Abstract
China has a history of using cultural policies to control infectious diseases, including schistosomiasis, which was once hyperendemic in the country. Since the founding of the People’s Republic of China, significant achievements have been made in schistosomiasis control, with a decrease in the number of cases and infection rates. This study provides a historical analysis of cultural policies in schistosomiasis control in China. During the Mao era (1949–1976), socialist ideology shaped cultural policies that included mass mobilization campaigns, propaganda, and cultural education to promote health practices, and community participation and empowerment. During the Reform era (1978–2012), there was a shift towards market-oriented policies and individual responsibility, and cultural policies promoted behavioral change, but there were challenges in implementing them in a rapidly changing society. In the “New Era” of socialism (2012–now), cultural policies are focused on promoting comprehensive schistosomiasis control strategies, technological advancements and innovation, and international cooperation. The Chinese experience in schistosomiasis control provides valuable lessons for other countries facing similar challenges and underscores the importance of cultural policies in promoting health and well-being.
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References
Brattig NW, Bergquist R, Qian MB, Zhou XN, Utzinger J (2020) Helminthiases in the People’s Republic of China: status and prospects. Acta Trop 212:105670. https://doi.org/10.1016/j.actatropica.2020.105670
Cao CL, Zhang LJ, Deng WP, Li YL, Lv C, Dai SM, Feng T, Qin ZQ, Duan LP, Zhang HB, Hu W, Feng Z, Xu J, Lv S, Guo JG, Li SZ, Cao JP, Zhou XN (2020) Contributions and achievements on schistosomiasis control and elimination in China by NIPD-CTDR. Adv Parasitol 110:1–62. https://doi.org/10.1016/bs.apar.2020.04.002
Changsong S, Binggui Y, Hongyi L, Yuhai D, Xu X, Huiguo Z, Yong J (2002) Achievement of the World Bank Loan Project on schistosomiasis control (1992-2000) in Hubei province and the challenge in the future. Acta Trop 82(2):169–174. https://doi.org/10.1016/s0001-706x(02)00008-6
Chen J, Xu J, Bergquist R, Li SZ, Zhou XN (2018) “Farewell to the God of Plague”: the importance of political commitment towards the elimination of schistosomiasis. Trop Med Infect Dis 3(4). https://doi.org/10.3390/tropicalmed3040108
Chen L, Zhong B, Xu J, Li RZ, Cao CL (2016) Health education as an important component in the national schistosomiasis control programme in the People’s Republic of China. Adv Parasitol 92:307–339. https://doi.org/10.1016/bs.apar.2016.03.004
Chen M (1999) Progress in schistosomiasis control in China. Chin Med J 112(10):930–933
Chen MG (1989) Schistosomiasis control program in the People’s Republic of China: a review. Southeast Asian J Trop Med Public Health 20(4):511–517
Chu CK, Sze TS (1978) The patriotic public health campaign--a nation-wide mobilization for health. Chin Med J 4(4):253–256
Collins C, Xu J, Tang S (2012) Schistosomiasis control and the health system in P.R. China. Infect Dis Poverty 1(1):8. https://doi.org/10.1186/2049-9957-1-8
Fan K (2010) Mass mobilization and the anti-schistosomiasis campaign in Maoist China (1955-1960). Medicine 51(2):176–187
Fan K (2018) Public resistance against the anti-schistosomiasis campaign of the 1950–1960s in China. History of Medicine 5(3):221–230
Fan K (2019) A Chinese comic book and the anti-schistosomiasis campaign during the cultural revolution. Studia Orientalia Slovaca 18(1):51–73
Fan K, Lai H (2008) Mao Zedong’s fight against schistosomiasis. Perspect Biol Med 51(2):176–187. https://doi.org/10.1353/pbm.0.0013
Grossmann I, Varnum ME (2015) Social structure, infectious diseases, disasters, secularism, and cultural change in America. Psychol Sci 26(3):311–324. https://doi.org/10.1177/0956797614563765
Hipgrave D (2011) Communicable disease control in China: from Mao to now. J Glob Health 1(2):224–238
Huang Y (2015) Governing health in contemporary China. Routledge
Huang Y, Manderson L (1992) Schistosomiasis and the social patterning of infection. Acta Trop 51(3-4):175–194. https://doi.org/10.1016/0001-706x(92)90037-x
Huang YX, Manderson L (2005) The social and economic context and determinants of schistosomiasis japonica. Acta Trop 96(2-3):223–231. https://doi.org/10.1016/j.actatropica.2005.07.015
Hussen SA, Kuppalli K, Castillo-Mancilla J, Bedimo R, Fadul N, Ofotokun I (2020) Cultural competence and humility in infectious diseases clinical practice and research. J Infect Dis 222(Suppl 6):S535–S542. https://doi.org/10.1093/infdis/jiaa227
Kloos H (1995) Human behavior, health education and schistosomiasis control: a review. Soc Sci Med 40(11):1497–1511. https://doi.org/10.1016/0277-9536(94)00310-p
Lampton DM (1972) Public health and politics in China’s past two decades. Health Serv Rep 87(10):895–904
Leshem E, Maor Y, Meltzer E, Assous M, Schwartz E (2008) Acute schistosomiasis outbreak: clinical features and economic impact. Clin Infect Dis 47(12):1499–1506. https://doi.org/10.1086/593191
Li Z (2021) How successful was China’s poverty alleviation drive. The Diplomat for The Diplomat. https://thediplomat.com/2021/09/how-successful-was-chinas-poverty-alleviation-drive/. Accessed 6 Sept 2021
Liu X, Mills A (2002) Financing reforms of public health services in China: lessons for other nations. Soc Sci Med 54(11):1691–1698. https://doi.org/10.1016/s0277-9536(01)00337-9
Logan O (1905) A case of dysentery in Hunan Province, caused by the trematode, Schistosomum japonicum. Chin Med J 19(06):243–245
Lv C, Deng W, Wang L, Qin Z, Zhou X, Xu J (2022) Molecular techniques as alternatives of diagnostic tools in China as schistosomiasis moving towards elimination. Pathogens 11(3). https://doi.org/10.3390/pathogens11030287
Maegraith B (1958) Schistosomiasis in China. Lancet 1(7013):208–214. https://doi.org/10.1016/s0140-6736(58)90686-x
Mao CP (1948) A review of the epidemiology of schistosomiasis japonica in China. Am J Trop Med Hyg 28(5):659–672. https://doi.org/10.4269/ajtmh.1948.s1-28.659
Mao SP (1987) Epidemiology and control of schistosomiasis in the People’s Republic of China. Mem Inst Oswaldo Cruz 82(Suppl 4):77–82. https://doi.org/10.1590/s0074-02761987000800012
Rinaldo D, Perez-Saez J, Vounatsou P, Utzinger J, Arcand JL (2021) The economic impact of schistosomiasis. Infect Dis Poverty 10(1):134. https://doi.org/10.1186/s40249-021-00919-z
Ross AG, Li YS, Sleigh AC, McManus DP (1997) Schistosomiasis control in the People’s Republic of China. Parasitol Today 13(4):152–155. https://doi.org/10.1016/s0169-4758(97)01026-0
Shi L, Zhang JF, Li W, Yang K (2022) Development of new technologies for risk identification of schistosomiasis transmission in China. Pathogens 11(2). https://doi.org/10.3390/pathogens11020224
Shi-Zhu L, Jing X, Tian-Ping W, Li-Yong W, Kun Y, Wei W, Shan L, Chun-Li C, Xiao-Nong Z (2019) Upholding Chinese spirit on schistosomiasis control in the new era to accelerate the progress towards schistosomiasis elimination in China. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 31(1):1–13. https://doi.org/10.16250/j.32.1374.2019043
Song LG, Wu XY, Sacko M, Wu ZD (2016) History of schistosomiasis epidemiology, current status, and challenges in China: on the road to schistosomiasis elimination. Parasitol Res 115(11):4071–4081. https://doi.org/10.1007/s00436-016-5253-5
Song Z, Ting L, Kun Y, Wei L, Jian-Feng Z, Li-Chuan G, Yan-Hong L, Yang D, Qing-Jie Y, Hai-Tao Y (2018) Establishment of a recombinase-aided isothermal amplification technique to detect Schistosoma japonicum specific gene fragments. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 30(3):273–277. https://doi.org/10.16250/j.32.1374.2018120
Sun Y, Sun X, Ren J, Li B (2021) Creating healthy enterprises: the workplace health action plan in China. China CDC Wkly 3(20):434–437. https://doi.org/10.46234/ccdcw2021.095
Tao W, Zeng Z, Dang H, Lu B, Chuong L, Yue D, Wen J, Zhao R, Li W, Kominski GF (2020) Towards universal health coverage: lessons from 10 years of healthcare reform in China. BMJ Glob Health 5(3):e002086. https://doi.org/10.1136/bmjgh-2019-002086
Utzinger J, Zhou XN, Chen MG, Bergquist R (2005) Conquering schistosomiasis in China: the long march. Acta Trop 96(2-3):69–96. https://doi.org/10.1016/j.actatropica.2005.08.004
Wang J, Mou Y (2021) The paradigm shift in the disciplining of village cadres in China: from Mao to Xi. China Q 248(S1):181–199
Wang L, Utzinger J, Zhou XN (2008) Schistosomiasis control: experiences and lessons from China. Lancet 372(9652):1793–1795. https://doi.org/10.1016/S0140-6736(08)61358-6
Wang L, Wang Z, Ma Q, Fang G, Yang J (2019a) The development and reform of public health in China from 1949 to 2019. Glob Health 15(1):45. https://doi.org/10.1186/s12992-019-0486-6
Wang L, Zou Y, Zhu X, Bottazzi ME, Hotez PJ, Zhan B (2019b) China's shifting neglected parasitic infections in an era of economic reform, urbanization, disease control, and the Belt and Road Initiative. PLoS Negl Trop Dis 13(1):e0006946. https://doi.org/10.1371/journal.pntd.0006946
Wang R (2000) Critical health literacy: a case study from China in schistosomiasis control. Health Promot Int 15(3):269–274
Wang W, Bergquist R, King CH, Yang K (2021) Elimination of schistosomiasis in China: current status and future prospects. PLoS Negl Trop Dis 15(8):e0009578. https://doi.org/10.1371/journal.pntd.0009578
Wang XY, He J, Yang K, Liang S (2016) Applications of spatial technology in schistosomiasis control programme in the People’s Republic of China. Adv Parasitol 92:143–163. https://doi.org/10.1016/bs.apar.2016.02.020
Wiest PM, Wu G, Zhang S, Yuan J, Peters PA, McGarvey ST, Tso M, Olveda R, Olds GR (1992) Morbidity due to schistosomiasis japonica in the People’s Republic of China. Trans R Soc Trop Med Hyg 86(1):47–50. https://doi.org/10.1016/0035-9203(92)90437-h
Wu LL, Hu HH, Zhang X, Zhou XN, Jia TW, Wang C, Hong Z, Xu J (2021) Cost-effectiveness analysis of the integrated control strategy for schistosomiasis japonica in a lake region of China: a case study. Infect Dis Poverty 10(1):79. https://doi.org/10.1186/s40249-021-00863-y
Xianyi C, Liying W, Jiming C, Xiaonong Z, Jiang Z, Jiagang G, Xiaohua W, Engels D, Minggang C (2005) Schistosomiasis control in China: the impact of a 10-year World Bank Loan Project (1992-2001). Bull World Health Organ 83(1):43–48
Xiaoyan D (2019) Between politics and prevention: a re-examination of China’s schistosomiasis control campaign in the 1950s. Endeavour 43(3):100696
Xu J, Bergquist R, Qian YJ, Wang Q, Yu Q, Peeling R, Croft S, Guo JG, Zhou XN (2016a) China-Africa and China-Asia collaboration on schistosomiasis control: a SWOT analysis. Adv Parasitol 92:435–466. https://doi.org/10.1016/bs.apar.2016.02.005
Xu J, Cao CL, Lu S, Li SZ, Zhou XN (2023) Schistosomiasis control in China from 2012 to 2021: progress and challenges. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 34(6):559–565. https://doi.org/10.16250/j.32.1374.2022257
Xu J, Xu JF, Li SZ, Zhang LJ, Wang Q, Zhu HH, Zhou XN (2015) Integrated control programmes for schistosomiasis and other helminth infections in P.R. China. Acta Trop 141(Pt B):332–341. https://doi.org/10.1016/j.actatropica.2013.11.028
Xu J, Yu Q, Tchuente LA, Bergquist R, Sacko M, Utzinger J, Lin DD, Yang K, Zhang LJ, Wang Q, Li SZ, Guo JG, Zhou XN (2016b) Enhancing collaboration between China and African countries for schistosomiasis control. Lancet Infect Dis 16(3):376–383. https://doi.org/10.1016/S1473-3099(15)00360-6
Xue Q, Deng Y, Liu Y, Wang Y, Hu W, Huang Y, Yang K (2023) A retrospective analysis of schistosomiasis related literature from 2011-2020: focusing on the next decade. Acta Trop 238:106750. https://doi.org/10.1016/j.actatropica.2022.106750
Yang K, Mehlhorn H (2021) Sino-African cooperation for schistosomiasis control in Zanzibar. Springer
Yang Y, Zhou YB, Song XX, Li SZ, Zhong B, Wang TP, Bergquist R, Zhou XN, Jiang QW (2016) Integrated control strategy of schistosomiasis in the People’s Republic of China: projects involving agriculture, water conservancy, forestry, sanitation and environmental modification. Adv Parasitol 92:237–268. https://doi.org/10.1016/bs.apar.2016.02.004
Yuan B, Jian W, Martinez-Alvarez M, McKee M, Balabanova D (2020) Health system reforms in China a half century apart: Continuity but adaptation. Soc Sci Med 265:113421. https://doi.org/10.1016/j.socscimed.2020.113421
Zeng H, Yang X, Meng S, Wang H, Tang X, Tang W, Zeng S, Jeschke S, Wang Y (2011) Awareness and knowledge of schistosomiasis infection and prevention in the “Three Gorges Dam” reservoir area: a cross-sectional study on local residents and health personnel. Acta Trop 120(3):238–244. https://doi.org/10.1016/j.actatropica.2011.09.003
Zhang JF, Xu J, Bergquist R, Yu LL, Yan XL, Zhu HQ, Wen LY (2016) Development and application of diagnostics in the national schistosomiasis control programme in the People’s Republic of China. Adv Parasitol 92:409–434. https://doi.org/10.1016/bs.apar.2016.02.008
Zhang LJ, Dai SM, Xue JB, Li YL, Lv S, Xu J, Li SZ, Guo JG, Zhou XN (2019) The epidemiological status of schistosomiasis in P. R. China after the World Bank Loan Project, 2002-2017. Acta Trop 195:135–141. https://doi.org/10.1016/j.actatropica.2019.04.030
Zhang SN, Liu ZB, Gu ZW (2002) Disease control and prevention in China in the 20(th) century and prospects for the new millennium. Environ Health Prev Med 7(3):132–137. https://doi.org/10.1265/ehpm.2002.132
Zhang Z, Zhu R, Ward MP, Xu W, Zhang L, Guo J, Zhao F, Jiang Q (2012) Long-term impact of the World Bank Loan Project for schistosomiasis control: a comparison of the spatial distribution of schistosomiasis risk in China. PLoS Negl Trop Dis 6(4):e1620. https://doi.org/10.1371/journal.pntd.0001620
Zhao S, Liu YH, Ye YY, Li W, Zhang JF, Guo LC, Ying QJ, Yang HT, Yang K (2020) Establishment of the gene detection method of Schistosoma mansoni based on the recombinase-aided isothermal amplification assay. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 32(4):335–339. https://doi.org/10.16250/j.32.1374.2020058
Zhou X (2020) The people’s health: health intervention and delivery in Mao’s China 1949-1983, vol 2. McGill-Queen's Press-MQUP
Zhou XN, Wang LY, Chen MG, Wang TP, Guo JG, Wu XH, Jiang QW, Zheng J, Chen XY (2005) An economic evaluation of the national schistosomiasis control programme in China from 1992 to 2000. Acta Trop 96(2-3):255–265. https://doi.org/10.1016/j.actatropica.2005.07.026
Zhou Y, Chen Y, Jiang Q (2021) History of Human schistosomiasis (bilharziasis) in China: from discovery to elimination. Acta Parasitol 66(3):760–769. https://doi.org/10.1007/s11686-021-00357-9
Zhu H, Yap P, Utzinger J, Jia TW, Li SZ, Huang XB, Cai SX (2016) Policy support and resources mobilization for the national schistosomiasis control programme in the People’s Republic of China. Adv Parasitol 92:341–383. https://doi.org/10.1016/bs.apar.2016.03.002
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This work was supported by the Jiangsu Province Endemic Association Project (x202102).
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Zhou, L. The cultural policies of schistosomiasis control in China: a historical analysis. Parasitol Res 122, 2457–2465 (2023). https://doi.org/10.1007/s00436-023-07966-5
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DOI: https://doi.org/10.1007/s00436-023-07966-5