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Human schistosomiasis is a water-borne infectious disease caused by infection with blood flukes of the genus Schistosoma. The disease occurs worldwide in 78 countries and regions in Asia, South America, the Middle East, and Africa. Globally, over 780 million people are at risk of infection and 250 million people are infected, of which 90% are concentrated in sub-Saharan Africa (2-4). The estimated global burden of schistosomiasis is 3.31 million disability-adjusted life years (DALYs) (5). In China, human schistosomiasis is only caused by S. japonicum. Like other human-hosting Schistosoma spp., the life cycle of S. japonicum includes adult worm, egg, miracidium, sporocyst, cercariae, and schistosomula, requiring an intermediate host and a definitive host to complete its asexual and sexual production separately (Figure 1). Oncomelania hupensis, an amphibious snail, is the only intermediate host of S. japonicum. Humans and over forty other mammals serve as definitive hosts of S. japonicum and play a role in spreading infections when they excrete feces containing schistosome eggs to the environment.
The control of schistosomiasis was a high priority in China soon after the founding of the People’s Republic of China in 1949, and schistosomiasis japonica was largely brought under control through 7 decades of effort. However, great challenges still exist to completely eliminate schistosomiasis from the country by 2030 due to climate change, natural disasters, socioeconomic development, environmental protection, etc. The progress of the national schistosomiasis control program and the experience accumulated over past several decades in China is reviewed in this article, and solutions to achieve the elimination of schistosomiasis through a One Health approach are explored, which addresses complex health issues from a holistic perspective of human-animal-environment interaction.
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