The national schistosomiasis control program was initiated in China in the 1950s and has undergone three stages, the transmission control, the morbidity control, and the new integrated strategy stages. At the first stage (from mid-1950s to early 1980s), the transmission control strategy that was implemented focused on the control of the intermediate host snails by means of environmental improvements and chemical treatment. This resulted in a remarkable decline in snail-infested habitats and of human S. japonicum infection cases. With the introduction of praziquantel a highly-effective, lowly-toxic, low-cost, and orally-administered schistosomicide in the late 1970s, the Chinese national schistosomiasis control strategy moved towards morbidity control in the 1980s (between mid-1980s and 2003). The praziquantel chemotherapy-based morbidity control strategy has been proven to be effective in reducing the prevalence and intensity of S. japonicum infections. Thus, schistosomiasis was eliminated in 5 out of the 12 provinces that were endemic for the disease during this stage. However, in the early 21st century, schistosomiasis japonica resurged as a response to the changes in natural and social factors. Such changes included frequent flooding along the Yangtze River valley and reduced financial support. To address this challenges, the central government of China reinforced the national schistosomiasis control program with the target of achieving human prevalence of below 5% by 2008 and below 1% by 2015. Furthermore, schistosomiasis, along with HIV/AIDS, hepatitis B, and tuberculosis were prioritized in communicable disease control in 2004. In addition, a new integrated strategy targeting the transmission pathway of schistosomiasis japonica was proposed in 2004. This aimed to stop the contamination of the environment with schistosome eggs, which emphasized the replacement of bovine with machines, improvement of sanitation and fencing of water buffaloes; along with health education, praziquantel-based chemotherapy, and snail control. Following an effective implementation of the new integrated strategy for schistosomiasis japonica control in China, infection and transmission control was achieved in 2008 and 2015, respectively. This highlighted the effectiveness of the new integrated strategy on the transmission of S. japonicum.
Based on the recognition that bovine was a major source of S. japonicum infection in the marshland and lake regions, the new integrated strategy was designed with the aim of reducing the role of bovines and humans as sources of infection, in the transmission of S. japonicum. The effectiveness of this new integrated strategy for schistosomiasis control in other environmental contexts, in China, is therefore questionable. Previous studies have demonstrated that the new integrated strategy is also effective in controlling of the transmission of S. japonicum in mountainous regions and lake regions. To date, there was no systematic review or meta-analysis that has assessed the effectiveness of this new integrated strategy to control the transmission of S. japonicum, although it has been extensively implemented across various environmental contexts, in China.
Studying publication outputs is key to understanding and improving a research system. Publication output has been assessed by means of different tools and methodologies, which may offer valuable information to scholars and policymakers. PubMed is a free and public search engine that provides access to over 24 million citations in all fields of life sciences, mostly located in the MEDLINE bibliographic database. Currently, PubMed is the most commonly used platform to retrieve research publications in the fields of biomedicine and life sciences. Therefore, a PubMed-based quantitative analysis of the publication output is of great importance to understanding the global transmissibility and sharing of the new integrated strategy for schistosomiasis japonica control, developed in China.
Based on the search strategy, we retrieved 70 publications in the PubMed database from January 1, 2004 to August 31, 2018 (no publication record was seen in 2004, 2006–2008, 2010 and early 2018 [until August 30]). This new integrated strategy was proposed in 2004, and then piloted across China, resulting in a low research output from 2005 to 2008. In addition, most of the studies were published in national journals, few of which were indexed in PubMed/MEDLINE, leading to the low productivity seen in the PubMed database. As a response to the gradual release of the results of pilot studies and inclusion of Chinese Journal of Schistosomiasis Control (Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi), a leading journal for communicating schistosomiasis research and control in China, in PubMed/MEDLINE since 2011, the publication outputs peaked from 2011 to 2014.
Out of the 70 publications retrieved from PubMed, 67.1% were Chinese literatures published in national peer-reviewed journals, suggesting a need to improve the global transmissibility of the new integrated strategy. Currently, preventive chemotherapy with praziquantel remains the global control strategy for schistosomiasis. However, mass drug administration with praziquantel alone has proven to be insufficient to eliminate schistosomiasis. Sharing the experiences from the Chinese new integrated strategy may provide insights into the adjustment and reshaping of the global and national schistosomiasis control program in affected areas.
