Spatio-temporal patterns of schistosomiasis japonica in lake and marshland areas in China: the effect of snail habitats.

The progress of the integrated control policy for schistosomiasis implemented since 2005 in China, which is aiming at reducing the roles of bovines and humans as infection sources, may be challenged by persistent presence of infected snails in lake and marshland areas. Based on annual parasitologic data for schistosomiasis during 2004-2011 in Xingzi County, a spatio-temporal kriging model was used to investigate the spatio-temporal pattern of schistosomiasis risk. Results showed that environmental factors related to snail habitats can explain the spatio-temporal variation of schistosomiasis. Predictive maps of schistosomiasis risk illustrated that clusters of the disease fluctuated during 2004-2008; there was an extensive outbreak in 2008 and attenuated disease occurrences afterwards. An area with an annually constant cluster of schistosomiasis was identified. Our study suggests that targeting snail habitats located within high-risk areas for schistosomiasis would be an economic and sustainable way of schistosomiasis control in the future.