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Low Transmission to Elimination: Rural Development as a Key Determinant of the End-Game Dynamics of Schistosoma japonicum in China

by 1,*, 2 and 3
School of Public Health, University of California, Berkeley, CA 94720-7360, USA
Institute of Parasitic Diseases, Sichuan Center for Disease Control and Prevention, Chengdu 610041, China
Department of Environmental and Global Health, College of Public Health and Health Professions, and Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610-3010, USA
Author to whom correspondence should be addressed.
Trop. Med. Infect. Dis. 2017, 2(3), 35;
Received: 13 July 2017 / Revised: 30 July 2017 / Accepted: 31 July 2017 / Published: 4 August 2017
Rural development has been a critical component of China’s economic miracle since the start of economic reform in the early 1980s, both benefiting from and contributing to the nation’s rapid economic growth. This development has yielded substantial improvements of public health relevance, including contributing to major reductions in schistosomiasis prevalence. The history of schistosomiasis elimination in Japan suggests that development played a dominant causal role in that nation. We argue that it is highly probable that a similar story is playing out in at least some large regions of China. In particular, we summarize evidence from Sichuan Province which supports the case that economic development has led to improvements in rural irrigation and water supply which, together with changes in crop selection and agricultural mechanization, have all contributed to sustainable reductions in the prevalence of Schistosoma japonicum. The two major factors that have experienced major reductions are the area of snail habitat and the degree of human exposure, both through a variety of mechanisms which differ by region and economic circumstance. However, hotspots of transmission remain. Overall, however, economic development in traditionally endemic areas has provided the resources to carry out projects that have had major beneficial impacts on disease transmission that are likely to be sustainable. View Full-Text
Keywords: S. japonicum; rural development; low transmission; elimination S. japonicum; rural development; low transmission; elimination
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Spear, R.; Zhong, B.; Liang, S. Low Transmission to Elimination: Rural Development as a Key Determinant of the End-Game Dynamics of Schistosoma japonicum in China. Trop. Med. Infect. Dis. 2017, 2, 35.

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