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Int. J. Environ. Res. Public Health 2014, 11(1), 701-712; doi:10.3390/ijerph110100701
Article

Changing Patterns of Spatial Clustering of Schistosomiasis in Southwest China between 1999–2001 and 2007–2008: Assessing Progress toward Eradication after the World Bank Loan Project

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Received: 11 November 2013; in revised form: 4 December 2013 / Accepted: 18 December 2013 / Published: 3 January 2014
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Abstract: We compared changes in the spatial clustering of schistosomiasis in Southwest China at the conclusion of and six years following the end of the World Bank Loan Project (WBLP), the control strategy of which was focused on the large-scale use of chemotherapy. Parasitological data were obtained through standardized surveys conducted in 1999–2001 and again in 2007–2008. Two alternate spatial cluster methods were used to identify spatial clusters of cases: Anselin’s Local Moran’s I test and Kulldorff’s spatial scan statistic. Substantial reductions in the burden of schistosomiasis were found after the end of the WBLP, but the spatial extent of schistosomiasis was not reduced across the study area. Spatial clusters continued to occur in three regions: Chengdu Plain, Yangtze River Valley, and Lancang River Valley during the two periods, and regularly involved five counties. These findings suggest that despite impressive reductions in burden, the hilly and mountainous regions of Southwest China remain at risk of schistosome re-emergence. Our results help to highlight specific locations where integrated control programs can focus to speed the elimination of schistosomiasis in China.
Keywords: schistosomiasis; spatial pattern; clustering; the World Bank Loan Project (WBLP); hilly and mountainous regions; Southwest China schistosomiasis; spatial pattern; clustering; the World Bank Loan Project (WBLP); hilly and mountainous regions; Southwest China
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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MDPI and ACS Style

Hu, Y.; Xiong, C.; Zhang, Z.; Luo, C.; Cohen, T.; Gao, J.; Zhang, L.; Jiang, Q. Changing Patterns of Spatial Clustering of Schistosomiasis in Southwest China between 1999–2001 and 2007–2008: Assessing Progress toward Eradication after the World Bank Loan Project. Int. J. Environ. Res. Public Health 2014, 11, 701-712.

AMA Style

Hu Y, Xiong C, Zhang Z, Luo C, Cohen T, Gao J, Zhang L, Jiang Q. Changing Patterns of Spatial Clustering of Schistosomiasis in Southwest China between 1999–2001 and 2007–2008: Assessing Progress toward Eradication after the World Bank Loan Project. International Journal of Environmental Research and Public Health. 2014; 11(1):701-712.

Chicago/Turabian Style

Hu, Yi; Xiong, Chenglong; Zhang, Zhijie; Luo, Can; Cohen, Ted; Gao, Jie; Zhang, Lijuan; Jiang, Qingwu. 2014. "Changing Patterns of Spatial Clustering of Schistosomiasis in Southwest China between 1999–2001 and 2007–2008: Assessing Progress toward Eradication after the World Bank Loan Project." Int. J. Environ. Res. Public Health 11, no. 1: 701-712.



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