A call to strengthen the global strategy against schistosomiasis and soil-transmitted helminthiasis: the time is now

Abstract

Summary In 2001, the World Health Assembly (WHA) passed the landmark WHA 54.19 resolution for global scale up of mass administration of anthelminthic drugs for morbidity control of schistosomiasis and soil-transmitted helminthiasis (STH), which affect over 1.5 billion of the world's poorest people. Since then, over a decade of research and experience has yielded critical new knowledge on the control and elimination of these helminthiases. However, the global strategy has remained largely unchanged since the original 2001 WHA resolution and associated World Health Organization (WHO) guidelines on preventive chemotherapy. Here, we highlight recent advances that, taken together, support a call to revise the global strategy and guidelines for preventive chemotherapy and complementary interventions against schistosomiasis and STH. This includes the development of guidance that is specific to goals of “morbidity control” and “elimination of transmission.” We quantify the result of forgoing this opportunity by computing the yearly disease burden, mortality, and lost economic productivity associated with maintaining status quo. Without change, we estimate that the population of sub-Saharan Africa will likely lose 2.3 million disability-adjusted life years and US$3.5 billion of economic productivity every year, which is comparable to recent acute epidemics, including the 2014 Ebola and 2015 Zika epidemics. We propose that the time is now to strengthen the global strategy to address the substantial disease burden of schistosomiasis and STH.

Improving public health control of schistosomiasis with a modified WHO strategy: a model-based comparison study

“…5,6 The emergence of socalled persistent hot spots in the face of continued MDA implementation (as recommended) in endemic regions calls for reassessment and possible revision to global implementation guidelines. 15 Previous modelling done by the Neglected Tropical Disease Modelling Consortium 16 found that the WHO goals for morbidity control and elimination as a public health problem are likely to be attainable in lowprevalence but not moderate to high-prevalence settings using current guidelines. The modelling consortium furthermore recommended increasing treatment frequency or coverage to 85% of children aged 5-14 years and 40% of individuals aged 15 years and older to reach these goals for moderate to high-prevalence settings.…”

Epidemiology of soil-transmitted helminths and Schistosoma mansoni: a base-line survey among school children, Ejaji, Ethiopia

“…Globally, in 2010 alone, an estimated 819.0 million, 438.9 million and 464.6 million people were infected with A. lumbricoides, the hookworms and T. trichiura, respectively [1]. Enormous disability adjusted life years (DALYs) are lost due to the STHs and S. mansoni in sub-Saharan Africa [2].…”

An Integrated Approach to Control Soil-Transmitted Helminthiasis, Schistosomiasis, Intestinal Protozoa Infection, and Diarrhea: Protocol for a Cluster Randomized Trial (Preprint)

“…There is considerable interest in the scientific community and among disease control programme managers to bring integrated approaches into action, though the challenges of scaling up such integrated, intersectoral, multi-disease control approaches are recognised [60,61]. Our study will shed new light on the effect of integrated approaches on different outcomes, including parasitic infections (soil-transmitted helminths, schistosomes and intestinal protozoa), incidence of diarrhoea, anthropometric measures and KAPB of populations.…”