji-Jie
authors.initials: JJ
authors.lastname: Xiong
authors.forename: Xiao-Hua
authors.initials: XH
authors.lastname: Wu
authors.forename: Xian-Hong
authors.initials: XH
authors.lastname: Wang
authors.forename: Li-Ying
authors.initials: LY
authors.lastname: Wang
authors.forename: Gang
authors.initials: G
authors.lastname: Xia
authors.forename: Yang
authors.initials: Y
authors.lastname: Hao
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Chin
authors.forename: Xiao-Nong
authors.initials: XN
authors.lastname: Zhou
mesh_terms: D000383:Agriculture; D000818:Animals; D002681:China / Q000453:epidemiology; D003140:Communicable Disease Control / Q000191:economics / Q000379:methods*; D003365:Costs and Cost Analysis; D018562:Disease Transmission, Infectious / Q000517:prevention & control; D004199:Disease Vectors; D005618:Fresh Water / Q000469:parasitology; D006266:Health Education; D006801:Humans; D012499:Sanitation; D012549:Schistosoma japonicum / Q000302:isolation & purification*; D012554:Schistosomiasis japonica / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission / Q000662:veterinary; D012908:Snails / Q000469:parasitology