Post-elimination schistosomiasis surveillance in Zhongjiang County, Sichuan, China: livestock surveillance, household livestock management, and knowledge, attitudes and practices among livestock-keeping household heads

After schistosomiasis elimination criteria have been met, negative parasitological findings require interpretation alongside surveillance design and effort, as well as household practices. In historically endemic hilly areas, household heads make livestock-management decisions not captured by parasitological testing. We described livestock surveillance and management, assessed schistosomiasis-related knowledge, attitudes and practices (KAP), and examined factors associated with self-reported preventive-practice scores in Zhongjiang County, Sichuan. We analysed seven rounds of routine livestock surveillance conducted from April 2024 to October 2025 and a cross-sectional household survey in May 2026. Miracidium hatching tests for Schistosoma japonicum were performed in cattle and goats from three purposively selected historically endemic townships; the analytical unit was an animal-round examination. A total of 118 livestock-keeping household heads completed a questionnaire containing 19 KAP items, with domain scores scaled to 20–100. Associations with preventive-practice scores were examined using a four-variable linear model with HC3 robust standard errors, 2,000 bootstrap resamples, and sensitivity analyses. Among 3,270 animal-round examinations, comprising 2,895 cattle examinations and 375 goat examinations, none tested positive. Of 118 households, 41 (34.75%) reported semi-grazing, 108 (91.53%) reported livestock transactions in the previous two years, and 89 of these 108 (82.41%) reported no use of a regulated market. Among 74 households that composted manure before field application, 59 (79.73%) reported a duration of seven days or less. Mean knowledge, attitude, and preventive-practice scores were 78.47 ± 17.18, 83.60 ± 17.71, and 78.10 ± 22.25, respectively. Knowledge (B = 0.450, 95% CI 0.253 to 0.647) and attitude (B = 0.534, 95% CI 0.345 to 0.723) were positively associated with practice scores (both p < 0.001), whereas education and age estimates were less stable after influential observations were excluded. No livestock infection was detected under the surveillance procedures used, but this result alone cannot verify elimination or exclude residual transmission. Household management and behavioural information may complement routine surveillance by identifying records or practices that need checking. Knowledge and attitude were associated with self-reported preventive practices, although the cross-sectional findings do not establish causality.