.2014 Nov 25:11:19.

doi: 10.1186/1742-7622-11-19. eCollection 2014.

Surveillance systems for neglected tropical diseases: global lessons from China's evolving schistosomiasis reporting systems, 1949-2014

Song Liang¹, Changhong Yang², Bo Zhong³, Jiagang Guo⁴, Huazhong Li⁵, Elizabeth J Carlton⁶, Matthew C Freeman⁷, Justin V Remais⁷

Affiliations

¹ Department of Environmental and Global Health, College of Public Health and Health Professions, and Emerging Pathogens Institute, University of Florida, 1225 Center Drive, Gainesville, FL 32611 USA.
² Sichuan Center for Disease Control and Prevention, Institute of Public Health Information, 6 Middle School Road, Chengdu, Sichuan, 610041 China.
³ Sichuan Center for Disease Control and Prevention, Institute of Parasitic Diseases, 6 Middle School Road, Chengdu, Sichuan, 610041 China.
⁴ Department of Schistosomiasis, Institute of Parasitic Diseases. Chinese Center for Disease Control and Prevention, Shanghai, China ; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland.
⁵ Department of Emergence Response, Chinese Center for Disease Control and Prevention, Beijing, China.
⁶ Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, CO USA.
⁷ Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA 30322 USA.

PMID:26265928
PMCID: PMC4531518
DOI: 10.1186/1742-7622-11-19

Surveillance systems for neglected tropical diseases: global lessons from China's evolving schistosomiasis reporting systems, 1949-2014

Song Liang et al. Emerg Themes Epidemiol.2014.

.2014 Nov 25:11:19.

doi: 10.1186/1742-7622-11-19. eCollection 2014.

Authors

Song Liang¹, Changhong Yang², Bo Zhong³, Jiagang Guo⁴, Huazhong Li⁵, Elizabeth J Carlton⁶, Matthew C Freeman⁷, Justin V Remais⁷

Affiliations

¹ Department of Environmental and Global Health, College of Public Health and Health Professions, and Emerging Pathogens Institute, University of Florida, 1225 Center Drive, Gainesville, FL 32611 USA.
² Sichuan Center for Disease Control and Prevention, Institute of Public Health Information, 6 Middle School Road, Chengdu, Sichuan, 610041 China.
³ Sichuan Center for Disease Control and Prevention, Institute of Parasitic Diseases, 6 Middle School Road, Chengdu, Sichuan, 610041 China.
⁴ Department of Schistosomiasis, Institute of Parasitic Diseases. Chinese Center for Disease Control and Prevention, Shanghai, China ; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland.
⁵ Department of Emergence Response, Chinese Center for Disease Control and Prevention, Beijing, China.
⁶ Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, CO USA.
⁷ Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA 30322 USA.

PMID:26265928
PMCID: PMC4531518
DOI: 10.1186/1742-7622-11-19

Abstract

Though it has been a focus of the country's public health surveillance systems since the 1950s, schistosomiasis represents an ongoing public health challenge in China. Parallel, schistosomiasis-specific surveillance systems have been essential to China's decades-long campaign to reduce the prevalence of the disease, and have contributed to the successful elimination in five of China's twelve historically endemic provinces, and to the achievement of morbidity and transmission control in the other seven. More recently, an ambitious goal of achieving nation-wide transmission interruption by 2020 has been proposed. This paper details how schistosomiasis surveillance systems have been structured and restructured within China's evolving public health system, and how parallel surveillance activities have provided an information system that has been integral to the characterization of, response to, and control of the disease. With the ongoing threat of re-emergence of schistosomiasis in areas previously considered to have achieved transmission control, a critical examination of China's current surveillance capabilities is needed to direct future investments in health information systems and to enable improved coordination between systems in support of ongoing control. Lessons drawn from China's experience are applied to the current global movement to reduce the burden of helminthiases, where surveillance capacity based on improved diagnostics is urgently needed.

Keywords: Case ascertainment; China; Neglected tropical diseases; Parasitic disease; Sampling; Schistosomiasis; Surveillance.

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Figures

**Figure 1**
**Structure of China’s Public Health System after 2002**[44].

**Figure 2**
**Sampling design for the 1989 and 1995*national*schistosomiasis surveys** [36]. A stratified cluster random sampling design with three strata was used. The first sampling stratum includes the seven schistosomiasis-endemic provinces (Jiangsu, Anhui, Jiangxi, Hubei, Hunan, Sichuan, and Yunnan) and one controlled province (Zhejiang). For endemic provinces, environmental and ecosystem characteristics were used to define the first sub-stratum (eco-type), and the level of prevalence defined the second sub-stratum (prevalence). A target survey population was drawn from each of the second sub-strata, with the characteristics defined in the figure. For areas that have achieved control (Zhejiang province in the 1989 and 1995national surveys), the target survey population was drawn from two administrative villages from each historically endemic county.

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Surveillance systems for neglected tropical diseases: global lessons from China's evolving schistosomiasis reporting systems, 1949-2014

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Surveillance systems for neglected tropical diseases: global lessons from China's evolving schistosomiasis reporting systems, 1949-2014

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