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Fig 1.

Control strategies used against schistosomiasis during the past century.

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Fig 2.

Strategy details for schistosomiasis control: the current paradigm and an alternative based on past successes.

(A) The current paradigm for global schistosomiasis control, adapted from [30], and (B) an alternative strategy based on historical successes (this paper). MDA = mass drug administration, TAT = targeted (“test-and-treat”) chemotherapy.

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Fig 3.

Countries and territories evaluated and their outcomes for schistosomiasis control or elimination.

“Successful” = there was a control program that preceded elimination or non-endemic status; “Fortuitous elimination” = elimination or non-endemic status with no control program; “Minimal control” = endemic disease in the face of minimal to no control, even if there were some pilot or small-scale programs; “Not (yet) successful” = endemic disease with a past or present control program.

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Table 1.

Countries and territories evaluated and their success categories, prevalence reduction, and percent reduction in population at risk for schistosomiasis (as a proportion of the total population).

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Fig 4.

Schistosomiasis control programs over time.

See Fig 5 for more details on control strategies and outcomes.

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Table 2.

Logistic regression for elimination/non-endemicity.

*

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Fig 5.

Schistosomiasis prevalence change over time.

Prevalence change by control program strategy (time 0 on the x-axis is set when control began; negative values for the normalized year show data n years before control started and positive values n years after).

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Fig 6.

Prevalence change by extent of snail control, or MDA, or both—see text for category definitions.

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Table 3.

Generalized linear mixed model (GLMM, see S2 and S3 Tables) comparing change in prevalence for control programs using: MDA with praziquantel, snail control primarily (snail control), both (MDA + snail control), or minimal control (<30% coverage, “low coverage,” not shown).

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Fig 7.

Sensitivity of schistosome prevalence reduction to the infected population size before the control program began.

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Fig 8.

Per capita gross domestic product (GDP) as it relates to control strategy and control start date in each country.

Points represent mean inflation-adjusted, per-capita GDP throughout the relevant time for which disease data were available, and bars represent the range.

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