Dynamics of spatial clustering of schistosomiasis in the Yangtze River Valley at the end of and following the World Bank Loan Project.

The 10-year (1992-2001) World Bank Loan Project (WBLP) contributed greatly to schistosomiasis control in China. However, the re-emergence of schistosomiasis in recent years challenged the long-term progress of the WBLP strategy. In order to gain insight in the long-term progress of the WBLP, the spatial pattern of the epidemic was investigated in the Yangtze River Valley between 1999-2001 and 2007-2008. Two spatial cluster methods were jointly used to identify spatial clusters of cases. The magnitude and number of clusters varied during 1999-2001. It was found that prevalence of schistosomiasis had been greatly reduced and maintained at a low level during 2007-2008, with little change. Besides, spatial clusters most frequently occurred within 16 counties in the Dongting Lake region and within 5 counties in the Poyang Lake region. These findings precisely pointed out the prior places for future public health planning and resource allocation of schistosomiasis.