Tailoring Water, Sanitation, and Hygiene (WASH) Targets for Soil-Transmitted Helminthiasis and Schistosomiasis Control

Campbell, Suzy J.; Biritwum, Nana‐Kwadwo; Woods, Geordie; Velleman, Yael; Fleming, Fiona; Stothard, J. Russell

doi:10.1016/j.pt.2017.09.004

Cited by 69 publications

(69 citation statements)

References 36 publications

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“…From recent surveys of adult shermen who have urogenital schistosomiasis, making speci c reference to male genital schistosomiasis, co-infection with S. mansoni has been noted alongside re-infections within a calendar year [20,21]. To augment MDA and communityaccess to praziquantel, it is important to strengthen health education and outreach with suitable water, sanitation and hygiene (WASH) interventions [20,22], better appropriate to this lakeshore setting, noting that even focal application of molluscicides is inappropriate [17], given this lake's global importance in biodiversity.…”

Section: Discussionmentioning

confidence: 99%

An outbreak of intestinal schistosomiasis, alongside increasing urogenital schistosomiasis prevalence, in primary school children on the shoreline of Lake Malawi, Mangochi District, Malawi

Kayuni

O’Ferrall

Baxter

et al. 2020

Preprint

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Background: Intestinal schistosomiasis was not considered endemic in Lake Malawi until November 2017 when populations of Biomphalaria pfeifferi were first reported; in May 2018, emergence of intestinal schistosomiasis was confirmed. This emergence was in spite of ongoing control of urogenital schistosomiasis by preventive chemotherapy. Our current study sought to ascertain whether intestinal schistosomiasis is transitioning from emergence to outbreak, to judge if stepped-up control interventions are needed.Methods: During late-May 2019, three cross-sectional surveys of primary school children for schistosomiasis were conducted using a combination of rapid diagnostic tests, parasitological examinations and applied morbidity-markers; 1) schistosomiasis dynamics were assessed at Samama (n = 80) and Mchoka (n = 80) schools, where Schistosoma mansoni was first reported, 2) occurrence of S. mansoni was investigated at two non-sampled schools, Mangochi Orphan Education and Training (MOET) (n = 60) and Koche (n = 60) schools, where B. pfeifferi was nearby, and 3) rapid mapping of schistosomiasis, and B. pfeifferi, conducted across a further 8 shoreline schools (n = 240). After data collection, univariate analyses and Chi-square testing were performed, followed by binary logistic regression using generalized linear models, to investigate epidemiological associations.Results: In total, 520 children from 12 lakeshore primary schools were examined, mean prevalence of S. mansoni by ‘positive’ urine circulating cathodic antigen (CCA)-dipsticks was 31.5% (95% Confidence Interval (CI): 27.5–35.5). Upon comparisons of infection prevalence in May 2018, significant increases at Samama (Relative Risk (RR) = 1.7, 95% CI: 1.4–2.2) and Mchoka (RR = 2.7, 95% CI: 1.7–4.3) schools were observed. Intestinal schistosomiasis was confirmed at MOET (18.3%) and Koche (35.0%) schools, and in all rapid mapping schools, ranging from 10.0% to 56.7%. Several populations of B. pfeifferi were confirmed, with two new eastern shoreline locations noted. Mean prevalence of urogenital schistosomiasis was 24.0% (95% CI: 20.3–27.7). Conclusions: We notify that intestinal schistosomiasis, once considered non-endemic in Lake Malawi, is now transitioning from emergence to outbreak. Once control interventions can resume after coronavirus disease 2019 (COVID-19) suspensions, we recommend stepped-up preventive chemotherapy, with increased community-access to treatments, alongside renewed efforts in appropriate environmental control.

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Section: Discussionmentioning

confidence: 99%

An outbreak of intestinal schistosomiasis, alongside increasing urogenital schistosomiasis prevalence, in primary school children on the shoreline of Lake Malawi, Mangochi District, Malawi

Kayuni

O’Ferrall

Baxter

et al. 2020

Preprint

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“…WASH infrastructure and behavior are key for the control of water-borne and water-related diseases including NTDs, and are critical for schistosomiasis control and elimination efforts [ 66 ]. The WHO, in 2019, published a “how-to”-guide that offers practical advice for NTD programs interested in establishing ties with the WASH sector [ 67 ].…”

Section: Resultsmentioning

confidence: 99%

“…Hardware-based solutions have shown limited impact on the local epidemiology of schistosomiasis unless they are accompanied by sustained changes in water contact behaviors [ 12 , 68 ]. Monitoring of integrated WASH/NTD implementation and generating evidence on the impact of strategies need to be enforced in view of long term investment and sustainability [ 66 ].…”

Section: Resultsmentioning

confidence: 99%

“…The rationale for integrated schistosomiasis control and elimination efforts to advance towards interruption of transmission as opposed to the current approach, mainly relying on MDA for elimination of schistosomiasis as a public health problem, has been discussed repeatedly for non-African settings [ 11 , 21 , 24 , 36 , 38 , 55 , 63 , 90 , 115 , 116 ], but also with reference to Nigeria [ 75 ], Zanzibar [ 117 ] and Egypt [ 105 ]. Low acceptance of MDA, vector control or WASH interventions [ 103 , 116 ] as well as insufficient resources, weak health systems and lack of coordination are a reality in many programs [ 11 , 21 , 38 , 55 , 63 , 66 , 95 , 97 , 115 , 116 ]. Impact modeling studies have shown that strategies combining different interventions are more likely to result in successful disease control and elimination [ 64 , 65 ].…”

Section: Resultsmentioning

confidence: 99%

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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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“…Reports by the World Health Organization indicated 20.7% global coverage of mass PZQ administration in 2014 [14]. Other control measures such as intermediate snail host control, water, sanitation and hygiene (WaSH) programs have also had very little impact [15]. Despite this massive and concerted efforts, active transmission of schistosomiasis are now being reported in geographical areas formerly known to be free of schistosomiasis [16].…”

Section: Introductionmentioning

confidence: 99%

Schistosomiasis vaccine development: update on human clinical trials

Molehin

2020

J Biomed Sci

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Schistosomiasis causes significant levels of morbidity and mortality in many geographical regions of the world. The disease is caused by infections with parasitic blood flukes known as schistosomes. The control of schistosomiasis over the last several decades has been centered on the mass drug administration (MDA) of praziquantel (PZQ), which is the only drug currently available for treatment. Despite the concerted efforts of MDA programs, the prevalence and transmission of schistosomiasis has remained largely unchecked due to the fact that PZQ is ineffective against juvenile schistosomes, does not prevent re-infection and the emergence of PZQ-resistant parasites. In addition, other measures such as the water, sanitation and hygiene programs and snail intermediate hosts control have had little to no impact. These drawbacks indicate that the current control strategies are severely inadequate at interrupting transmission and therefore, implementation of other control strategies are required. Ideally, an efficient vaccine is what is needed for long term protection thereby eliminating the current efforts of repeated mass drug administration. However, the general consensus in the field is that the integration of a viable vaccine with MDA and other control measures offer the best chance of achieving the goal of schistosomiasis elimination. This review focuses on the present status of schistosomiasis vaccine candidates in different phases of human clinical trials and provide some insight into future vaccine discovery and design.

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Tailoring Water, Sanitation, and Hygiene (WASH) Targets for Soil-Transmitted Helminthiasis and Schistosomiasis Control

Cited by 69 publications

References 36 publications

An outbreak of intestinal schistosomiasis, alongside increasing urogenital schistosomiasis prevalence, in primary school children on the shoreline of Lake Malawi, Mangochi District, Malawi

An outbreak of intestinal schistosomiasis, alongside increasing urogenital schistosomiasis prevalence, in primary school children on the shoreline of Lake Malawi, Mangochi District, Malawi

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

Schistosomiasis vaccine development: update on human clinical trials

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