The effects of health education on schistosomiasis japonica prevalence and relevant knowledge in the People's Republic of China: A systematic review and meta-analysis

Schistosomiasis japonica continues to be an important zoonotic disease in the People's Republic of China (P.R. China), despite decades of dedicated control efforts. Different interventions for its control including chemotherapy of humans and animals, mollusciciding, environmental modification, and health education have been implemented at various stages of the control efforts and in different combinations, resulting in remarkable achievements. Here, we present a systematic review and meta-analysis of the documented effectiveness of health education to reduce schistosomiasis japonica transmission in P.R. China. A total of 10 relevant publications were identified and included in the meta-analysis. The reported results indicate that the prevalence of Schistosoma japonicum infection in humans and schistosomiasis-related knowledge are significantly influenced by health education. The implementation of health education over more than 2 years was associated with an overall schistosomiasis japonica prevalence decrease of 6% (95% CI: 2%, 11%) and an overall increase of 51% (95% CI: 41%, 61%) in schistosomiasis-related knowledge after controlling for confounding factors. Among control groups, the prevalence of schistosomiasis japonica and relevant knowledge levels were not significantly influenced. The relative risk (RR) of an infection with S. japonicum following health education lasting more than 2 years was 0.43 (95% CI: 0.24, 0.78). In summary, a considerable effectiveness of health education with regard to preventing S. japonicum infections in P.R. China and increasing relevant knowledge is documented in the extant literature. This suggests that the effectiveness of health education may be considerable, particularly after its long-term implementation.

Schistosomiasis japonica is a zoonotic disease in China. Over the past decades, integrated interventions including health education have been implemented, resulting in a remarkable decrease of the number of infected people. The significance of health education in this context has not yet been comprehensively documented. We carried out a systematic review and meta-analysis to evaluate the documented effectiveness, and found that the implementation of health education was associated with a 6% decrease in the prevalence of schistosomiasis and a 51% increase in schistosomiasis-related knowledge.Figure optionsDownload as PowerPoint slideHighlights
► We have carried out a systematic review and meta-analysis.
► We assess the effect of health education on schistosomiasis transmission in China.
► The decrease in the prevalence of schistosomiasis is estimated at 6%.
► The increase in schistosomiasis-related knowledge is estimated at 51%.
► The effectiveness of health education may be considerable.