Ecological environmental management program promotes Schistosomiasis control in Erhai Lake of China: an analysis based on SWOT-ANP-ADAM approach

Abstract Background The transmission of Schistosoma japonicum is closely related to the surrounding natural environment and socio-economic factors. In recent years, the ecological environmental management program has been implemented in S. japonicum endemic areas around Erhai Lake of China. Relevant protection and governance measures affected the transmission of S. japonicum . This study was conducted to assess the impact of ecological environmental management program on S. japonicum control, and proposed strategic alternatives with a prioritized order of implementation in Erhai Lake. Methods An integrated SWOT-ANP-ADAM analysis is performed to accomplish the set objective in this study. The strengths, weaknesses, opportunities, and threats (SWOT) analysis is conducted to identify the impact factors of ecological environmental management program on S. japonicum control and strategic alternatives. The Analytical Network Process (ANP) was used to evaluate the impact factors, and the Axial Distance-Based Aggregated Measurement (ADAM) method was applied to constructed multi-faceted polyhedron for the ranking the strategic alternatives, thereby better informing decisions for synergistic ecological-disease management. Results A total of 14 impact factors and 12 strategic alternatives were obtained. The relative importance of the group of impact factors is ranked as strengths, opportunities, weaknesses, and threats, with weights equal to 0.3092, 0.2610, 0.2324, and 0.1975, respectively. The Chinese central government's prioritization of S. japonicum control and ecological environmental management (weight equal to 0.1562), as well as the lack of a top-level cooperative mechanism designed to integrate S. japonicum control and ecological environmental management (weight equal to 0.1424), are the most noteworthy factors. In ecological environmental management program of Erhai Lake, management of agricultural non-point source pollution (weight equal to 0.1209), construction of high-efficiency water-saving irrigation systems(weight equal to 0.0853) reduce the risk of S. japonicum transmission, while the wetland restoration may create more favorable habitats for Oncomelania hupensis , as well as increase the number of wildlife populations posing challenges for S. japonicum control(weight equal to 0.0700). Additionally, construction of the ecological management- S. japonicum control model in an integrated manner is the most important strategy (volume of complex polyhedron equal to 0.0693). Conclusions Ecological environmental management program in the Erhai Lake has significant strengths and opportunities in promoting S. japonicum control, but also faces certain weaknesses and threats according to the weight of impact factors. This study confirms ecological environmental management as a viable complementary strategy to conventional S. japonicum control. Scientific planning and comprehensive integration can maximize synergies between schistosomiasis control and ecological protection. Additionally, 12 strategic alternatives with prioritized implementation may provide suggestions for decision makers in similar areas to adopt strategic decisions, which are of great practical significance and application value. Graphical Abstract