Optimal combined approaches of field intervention for schistosomiasis control in China

Before the mid 1980s, the emphasis in schistosomiasis control in China was on transmission control. Thus, the aim was to eliminate the intermediate host snail by environmental management, combined with chemotherapy, water supply and sanitation, and hygiene improvement. During the last 20 years, however, control approaches mainly consisting of large-scale praziquantel- based chemotherapy and health education started to be advocated and also increasingly applied. Here, we review the literature with an emphasis on combined approaches of field interventions that have been implemented for schistosomiasis control in China over the past 50 years. The interventions consist of both pilot studies and large-scale implementation during different historical periods. The feasibility and effectiveness of the various combined approaches are examined and analysed in relation to local economic conditions and the prevailing scientific and technical expertise. Finally, a set of recommendations is put forward for contemporary schistosomiasis control readily adapted to different eco-epidemiological settings in China. (c) 2005 Elsevier B.V. All rights reserved.