Table 12 An integrated approach to zoonotic schistosomiasis in the Dongting region of China

Control of Schistosoma japonicum in China has long been the focus of concerted state intervention over the past 60 years. The disease is predominated spread by cattle and water buffaloes. In the Dongting Lake region, changes to the vast marshland ecosystem and socio-demographic shifts continue to increase the range of the local snail host, while the completion of the Three Gorges Dam (the world’s largest hydroelectric project) is predicted to drive a re-emergence of the disease.

While mass drug administration of praziquantel has been the mainstay of control in the Dongting Lake region, annual reinfection was found to occur in up to 20% of people due to occupational risks. To address this, an integrated approach was developed. This has included various educational strategies, such as videos and booklets delivered to schools. It has involved environmental modification, through building concrete irrigation systems and fences to separate livestock from water bodies. Campaigns for safe water and sanitation have been implemented, alongside focused snail control using niclosamide. Officials have also targeted high-risk groups for livelihood improvements and to reduce exposure time to infected water bodies. This has involved introducing mechanized farm equipment in an attempt to lower livestock herds as well as the resettlement of itinerant fishermen by providing free land and houses, which reduces the amount of time they spent in the lake. Compared to previous strategies, this integrated approach has significantly reduced the number of schistosome-endemic villages, populations at risk and the number of human cases between 1990 and 2010.

From McManus et al. [146]