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Background <p>Asian schistosomiasis is projected to be eliminated by 2030 according to World Health Organization road map for neglected tropical diseases 2021–2030. Snail control is an important measure but has not yet been systematically evaluated at a country scale. Here, we report the findings from a nationwide survey to demonstrate the dynamics of <i>Oncomelania</i> and its potential role in transmission interruption of schistisomiasis in the People’s Republic of China (P.R. China).</p> Methods <p>Between March 2016 and December 2017, we conducted a nationwide census on <i>Oncomelania</i> snail habitats in P.R. China. All historically recorded snail habitats were identified and reviewed. Information on habitat attributes, including the infestation of snails, was collected. The shape of habitats was determined using global positioning system and geographical information system technologies. The relationship between snail control and schistosomiasis elimination was established in 378 endemic counties. The comparison of accumulated snail-infested range (ASR) and the median ratio of eliminated ASR between the transmission-interrupted and endemic counties was tested by a non-parametric test (Mann–Whitney) with a significance level of 0.05.</p> Results <p>Overall, 15,377.7&#xa0;million&#xa0;m<sup>2</sup> of potential snail habitats with a total of 356,550 snail habitats were identified in P.R. China. The ASR amounted to 86.0% of the total area. Most of the ASR (94.9%) and habitats (68.5%) were distributed in the middle and lower reaches of the Yangtze River. Snail habitats were found up to an altitude of 2859&#xa0;m above the mean sea level. By 2017, 85.1% of habitats (73.0% of the ASR) had been eliminated with almost half of them eliminated between 1965 and 1982. The elimination of snail habitats promoted transmission interruption of schistosomiasis, but showed variable patterns in different landscapes. The ratio of eliminated ASR was 99.6 and 91.4% in water network and hilly areas, respectively, while it was only 64.8% in marshland areas, particularly in Hunan and Jiangxi where the two largest freshwater lakes of P.R. China are located. Marshland habitats were seen as the most difficult for transmission interruption, which calls for additional control measures in these settings.</p> Conclusions <p>Our results support recent recommendations by the World Health Organization to implement snail control and demonstrate that schistosomiasis elimination can be achieved. The nationwide, high-resolution map of <i>Oncomelania</i> snail habitats in P.R. China will support further efforts to eliminate schistosomiasis.</p> Graphical Abstract <p></p>

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Snail control as a crucial approach to schistosomiasis elimination: evidence from the People’s Republic of China

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月21日

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  • Shan Lv,
  • Jing Xu,
  • Yin-Long Li,
  • Zi-Ping Bao,
  • Li-Juan Zhang,
  • Kun Yang,
  • Dan-Dan Lin,
  • Jian-Bing Liu,
  • Tian-Ping Wang,
  • Guang-Hui Ren,
  • Bo Zhong,
  • Yi Dong,
  • Li Cai,
  • Li-Yong Wen,
  • Zhi-Hua Jiang,
  • Zhuo-Hui Deng,
  • Han-Guo Xie,
  • Shi-Zhu Li,
  • Robert Bergquist,
  • Jürg Utzinger,
  • Xiao-Nong Zhou

摘要

Background

Asian schistosomiasis is projected to be eliminated by 2030 according to World Health Organization road map for neglected tropical diseases 2021–2030. Snail control is an important measure but has not yet been systematically evaluated at a country scale. Here, we report the findings from a nationwide survey to demonstrate the dynamics of Oncomelania and its potential role in transmission interruption of schistisomiasis in the People’s Republic of China (P.R. China).

Methods

Between March 2016 and December 2017, we conducted a nationwide census on Oncomelania snail habitats in P.R. China. All historically recorded snail habitats were identified and reviewed. Information on habitat attributes, including the infestation of snails, was collected. The shape of habitats was determined using global positioning system and geographical information system technologies. The relationship between snail control and schistosomiasis elimination was established in 378 endemic counties. The comparison of accumulated snail-infested range (ASR) and the median ratio of eliminated ASR between the transmission-interrupted and endemic counties was tested by a non-parametric test (Mann–Whitney) with a significance level of 0.05.

Results

Overall, 15,377.7 million m2 of potential snail habitats with a total of 356,550 snail habitats were identified in P.R. China. The ASR amounted to 86.0% of the total area. Most of the ASR (94.9%) and habitats (68.5%) were distributed in the middle and lower reaches of the Yangtze River. Snail habitats were found up to an altitude of 2859 m above the mean sea level. By 2017, 85.1% of habitats (73.0% of the ASR) had been eliminated with almost half of them eliminated between 1965 and 1982. The elimination of snail habitats promoted transmission interruption of schistosomiasis, but showed variable patterns in different landscapes. The ratio of eliminated ASR was 99.6 and 91.4% in water network and hilly areas, respectively, while it was only 64.8% in marshland areas, particularly in Hunan and Jiangxi where the two largest freshwater lakes of P.R. China are located. Marshland habitats were seen as the most difficult for transmission interruption, which calls for additional control measures in these settings.

Conclusions

Our results support recent recommendations by the World Health Organization to implement snail control and demonstrate that schistosomiasis elimination can be achieved. The nationwide, high-resolution map of Oncomelania snail habitats in P.R. China will support further efforts to eliminate schistosomiasis.

Graphical Abstract