Schistosomiasis in Africa: Improving strategies for long-term and sustainable morbidity control

French, Michael; Evans, Darin; Fleming, Fiona; Secor, W. Evan; Biritwum, Nana Kwadwo; Brooker, Simon; Bustinduy, Amaya L.; Gouvras, Anouk N.; Kabatereine, Narcis B.; King, Charles H.; Polo, Maria Rebollo; Reinhard-Rupp, Jutta; Rollinson, David; Tchuenté, L. A. Tchuem; Utzinger, Jürg; Waltz, Johannes; Zhang, Yaobi

doi:10.1371/journal.pntd.0006484

Cited by 45 publications

(40 citation statements)

References 8 publications

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“…We and others maintain that elimination of schistosomiasis in sub-Saharan Africa is an unachievable goal using school-based praziquantel MDA alone, and a better use of current resources there would result in more effective control of schistosomiasis morbidity [ 36 ]. Interruption of transmission will only be possible with the introduction of additional control measures.…”

Section: What Is the Way Forward?mentioning

confidence: 99%

When Should the Emphasis on Schistosomiasis Control Move to Elimination?

Secor

Colley

2018

TropicalMed

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The stated goal of the World Health Organization’s program on schistosomiasis is paraphrased as follows: to control morbidity and eliminate transmission where feasible. Switching from a goal of controlling morbidity to interrupting transmission may well be currently feasible in some countries in the Caribbean, some areas in South America, northern Africa, and selected endemic areas in sub-Saharan Africa where there have been improvements in sanitation and access to clean water. However, in most of sub-Saharan Africa, where programmatic interventions still consist solely of annual mass drug administration, such a switch in strategies remains premature. There is a continued need for operational research on how best to reduce transmission to a point where interruption of transmission may be achievable. The level of infection at which it is feasible to transition from control to elimination must also be defined. In parallel, there is also a need to develop and evaluate approaches for achieving and validating elimination. There are currently neither evidence-based methods nor tools for breaking transmission or verifying that it has been accomplished. The basis for these statements stems from numerous studies that will be reviewed and summarized in this article; many, but not all of which were undertaken as part of SCORE, the Schistosomiasis Consortium for Operational Research and Evaluation.

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Section: What Is the Way Forward?mentioning

confidence: 99%

When Should the Emphasis on Schistosomiasis Control Move to Elimination?

Secor

Colley

2018

TropicalMed

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“…The control of morbidity due to schistosomiasis and its eventual elimination has been the focus of multiple World Health Assembly (WHA) resolutions (e.g., WHA 54.19, WHA 65.21, and WHA 66.12) [1][2][3][4][5][6] and is being pursued by many neglected tropical disease (NTD) national programs in Africa, Asia, the Middle East, and South America. The standard approach used by most programs is preventive chemotherapy by mass drug administration (MDA) 7 using the antischistosomal drug praziquantel (PZQ).…”

Section: Introductionmentioning

confidence: 99%

Persistent Hotspots in Schistosomiasis Consortium for Operational Research and Evaluation Studies for Gaining and Sustaining Control of Schistosomiasis after Four Years of Mass Drug Administration of Praziquantel

Kittur

King

Campbell

et al. 2019

The American Journal of Tropical Medicine and Hygiene

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Control of schistosomiasis presently relies largely on preventive chemotherapy with praziquantel through mass drug administration (MDA) programs. The Schistosomiasis Consortium for Operational Research and Evaluation has concluded five studies in four countries (Côte d'Ivoire, Kenya, Mozambique, and Tanzania) to evaluate alternative approaches to MDA. Studies involved four intervention years, with final evaluation in the fifth year. Mass drug administration given annually or twice over 4 years reduced average prevalence and intensity of schistosome infections, but not all villages that were treated in the same way responded similarly. There are multiple ways by which responsiveness to MDA, or the lack thereof, could be measured. In the analyses presented here, we defined persistent hotspots (PHS) as villages that achieved less than 35% reduction in prevalence and/or less than 50% reduction in infection intensity after 4 years of either school-based or community-wide MDA, either annually or twice in 4 years. By this definition, at least 30% of villages in each of the five studies were PHSs. We found no consistent relationship between PHSs and the type or frequency of intervention, adequacy of reported MDA coverage, and prevalence or intensity of infection at baseline. New research is warranted to identify PHSs after just one or a few rounds of MDA, and new adaptive strategies need to be advanced and validated for turning PHSs into responder villages.

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“…One hundred and twenty three million (123 M) of people affected by schistosomiasis are children [4] and among them 23 million are below the age of 6 years. Ninety percent (90%) of the cases of schistosomiasis are found in Sub-Saharan Africa [5,6]. Children infected with schistosomes at the age of ve years and below may have compromised development manifesting as stunted growth, lethargy, cognitive and memory impairment [7].…”

Section: Introductionmentioning

confidence: 99%

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.

Ncube

Kabuyaya

Chimbari

2020

Preprint

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Background The early childhood development of millions of children in some low and medium income countries may be compromised by schistosomiasis infections contracted at the age of 5 years or below. Currently there are no standard guidelines for treating schistosomiasis in children that are five years and younger using praziquantel (PZQ), the only drug that the WHO recommends to treat schistosomiasis. This review is on processes and resources involved in the treatment of schistosomiasis in children aged five years and below. Methods An electronic search for peer-reviewed articles published in the period from 2008 to 2018 (August) was done in the Academic Search Complete, CINAHL with Full Text, Health Source: Nursing/Academic Edition, and MEDLINE databases via EBSCOHost and Google Scholar databases. The search targeted journals that described the treatment of schistosomiasis in children five years and below using praziquantel. Results Twelve studies met the inclusion criteria. The process of treating schistosomiasis in the children aged five years old and below included the following activities: enrolment of the children into the treatment program; clinical examination; diagnosis; taking anthropometric measurements; feeding the children, making the PZQ palatable to the children; administration of PZQ and monitoring of side effects. There was also a variation in the resources used to treat children aged five- and below for schistosomiasis. Conclusions A PZQ mass drug administration program for children aged five years old and below in endemic areas should exclude diagnosis of schistosomiasis before treatment. The resources required in the treatment process should be affordable, should not require skills and maintenance resources that are beyond those that are available at primary healthcare level.

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Schistosomiasis in Africa: Improving strategies for long-term and sustainable morbidity control

Cited by 45 publications

References 8 publications

When Should the Emphasis on Schistosomiasis Control Move to Elimination?

When Should the Emphasis on Schistosomiasis Control Move to Elimination?

Persistent Hotspots in Schistosomiasis Consortium for Operational Research and Evaluation Studies for Gaining and Sustaining Control of Schistosomiasis after Four Years of Mass Drug Administration of Praziquantel

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.

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