Mass drug administration and the global control of schistosomiasis: successes, limitations and clinical outcomes

Olveda, David U.; McManus, Donald P.; Ross, Allen G.

doi:10.1097/qco.0000000000000312

Cited by 39 publications

(47 citation statements)

References 80 publications

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“…However, it is almost impossible to achieve schistosomiasis elimination depending on mass drug administration (MDA) with praziquantel alone, which remains the primary strategy for schistosomiasis control until now [89–91]. Currently, China is aiding the elimination of schistosomiasis from mainland Africa [92, 93].…”

Section: Discussionmentioning

confidence: 99%

Approaches being used in the national schistosomiasis elimination programme in China: a review

Wang

Hong

et al. 2017

Infect Dis Poverty

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Schistosomiasis japonica, caused by the human blood fluke Schistosoma japonicum, remains a major public health problem in China, although great success has been achieved. The control efforts during the past half-decade, notably the wide implementation of the new integrated strategy with emphasis on control of the source of S. japonicum infection across the country since 2004, has greatly reduced S. japonicum in humans, livestock, and intermediate host Oncomelania hupensis snails, and transmission control of schistosomiasis was achieved in China in 2015. A two-stage roadmap was therefore proposed for schistosomiasis elimination in 2015, with aims to achieve transmission interruption by 2020 and achieve disease elimination by 2025 in the country. During the last two decades, a variety of approaches, which target the epidemiological factors of schistosomiasis japonica have been developed, in order to block the transmission cycle of the parasite. These approaches have been employed in the national or local schistosomiasis control activities, and facilitated, at least in part, the progress of the schistosomiasis elimination programs. Here, we present an approach to control the source of S. japonicum infection, three new tools for snail control, three approaches for detecting and monitoring S. japonicum infection, and a novel model for health education. These approaches are considered to play a great role in the stage moving towards transmission interruption and elimination of schistosomiasis in China.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-017-0271-9) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Approaches being used in the national schistosomiasis elimination programme in China: a review

Wang

Hong

et al. 2017

Infect Dis Poverty

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“…Periodic mass treatment of communities with praziquantel is the most widely used approach to control schistosomiasis [9] with numerous gains reported [10, 11]. Although effective, it does have its drawbacks.…”

Section: Introductionmentioning

confidence: 99%

“…Since praziquantel does not prevent re-infection, the treatment must be provided repeatedly on a regular basis and the side effects can be unpleasant [15]. Due to these drawbacks and other factors such as poor drug coverage and poor drug compliance, control of schistosomiasis by mass treatment with praziquantel has not been consistent in the long-term [11, 16]. Therefore, effective long-term control of schistosomiasis by praziquantel mass treatment will rely on modifying the other components that facilitate infection transmission [17].…”

Section: Introductionmentioning

confidence: 99%

Perceptions about interventions to control schistosomiasis among the Lake Victoria island communities of Koome, Uganda

et al. 2017

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BackgroundPraziquantel-based mass treatment is the main approach to controlling schistosomiasis mansoni in endemic areas. Interventions such as provision and use of safe water, minimising contact with infested water, disposal of stool in latrines and snail control provide key avenues to break the transmission cycle and can sustain the benefits of mass treatment in the long term. Efforts are also being made to develop a schistosomiasis vaccine which, if effective, might reduce the incidence of re-infection after treatment. However, any interventions deployed need to be acceptable to, and sustainable by, the target communities.MethodsIn this qualitative study, we investigated the perceptions of six Lake Victoria island communities of Koome, Uganda, about interventions to control Schistosoma mansoni infection and their willingness to participate in Schistosoma vaccine trials. Thirty-two in-depth interviews, 12 key informant interviews and 10 focus group discussions were conducted. Data were analysed using a thematic content approach.FindingsIntestinal schistosomiasis was not regarded as a serious health problem because a mass treatment programme is in place. However, the communities lack safe water sources and latrines. Mass treatment with praziquantel, safe water supplies and use of toilets were deemed the most acceptable interventions by the participants. The communities are willing to participate in Schistosoma vaccine trials.Conclusion/SignificanceKnowledge of a community’s perception about interventions to control schistosomiasis can be valuable to policy makers and programme implementers intending to set up interventions co-managed by the community members. In this study, the views of the Lake Victoria island communities of Koome are presented. This study also provides data to guide further work on alternative interventions such as Schistosoma vaccine trials in these communities.

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“…Efforts to control schistosomiasis in endemic areas have largely been based on mass drug administration (MDA) of praziquantel (PZQ), control of intermediate snail host populations and improved sanitation. Although these control strategies have shown some promise in certain areas, evident limitations such as sustained reinfection rates, emergence of drug‐resistant parasites, and a lack of adequate infrastructure, necessitate the development of a schistosomiasis vaccine to supplement (or even supplant) existing control strategies . Additionally, PZQ is nonprophylactic and only effective against adult parasites; repeated treatments are therefore required to alleviate the burden of schistosomiasis in endemic areas …”

Section: Introductionmentioning

confidence: 99%

Sm‐p80‐based vaccine trial in baboons: efficacy when mimicking natural conditions of chronic disease, praziquantel therapy, immunization, and Schistosoma mansoni re‐encounter

Siddiqui

Molehin

Zhang

et al. 2018

Annals of the New York Academy of Sciences

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Sm-p80-based vaccine efficacy for Schistosoma mansoni was evaluated in a baboon model of infection and disease. The study was designed to replicate a human vaccine implementation scenario for endemic regions in which vaccine would be administered following drug treatment of infected individuals. In our study, the Sm-p80-based vaccine reduced principal pathology producing hepatic egg burdens by 38.0% and egg load in small and large intestines by 72.2% and 49.4%, respectively, in baboons. Notably, hatching rates of eggs recovered from liver and small and large intestine of vaccinated animals were significantly reduced, by 60.4%, 48.6%, and 82.3%, respectively. Observed reduction in egg maturation/hatching rates was supported by immunofluorescence and confocal microscopy showing unique differences in Sm-p80 expression in worms of both sexes and matured eggs. Vaccinated baboons had a 64.5% reduction in urine schistosome circulating anodic antigen, a parameter that reflects worm numbers/health status in infected hosts. Preliminary analyses of RNA sequencing revealed unique genes and canonical pathways associated with establishment of chronic disease, praziquantel-mediated parasite killing, and Sm-p80-mediated protection in vaccinated baboons. Overall, our study demonstrated efficacy of the Sm-p80 vaccine and provides insight into some of the epistatic interactions associated with protection.

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Mass drug administration and the global control of schistosomiasis: successes, limitations and clinical outcomes

Abstract: Preventive chemotherapy is advocated for the global control and elimination of schistosomiasis. The short-term benefits of MDA campaigns are well documented but the long-term benefits are questionable.

Cited by 39 publications

References 80 publications

Approaches being used in the national schistosomiasis elimination programme in China: a review

Approaches being used in the national schistosomiasis elimination programme in China: a review

Perceptions about interventions to control schistosomiasis among the Lake Victoria island communities of Koome, Uganda

Sm‐p80‐based vaccine trial in baboons: efficacy when mimicking natural conditions of chronic disease, praziquantel therapy, immunization, and Schistosoma mansoni re‐encounter

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