Introduction: Schistosomiasis is a clinical term applied to infection with one of a series of related trematode parasites that are endemic

to at least 76 tropical and sub-tropical countries. Four species routinely infect the human host, and several others rarely do so. Many have reservoir hosts, making eradication efforts nearly impossible in some cases. Taken together, these organisms infect some 220 million people throughout the world, while 600 million others remain at risk. All species of schistosomes employ freshwater snails as intermediate hosts that are essential to the completion of their life cycle. The ecology of schistosomiasis includes tropical lotic (lakes and reservoirs) and lentic environments (rivers), and the behavior of people and their domestic animals that live near these aquatic environments. The recent surge in construction of large impoundments throughout many parts of the tropics and China has dramatically increased the health risks associated with acquiring schistosomiasis, and represents a growing concern among public health professionals in those regions. Other parasitic infections, including malaria, trypanosomiasis, and leishmaniasis have also increased in prevalence as a direct result of this activity. As will be documented, controlling schistosomiasis at the community level is especially daunting, primarily because these parasites are so thoroughly integrated into the ecosystems in which they occur. A notable exception is Japan, where Schistosoma japonicum was eliminated from all of its islands as of 1976, largely based on ecological approaches. It has yet to return to that country and is now considered eradicated. In contrast, most underdeveloped countries do not have the political stability, infrastructure, nor the funding to institute on-going control measures. Instead, civil unrest and war have taken their toll, increasing the likelihood that schistosomiasis will remain a health problem for some time to come in those chaotic environments. Several recent summits have been held on this important health topic. Yet, despite these efforts to draw together, into a single plan, efforts to control these infections, new initiatives are still not in place in areas where they are needed most.