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

1,2,3,†email, 4,†email, 1,2,3,* email, 5email, 6email, 1,2,3email, 7email and 1,2,3email
1 Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai 200032, China 2 Key Laboratory of Public Health Safety, Ministry of Education, Shanghai 200032, China 3 Laboratory for Spatial Analysis and Modeling, School of Public Health, Fudan University, Shanghai 200032, China 4 Department of Microbiology and health, School of Public Health, Fudan University, Shanghai 200032, China 5 Department of Environmental Art and Architecture, Changsha Environmental Protection Vocational Technical College, Hunan 410004, China 6 Division of Global Health Equity, Brigham and Women's Hospital & Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA 7 National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China These authors contributed equally to this work.
* Author to whom correspondence should be addressed.
Received: 11 November 2013; in revised form: 4 December 2013 / Accepted: 18 December 2013 / Published: 3 January 2014
PDF Full-text Download PDF Full-Text [1329 KB, uploaded 3 January 2014 08:43 CET]
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

Article Statistics

Load and display the download statistics.

Citations to this Article

Cite This Article

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.

Int. J. Environ. Res. Public Health EISSN 1660-4601 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert