Intestinal Schistosomiasis and Giardiasis Co-Infection in Sub-Saharan Africa: Can a One Health Approach Improve Control of Each Waterborne Parasite Simultaneously?

Abstract

Both intestinal schistosomiasis and giardiasis are co-endemic throughout many areas of sub-Saharan Africa, significantly impacting the health of millions of children in endemic areas. While giardiasis is not considered a neglected tropical disease (NTD), intestinal schistosomiasis is formally grouped under the NTD umbrella and receives significant advocacy and financial support for large-scale control. Although there are differences in the epidemiology between these two diseases, there are also key similarities that might be exploited within potential integrated control strategies permitting tandem interventions. In this review, we highlight these similarities and discuss opportunities for integrated control of giardiasis in low and middle-income countries where intestinal schistosomiasis is co-endemic. By applying new, advanced methods of disease surveillance, and by improving the provision of water, sanitation and hygiene (WASH) initiatives, (co)infection with intestinal schistosomiasis and/or giardiasis could not only be more effectively controlled but also better understood. In this light, we appraise the suitability of a One Health approach targeting both intestinal schistosomiasis and giardiasis, for if adopted more broadly, transmission of both diseases could be reduced to gain improvements in health and wellbeing.

Climate Change and Cascading Risks from Infectious Disease

“…Infections with parasitic blood flukes of the species Schistosoma mansoni, S. japonicum, S. intercalatum, S. mekongi, and S. guineensis can cause intestinal schistosomiasis, associated with systemic inflammation. Cases have been reported in Africa, Latin America, the Middle East, and Southeast Asia [113][114][115]. Temperature is a determinant of the geographic distribution of flukes and a climate change assessment indicated increased transmission as well as potential shrinkages in certain areas [116].…”

Exploring genetic variability of Giardia duodenalis and Enterocytozoon bieneusi in raw vegetables and fruits: implications for food safety and public health in Mozambique

“…In southern Africa, some of the few studies on these two pathogenic microorganisms were also performed in water (Dalu et al, 2011;Mtapuri-Zinyowera et al, 2014;Archer et al, 2020;Siwila et al, 2020). Globally, the occurrence of protozoan parasitic contamination in vegetables and fruits ranges from 1.9 to 9.3% (Li et al, 2019a).…”

Towards global control of parasitic diseases in the Covid-19 era: One Health and the future of multisectoral global health governance

“…( Ung et al, 2019 ), giardiasis ( Coelho et al, 2017 ), loiasis ( Zouré et al, 2011 ), and toxocariasis ( Hotez and Wilkins, 2009 ). Compelling arguments could certainly be made for infections that often co-exist with existing NTDs, such as waterborne giardia and schistosome infections ( Archer et al, 2020 ), and the major filarial nematode infections loiasis, lymphatic filariasis, and onchocerciasis ( Cano et al, 2018 ). The costs of suspended global malaria and NTD programmes will therefore have consequences that stretch far beyond the control of parasitic infections themselves, with significant implications for where, when, and how future elimination efforts might be conducted.…”