Paediatric schistosomiasis: What we know and what we need to know

Abstract

Schistosomiasis affects over 200 million people worldwide, most of whom are children. Research and control strategies directed at preschool-aged children (PSAC), i.e., ≤5 years old, have lagged behind those in older children and adults. With the recent WHO revision of the schistosomiasis treatment guidelines to include PSAC, and the recognition of gaps in our current knowledge on the disease and its treatment in this age group, there is now a concerted effort to address these shortcomings. Global and national schistosome control strategies are yet to include PSAC in treatment schedules. Maximum impact of schistosome treatment programmes will be realised through effective treatment of PSAC. In this review, we (i) discuss the current knowledge on the dynamics and consequences of paediatric schistosomiasis and (ii) identify knowledge and policy gaps relevant to these areas and to the successful control of schistosome infection and disease in this age group. Herein, we highlight risk factors, immune mechanisms, pathology, and optimal timing for screening, diagnosis, and treatment of paediatric schistosomiasis. We also discuss the tools required for treating schistosomiasis in PSAC and strategies for accessing them for treatment.

Mapping the Process and the Resources that are Needed to Implement A Praziquantel Mass Drug Administration Program for Children Aged Five Years Old and Below in Resource Limited Settings.

“…Forti ed has the advantage of providing multi-nutrients to children [53] thereby addressing the needs of the schistosomiasis control MDA program for children aged ve years old and below and also tackling the challenge of malnutrition [54]. Schistosomiasis and childhood often exist as co-epidemics [18,54]. The studies reported using either pestle and mortar or spoons to crush the PZQ tablets.…”

“…Numerous challenges associated with treating schistosomiasis in children aged ve years and below have been reported [12]. The PZQ tablet is bitter and di cult to swallow for young children because of its size [18]. The healthcare systems in some of the areas affected by schistosomiasis cannot afford to purchase or maintain scales [18].…”

“…The PZQ tablet is bitter and di cult to swallow for young children because of its size [18]. The healthcare systems in some of the areas affected by schistosomiasis cannot afford to purchase or maintain scales [18]. In the absence of scales, WHO recommends the use of height based dose poles to determine PZQ doses [19].…”

Association of Schistosoma haematobium Infection Morbidity and Severity on Co-infections status in Pre-school Age Children Living in a Rural Endemic Area in Zimbabwe

“…To date, however, little focus has been given to preschool age children (PSAC), who were regarded as a low risk group. However, recent studies suggest that they may have similar risk to adults (11). The prevalence and relationship of schistosomiasis to coinfections in PSAC has not yet been described.…”

Gender Related Differences in Infection Intensity, Prevalence and Risk of Schistosoma Mansoni and Schistosoma Haematobium: A Systematic Review Protocol

“…The newly drafted World Health Organization (WHO) NTD roadmap for 2021-2030 outlines achieving elimination as a public health problem for schistosomiasis and aims to attain this by extending treatment to all in need [9]. Recently, emphasis has been placed on gender equity and advocating for expanded treatment beyond school aged children (SAC; 5-14 years old) to often overlooked age groups (pre-SAC and adults) [7,[10][11][12]. However, little is known about the distribution of prevalence and intensity of schistosomiasis by sex, and what this means for treatment programmes.…”