A. Sleigh et al., Eradication of schistosomiasis in Guangxi, China. Part 3. Community diagnosis of the worst-affected areas and maintenance strategies for the future, B WHO, 76(6), 1998, pp. 581-590
Citations number
9
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
Reported are the results of a community-based assessment of maintenance of
schistosomiasis eradication in Guangxi, a large autonomous region of China
with a population of 44 million. Eradication of the disease was acheived in
1989 in Guangxi but maintenance costs are rising. We focused on three coun
ties that had the most intense transmission in the past: Binyang, Jingxi, a
nd Yishan. Four instruments were used: in-depth interviews, focus group dis
cussions, a knowledge, attitudes and practices survey and subsequent commun
ity feedback.
In the past, schistosomiasis had serious consequences in Guangxi, decreasin
g work capacity and restricting marriage and occupational mobility. Since i
fs eradication there have been clear benefits in terms of increased agricul
tural output and improved farming conditions. Personal habits and tradition
al manual farming activities in Guangxi would continue to expose a large pr
oportion of the population to environmental risk if the disease were to ret
urn. Ignorance about control programme achievements is increasing and is re
lated to youth and inexperience. There was a universal desire in the study
counties for more local education about the history of the programme and ab
out the risk of schistosomiasis returning. Snail surveillance is considered
important, but people are not willing to volunteer for such work.
Our study methods were novel for Guangxi and community feedback was helpful
. Snail checking procedures have been modified to make them more efficient
and no snails have been found since 1992. The animal and human stool examin
ations have ceased and vigilance now concentrates on snails and children (s
kin tests). The long-term strategy is to make the population invulnerable t
o future schistosomiasis transmission if the snail vectors return. This mea
ns continuing education and making the former endemic counties a high prior
ity for wafer and sanitation improvements.