Successful outcome of an integrated strategy for the reduction of schistosomiasis transmission in an endemically complex area.

Schistosomiasis is one of the major public health problems in the People's Republic of China (and elsewhere), seriously threatening health as well as social and economic development. An integrated control strategy, emphasising transmission control but also aimed at reducing greenhouse gases, was carried out in Jiangling county, Hubei province from 2007 to 2009. Three villages were chosen for a pilot study involving removal of cattle from neighbouring, snail-infested grasslands, improving sanitation and construction of units for household biogas production in addition to routine control measures. Both prevalence and intensity of infection in the snails in the neighbourhood were greatly reduced after two years of implementation, while the prevalence of schistosomiasis in humans in the three villages had been reduced by 29%, 34% and 24%, respectively. The removal of cattle and construction of biogas production units had an additional positive effect in that the annual, average emission of greenhouse gases such as methane (CH4) and carbon dioxide (CO2) were reduced by an estimated 7.8 and 80.2 tons, respectively.