“Farewell to the God of Plague”: The Importance of Political Commitment Towards the Elimination of Schistosomiasis

Jin, Chen; Xu, Jing; Bergquist, Robert; Zhou, Xiao‐Nong

doi:10.3390/tropicalmed3040108

Cited by 23 publications

(16 citation statements)

References 13 publications

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“…In China, Chairman Mao Zedong, not only instigated the National Schistosomiasis Control Programme [14] but also took an interest in malaria. The launch of the malaria research programme (under code name 523) in 1967 focused on herbs used in traditional Chinese medicine.…”

Section: Introductionmentioning

confidence: 99%

Artemether and Praziquantel: Origin, Mode of Action, Impact, and Suggested Application for Effective Control of Human Schistosomiasis

Bergquist¹,

Elmorshedy

2018

TropicalMed

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The stumbling block for the continued, single-drug use of praziquantel (PZQ) against schistosomiasis is less justified by the risk of drug resistance than by the fact that this drug is inactive against juvenile parasites, which will mature and start egg production after chemotherapy. Artemisinin derivatives, currently used against malaria in the form of artemisinin-based combination therapy (ACT), provide an opportunity as these drugs are not only active against malaria plasmodia, but surprisingly also against juvenile schistosomes. An artemisinin/PZQ combination would be complementary, and potentially additive, as it would kill two schistosome life cycle stages and thus confer a transmission-blocking modality to current chemotherapy. We focus here on single versus combined regimens in endemic settings. Although the risk of artemisinin resistance, already emerging with respect to malaria therapy in Southeast Asia, prevents use in countries where ACT is needed for malaria care, an artemisinin-enforced praziquantel treatment (APT) should be acceptable in regions of North Africa (including Egypt), the Middle East, China, and Brazil that are not endemic for malaria. Thanks to recent progress with respect to high-resolution diagnostics, based on circulating schistosome antigens in humans and molecular approaches for snail surveys, it should be possible to keep areas scheduled for schistosomiasis elimination under surveillance, bringing rapid response to bear on problems arising. The next steps would be to investigate where and for how long APT should be applied to make a lasting impact. A large-scale field trial in an area with modest transmission should tell how apt this approach is.

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Section: Introductionmentioning

confidence: 99%

Artemether and Praziquantel: Origin, Mode of Action, Impact, and Suggested Application for Effective Control of Human Schistosomiasis

Bergquist¹,

Elmorshedy

2018

TropicalMed

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“…This approach has been identified as important to reduce schistosomiasis japonica levels across P.R. China [ 22 , 26 , 27 , 29 , 39 , 42 , 95 – 97 ]. The value of integrated One Health approaches has been described in the context of Schistosoma mekongi elimination efforts in Lao PDR and Cambodia [ 24 ].…”

Section: Resultsmentioning

confidence: 99%

“…Solid evidence demonstrates that sustainable control and particularly interruption of transmission and elimination of human schistosomiasis is only possible through multipronged long-term strategies that are adapted to local conditions, sustained by political commitment and funded adequately [ 22 , 27 , 63 , 74 , 92 ]. Intervention strategies need to be based on (predictive) risk mapping and combine different interventions that are tailored to the local socio-economic and epidemiological context through close consultation with the local population.…”

Section: Discussionmentioning

confidence: 99%

Core components, concepts and strategies for parasitic and vector-borne disease elimination with a focus on schistosomiasis: A landscape analysis

et al. 2020

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Efforts to control and eliminate human schistosomiasis have accelerated over the past decade. In a number of endemic countries and settings, interruption of schistosome transmission has been achieved. In others, Schistosoma infections continue to challenge program managers at different levels, from the complexity of the transmission cycle, over limited treatment options and lack of field-friendly accurate diagnostics, to controversy around adequate intervention strategies. We conducted a landscape analysis on parasitic and vector-borne disease elimination approaches with the aim to identify evidence-based strategies, core components and key concepts for achieving and sustaining schistosomiasis control and for progressing elimination efforts towards interruption of transmission in sub-Saharan Africa. A total of 118 relevant publications were identified from Web of Science, Pubmed and the grey literature and reviewed for their content. In addition, we conducted in-depth interviews with 23 epidemiologists, program managers, policymakers, donors and field researchers. Available evidence emphasizes the need for comprehensive, multipronged and long-term strategies consisting of multiple complementary interventions that must be sustained over time by political commitment and adequate funding in order to reach interruption of transmission. Based on the findings of this landscape analysis, we propose a comprehensive set of intervention strategies for schistosomiasis control and elimination. Before deployment, the proposed interventions will require review, evaluation and validation in the frame of an expert consultation as a step towards adaptation to specific contexts, conditions and settings. Field testing to ensure local relevance and effectiveness is paramount given the diversity of socio-ecological and epidemiological contexts.

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“…This clearly applies to sub-Saharan Africa, having the highest prevalence of schistosomiasis coupled with the lowest income per-capita [49], and to the situation in Yemen [38]. This is in contrast to developed countries which succeeded in eliminating this infection; for example, Japan [50] and modern-day China [51], which has made a remarkable progress towards elimination. Also, in the Middle East and North Africa (MENA) region, the economic transition in Saudi Arabia played an immense role in diseases elimination [38].…”

Section: Discussionmentioning

confidence: 99%

Elimination of schistosomiasis requires multifactorial diagnostics: evidence from high- and low-prevalence areas in the Nile Delta, Egypt

Elmorshedy

Bergquist²,

Fayed

et al. 2020

Infect Dis Poverty

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Background: Schistosomiasis is one of the neglected tropical diseases (NTDs) selected for worldwide elimination in the near future. Egypt has made strong progress against its two endemic species of Schistosoma mansoni and S. haematobium. The former is prevalent in the Nile Delta with the latter dominating in the Nile south of Cairo. Innovative efforts are needed to reach the goal as further reduction of the prevalence has stalled due to ongoing transmission. In this study we aimed to explore the difference between low and high prevalence villages with regard to knowledge attitude and practice about schistosomiasis, utilization of health services, infection and transmission indices. Methods: A hybrid cross-sectional longitudinal study was conducted with three annual follow-ups conducted during 1994-1996. We used a representative systematic random sampling technique investigating 993 individuals from the high prevalence village and 614 from the low prevalence village. Data were analyzed using SPSS, comparing proportions with the Chi square test and means with the Student t test, and ANOVA. Results: Compliance of faecal sampling and chemotherapy was above 70% in both villages over the whole study period. Selective praziquantel treatment resulted in a significant reduction of prevalence and intensity of infection in both villages, dropping from 35.8% prevalence to 20.6%, in the low-prevalence village, and from 69.5 to 45.9% in the high-prevalence one. Intensity of infection at the base line was 30 eggs per gram (EPG) of stool in the low-prevalence village versus 105 EPG in the high-prevalence village. However, after the second round, reinfection rebounded by 22% in the high-prevalence village, while a slight improvement of the infection indices was demonstrated in the low-prevalence one. The level of knowledge was modest in both villages: people knew about self-protection and treatment, but not much about the role of human excreta for schistosomiasis transmission. While all participants maintained that using the water from the canals was inevitable, inhabitants in the high-prevalence village showed significantly lower scores reflecting higher water contact compared to the low

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“Farewell to the God of Plague”: The Importance of Political Commitment Towards the Elimination of Schistosomiasis

Abstract: n/a

Cited by 23 publications

References 13 publications

Artemether and Praziquantel: Origin, Mode of Action, Impact, and Suggested Application for Effective Control of Human Schistosomiasis

Artemether and Praziquantel: Origin, Mode of Action, Impact, and Suggested Application for Effective Control of Human Schistosomiasis

Core components, concepts and strategies for parasitic and vector-borne disease elimination with a focus on schistosomiasis: A landscape analysis

Elimination of schistosomiasis requires multifactorial diagnostics: evidence from high- and low-prevalence areas in the Nile Delta, Egypt

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