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Qi YX, Huang MR, Sun HY, Wu XY, Liu ZT, Lu DB. Prevalence of depressive symptoms in patients with advanced schistosomiasis in China: A systematic review and meta-analysis. PLoS Negl Trop Dis 2024; 18:e0012003. [PMID: 38452104 PMCID: PMC10950241 DOI: 10.1371/journal.pntd.0012003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 03/19/2024] [Accepted: 02/16/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Advanced schistosomiasis is the most serious outcome of infection and has a negative impact on both physical fitness and mental health of patients, the latter of which has long been overlooked. Therefore, we performed this systematic review and meta-analysis to estimate the overall prevalence of depressive symptoms, one of the most common mental problems, in patients with advanced schistosomiasis in China. METHODS Six electronic databases were searched for studies reporting the prevalence of depressive symptoms in the targeted patients. Assessments were pooled using a fixed- or random-effects model based on heterogeneity test. Subgroup analyses were further performed and differences between/among groups were examined using the chi-squared test. The protocol had previously been registered in PROSPERO (CRD42023406708). RESULTS A total of 11 studies with 1,673 participants were included. The pooled prevalence of depressive symptoms in advanced schistosomiasis in China was 62.01% (95% CI: 51.30% - 72.72%), with a significant heterogeneity among studies. Depressive symptoms were more prevalent in patients with complications and more than half of the patients suffered a mild- or moderate-level of depression. No publication bias was found, and sensitivity analysis showed a stable result. CONCLUSIONS The overall prevalence of depressive symptoms in advanced schistosomiasis in China was high enough to warrant psychotherapeutic interventions, especially for patients with complications. This would greatly prevent or/and reduce depression and improve their quality of life.
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Affiliation(s)
- Yu-Xin Qi
- Department of Epidemiology and Statistics, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, People’s Republic of China
| | - Meng-Rui Huang
- Department of Epidemiology and Statistics, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, People’s Republic of China
| | - Hui-Ying Sun
- Department of Epidemiology and Statistics, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, People’s Republic of China
| | - Xiao-Yan Wu
- Department of Epidemiology and Statistics, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, People’s Republic of China
| | - Ze-Ting Liu
- Department of Epidemiology and Statistics, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, People’s Republic of China
| | - Da-Bing Lu
- Department of Epidemiology and Statistics, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, People’s Republic of China
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Lubanga AF, Bwanali AN, Munthali LE, Mphepo M, Chumbi GD, Kangoma M, Matola Y, Kaonga B, Moyo CS. Exploring the Role of Community Involvement in Reducing the Burden of Schistosomiasis and Other Neglected Tropical Diseases in Malawi: Where are We in the Fight Against Neglected Tropical Diseases? Res Rep Trop Med 2024; 15:51-58. [PMID: 38435085 PMCID: PMC10909323 DOI: 10.2147/rrtm.s448425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 02/24/2024] [Indexed: 03/05/2024] Open
Abstract
Schistosomiasis has been endemic in Malawi since 1947. Despite the longevity of endemicity of the disease, it still maintains a high burden in Malawi. This could be attributed to insufficient coverage of preventive and therapeutic mass drug administration (MDA) which mainly targets school-aged children, leaving out adults who also bear a high burden of the disease. Additionally, despite well documented impact of community involvement in boosting up the effectiveness of health programmes, there is minimal community involvement in schistosomiasis control and prevention programmes. Therefore, this perspective seeks to discuss the historical background of schistosomiasis in Malawi, gaps in community engagement and participation and suggest ways of enhancing the role of the community in prevention and control programmes. Amongst other challenges, the control programmes are centralised, leading to minimal input at the district and community level as well as low awareness of schistosomiasis control and prevention methods at the community level. It is of utmost significance therefore to provide comprehensive schistosomiasis health education to the communities and devise a thorough outline of the specific roles and responsibilities of all stakeholders including community members in the fight against schistosomiasis and other neglected tropical diseases.
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Affiliation(s)
- Adriano Focus Lubanga
- Education and Research, Clinical Research Education and Management Services Ltd (CREAMS), Lilongwe, Malawi
- Department of Clinical Services, Kamuzu Central Hospital, Lilongwe, Malawi
| | - Akim Nelson Bwanali
- Education and Research, Clinical Research Education and Management Services Ltd (CREAMS), Lilongwe, Malawi
- Department of Clinical Services, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | | | - Mzati Mphepo
- Department of Clinical Services, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | | | - Melina Kangoma
- Department of Clinical Services, Kamuzu Central Hospital, Lilongwe, Malawi
| | - Yankho Matola
- Department of Clinical Services, Kamuzu Central Hospital, Lilongwe, Malawi
| | - Byenala Kaonga
- Department of Clinical Services, Kamuzu Central Hospital, Lilongwe, Malawi
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Gichuki PM, Kibe L, Mwatele C, Mwangangi J, Mbogo CM. Towards an integrated vector management approach for sustainable control of schistosomiasis and malaria in Mwea, Kirinyaga County, Kenya: Baseline epidemiological and vector results. Heliyon 2023; 9:e20966. [PMID: 37876477 PMCID: PMC10590948 DOI: 10.1016/j.heliyon.2023.e20966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 10/12/2023] [Accepted: 10/12/2023] [Indexed: 10/26/2023] Open
Abstract
Background Vector control is an important approach in the control of most parasitic and vector-borne diseases including malaria, and schistosomiasis. Distribution of these two infections often overlaps and in such areas it's more economically viable to employ an integrated approach in the control of their vectors which largely shares the same breeding ecosystem. We carried out a baseline epidemiological and vector surveys for malaria and schistosomiasis in Mwea, Kirinyaga County, in preparation for the upscaling of integrated vector management (IVM) for the two diseases. Methods This was a repeated cross sectional survey, where mosquito and snails were sampled during dry and wet seasons in three different ecological zones, Kiamaciri, Thiba and Murinduko to identify possible breeding sites. Mosquito larvae were collected using standard dippers, adults using CDC miniature light traps while snail vectors were sampled using standard snail scoops in different breeding habitats. A total of 1200 pupils from 12 primary schools were tested for malaria using rapid diagnostic tests (Malaria Pf/PAN Ag combo). Stool samples were processed using the Kato Katz technique for intestinal schistosomiasis. Results The overall prevalence of intestinal schistosomiasis was 9.08 % (95 % CI: 07.00-11.00), with Kiamaciri zone recording the highest prevalence at 19 % (95%CI: 15.00-23.00) and Murinduko zone the least at 0.17 % (95%CI: 0.00-0.01). Majority of the infections were of light intensity 78.9 % (95%CI: 70.04-86.13). There was no positive malaria case detected in this study. Of the 3208 adult mosquitoes sampled during the dry season, 20.6 % (95 % CI: 19.25-22.08) were Anopheles gambiae s.l while 79.4 % (95 % CI: 77.92-80.75) were culicines. During the wet season, 3378 adult mosquitoes were collected, of which 14.7 % (95 % CI: 13.56-15.98) were Anopheles gambiae s.l and 85.3 % (95 % CI: 84.02-86.44) culicines. Overall, 4085 mosquito larvae were collected during the two seasons, of which, 57.3 % and 42.7 % were anopheles and culicine respectively. Majority of the larvae (85.1 % (95%CI: 84.01-86.10) were collected during the wet season, with only 14.9 % (95%CI: 14.10-16.00) being collected during the dry season. A total of 2292 fresh water vector snails were collected with a majority (69.6 % (95%CI: 68.00-71.10) being Biomphalaria pffeiferi responsible for transmission of intestinal schistosomiasis. Conclusion This study demonstrates that intestinal schistosomiasis is prevalent in Kiamaciri and Thiba zones, and points to the possibility of active transmission of schistosomiasis in Murinduko zone. Malaria vectors were predominantly observed in all sites despite there being no malaria positive case. Culex quinquefaciatus responsible for the spread of several arboviruses was also observed. The presence of these vectors may lead to future disease outbreaks in the area if concerted control initiatives are not undertaken. The disease vectors shared the same breeding sites and thus its economical and feasible to adopt an integrated vector management approach in control efforts for these disease in the study area.
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Affiliation(s)
- Paul M. Gichuki
- Kenya Medical Research Institute (KEMRI), Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Nairobi, P.O BOX 54840-00200 Nairobi, Kenya
- School of Health Sciences, Meru University of Science and Technology, P.O BOX 972-60200 Meru, Kenya
| | - Lydia Kibe
- Kenya Medical Research Institute (KEMRI), Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Nairobi, P.O BOX 54840-00200 Nairobi, Kenya
| | - Cassian Mwatele
- Kenya Medical Research Institute (KEMRI), Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Nairobi, P.O BOX 54840-00200 Nairobi, Kenya
| | - Joseph Mwangangi
- KEMRI-Wellcome Trust Research Programme, Public Health Unit, PO Box 43640 - 00100, Nairobi, Kenya
- Kenya Medical Research Institute (KEMRI), Centre for Geographical Medicine Research-Coast (CGMR-C). P.O Box 230- 80108 Kilifi, Kenya
| | - Charles M. Mbogo
- Kenya Medical Research Institute (KEMRI), Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Nairobi, P.O BOX 54840-00200 Nairobi, Kenya
- KEMRI-Wellcome Trust Research Programme, Public Health Unit, PO Box 43640 - 00100, Nairobi, Kenya
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Nyangulu W, Sadimba C, Nyirenda J, Twaibu G, Kamwendo J, Chawawa K, Masano A, Chilinda E, Kayuni S, Muula AS, Maleta K. The prevalence of Schistosoma mansoni infection among adults with chronic non-communicable diseases in Malawi. Trop Med Health 2022; 50:56. [PMID: 35986382 PMCID: PMC9389769 DOI: 10.1186/s41182-022-00450-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/12/2022] [Indexed: 11/10/2022] Open
Abstract
Background Schistosomiasis is a parasitic infectious disease caused by flatworms of the Schistosoma genus. The global burden of schistosomiasis is high. In Malawi, schistosomiasis is among the top 20 causes of outpatient department visits in health facilities. Schistosomiasis is among the most important but neglected causes of non-communicable diseases (NCD) peculiar to tropical endemic settings. While much is known about the contribution of S. haematobium to the NCD burden in Malawi, the role of S. mansoni remains largely unknown.
Methods We conducted a cross-sectional study at Mangochi District Hospital. Adults over 18 years diagnosed with NCDs (n = 414), admitted or attending weekly outpatient clinics were recruited between August 2021 and February 2022. Data were collected on sociodemographic characteristics, medical history, body weight, blood pressure, and fasting blood glucose. Stool and midstream urine were collected for Kato–Katz (KK) microscopy and urine point of care-circulating cathodic antigen (POC-CCA) tests, respectively. We computed prevalence of S. mansoni as number of positive KK and CCA tests, each divided by total submitted samples. Univariate and multivariable logistic regression were done to evaluate risk factors of NCDs and association between S. mansoni infection and NCDs. Results We recruited 414 participants, mean age 57 years (SD 16), 67% of whom were female. Prevalence of S. mansoni based on urine CCA was 15% (95% CI: 11–19) and 0% on KK microscopy. Hypertension was the most common condition with a prevalence of 85% (95% CI: 81–89), followed by diabetes mellitus with a prevalence of 42% (95% CI: 37–46) and heart disease with a prevalence of 3% (95% CI: 2–5). S. mansoni infection was not significantly associated with hypertension (OR: 1.2, 95% CI: 0.5–3.1), diabetes (OR: 0.6, 95% CI: 0.3–1.10) or heart disease (OR: 2.0, 95% CI: 0.4–10). Conclusions We observed moderate prevalence of S. mansoni infection among adults in the study per WHO classification of endemicity. This is within the range observed in children in Mangochi from 10 to 56.7%. Supplementary Information The online version contains supplementary material available at 10.1186/s41182-022-00450-3.
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Guzman MA, Rugel A, Alwan SN, Tarpley R, Taylor AB, Chevalier FD, Wendt GR, Collins JJ, Anderson TJC, McHardy SF, LoVerde PT. Schistosome Sulfotransferases: Mode of Action, Expression and Localization. Pharmaceutics 2022; 14:1416. [PMID: 35890311 PMCID: PMC9323829 DOI: 10.3390/pharmaceutics14071416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 06/30/2022] [Accepted: 07/01/2022] [Indexed: 11/24/2022] Open
Abstract
Oxamniquine (OXA) is a prodrug activated by a sulfotransferase (SULT) that was only active against Schistosoma mansoni. We have reengineered OXA to be effective against S. haematobium and S. japonicum. Three derivatives stand out, CIDD-0066790, CIDD-0072229, and CIDD-0149830 as they kill all three major human schistosome species. However, questions remain. Is the OXA mode of action conserved in derivatives? RNA-interference experiments demonstrate that knockdown of the SmSULT, ShSULT, and SjSULT results in resistance to CIDD-0066790. Confirming that the OXA-derivative mode of action is conserved. Next is the level of expression of the schistosome SULTs in each species, as well as changes in SULT expression throughout development in S. mansoni. Using multiple tools, our data show that SmSULT has higher expression compared to ShSULT and SjSULT. Third, is the localization of SULT in the adult, multicellular eucaryotic schistosome species. We utilized fluorescence in situ hybridization and uptake of radiolabeled OXA to determine that multiple cell types throughout the adult schistosome worm express SULT. Thus, we hypothesize the ability of many cells to express the sulfotransferase accounts for the ability of the OXA derivatives to kill adult worms. Our studies demonstrate that the OXA derivatives are able to kill all three human schistosome species and thus will be a useful complement to PZQ.
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Affiliation(s)
- Meghan A. Guzman
- Department of Microbiology and Immunology, University of Texas Health, San Antonio, TX 78229, USA; (M.A.G.); (A.R.)
- Department of Biochemistry and Structural Biology, University of Texas Health, San Antonio, TX 78229, USA; (S.N.A.); (A.B.T.)
| | - Anastasia Rugel
- Department of Microbiology and Immunology, University of Texas Health, San Antonio, TX 78229, USA; (M.A.G.); (A.R.)
- Department of Biochemistry and Structural Biology, University of Texas Health, San Antonio, TX 78229, USA; (S.N.A.); (A.B.T.)
| | - Sevan N. Alwan
- Department of Biochemistry and Structural Biology, University of Texas Health, San Antonio, TX 78229, USA; (S.N.A.); (A.B.T.)
| | - Reid Tarpley
- Center for Innovative Drug Discovery, University of Texas at San Antonio, San Antonio, TX 78249, USA; (R.T.); (S.F.M.)
| | - Alexander B. Taylor
- Department of Biochemistry and Structural Biology, University of Texas Health, San Antonio, TX 78229, USA; (S.N.A.); (A.B.T.)
| | - Frédéric D. Chevalier
- Host Pathogen Interactions Program, Texas Biomedical Research Institute, San Antonio, TX 78227, USA;
| | - George R. Wendt
- Department of Pharmacology, UT Southwestern Medical Center, Dallas, TX 75390, USA; (G.R.W.); (J.J.C.III)
| | - James J. Collins
- Department of Pharmacology, UT Southwestern Medical Center, Dallas, TX 75390, USA; (G.R.W.); (J.J.C.III)
| | - Timothy J. C. Anderson
- Disease Intervention & Prevention, Texas Biomedical Research Institute, San Antonio, TX 78227, USA;
| | - Stanton F. McHardy
- Center for Innovative Drug Discovery, University of Texas at San Antonio, San Antonio, TX 78249, USA; (R.T.); (S.F.M.)
| | - Philip T. LoVerde
- Department of Biochemistry and Structural Biology, University of Texas Health, San Antonio, TX 78229, USA; (S.N.A.); (A.B.T.)
- Department of Pathology and Laboratory Medicine, University of Texas Health, San Antonio, TX 78229, USA
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Zhu H, Liu JB, Xiao Y, Tu ZW, Shan XW, Li B, Wu JL, Zhou XR, Sun LC, Xia J, Liu S, Huang XB. Efforts to eliminate schistosomiasis in Hubei province, China: 2005-2018. Acta Trop 2022; 231:106417. [PMID: 35318000 DOI: 10.1016/j.actatropica.2022.106417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 03/17/2022] [Accepted: 03/17/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND The Hubei province is one of the most schistosomiasis-epidemic-prone provinces in China. A series of strategies were adopted by the government to curb the rebound schistosomiasis endemic status that has prevailed since the early 2000s. This study aimed to elucidate the trends of schistosomiasis transmission and to appraise the effectiveness of the integrated control strategy in lake and marshland areas. METHODS Surveillance data of schistosomiasis in the Hubei province between 2005 and 2018 were analyzed, including conventional health control measures, integrated strategies, and measures that focused on the infection source. According to the local annual plan for schistosomiasis control in endemic counties, previous measures were human and snail control and surveillance. Residents aged 6-65 years were screened by an immunological detection method called indirect hemagglutination assay (IHA) after the transmission season each year. All residents who tested positive were then asked to provide a fecal sample for examination by the miracidium hatching technique (MHT) to detect the presence of schistosomes. Moreover, systematic snail surveys were conducted as a part of the combined environmental sampling method. The latter included integrated strategies and measures that focused on the infection source. Bovine stool samples were also collected and concurrently assessed using the MHT by the agriculture department, river-hardening slope protection was constructed by the water conservancy department, and forestation promotion was conducted by the forest department. The effectiveness of the integrated control strategy was assessed using two indicators of resident and livestock infection rates and three indicators of snail epidemics across all endemic areas. RESULTS From 2005 to 2018, a total of 28. 46 million and 2. 05 million residents were assessed by immunological (IHA) and etiological (MHT) detection techniques, respectively. Snail surveys and molluscicide application were performed in 2. 26 hectares and 0. 37 hectares, respectively. Moreover, 2. 60 million bovines were assessed by etiological detection techniques (MHT). The river-hardening slope protection project was implemented in 503 places, and 46 thousand hectares in endemic areas underwent environmental modification. Forestation was implemented at an area of 0. 15 million hectares. Between 2005 and 2018, the epidemic indicators, including resident and livestock infection rates and the infested areas and infection rate of snails, all presented downward trends. The resident infection rate decreased from 3. 78% in 2005 to 0% in 2016, which persisted through 2018. The livestock infection rate decreased from 5. 63% in 2005 to 0% in 2013, which also persisted through 2018. From 2005 to 2018, the snail-inhabited area was slightly reduced, but the area of infected snails decreased to 0 in 2012; this persisted through 2018. All counties met the goal for schistosomiasis infection control, transmission control, and disruption of schistosomiasis activity in 2008, 2013, and 2018 separately. That means the goal has been achieved in each stage. CONCLUSIONS The decline of the schistosomiasis epidemic rate demonstrates that the Chinese government was successful in meeting its public health goal in Hubei province. In the next decade, precision interventions must be implemented in endemic counties with a relatively low epidemic status to achieve the goals of the Outline of the Healthy China 2030 Plan. A similar strategy can be applied in other countries to eliminate schistosomiasis globally.
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Automated diagnosis of schistosomiasis by using faster R-CNN for egg detection in microscopy images prepared by the Kato–Katz technique. Neural Comput Appl 2022. [DOI: 10.1007/s00521-022-06924-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Bustinduy AL, Randriansolo B, Sturt AS, Kayuni SA, Leustcher PDC, Webster BL, Van Lieshout L, Stothard JR, Feldmeier H, Gyapong M. An update on female and male genital schistosomiasis and a call to integrate efforts to escalate diagnosis, treatment and awareness in endemic and non-endemic settings: The time is now. ADVANCES IN PARASITOLOGY 2022; 115:1-44. [PMID: 35249661 DOI: 10.1016/bs.apar.2021.12.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The last decades have brought important insight and updates in the diagnosis, management and immunopathology of female genital schistosomiasis (FGS) and male genital schistosomiasis (MGS). Despite sharing a common parasitic aetiological agent, FGS and MGS have typically been studied separately. Infection with Schistosoma haematobium manifests with gender-specific clinical manifestations and consequences of infection, albeit having a similar pathogenesis within the human genital tract. Schistosoma haematobium is a known urinary bladder carcinogen, but its potential causative role in other types of neoplasia, such as cervical cancer, is not fully understood. Furthermore, the impact of praziquantel treatment on clinical outcomes remains largely underexplored, as is the interplay of FGS/MGS with relevant reproductive tract infections such as HIV and Human Papillomavirus. In non-endemic settings, travel and immigrant health clinics need better guidance to correctly identify and treat FGS and MGS. Our review outlines the latest advances and remaining knowledge gaps in FGS and MGS research. We aim to pave a way forward to formulate more effective control measures and discuss elimination targets. With a growing community awareness in health practitioners, scientists and epidemiologists, alongside the sufferers from these diseases, we aspire to witness a new generation of young women and men free from the downstream disabling manifestations of disease.
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Affiliation(s)
- Amaya L Bustinduy
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, United Kingdom.
| | | | - Amy S Sturt
- Section of Infectious Diseases, Veterans Affairs Palo Alto Health Care System, Palo Alto, United States
| | - Seke A Kayuni
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom; MASM Medi Clinics Limited, Blantyre, Malawi
| | - Peter D C Leustcher
- Centre for Clinical Research, North Denmark Regional Hospital, Hjoerring, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | | | - Lisette Van Lieshout
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - J Russell Stothard
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Hermann Feldmeier
- Charité University Medicine Berlin, Institute of Microbiology, Infectious Diseases and Immunology, Berlin, Germany
| | - Margaret Gyapong
- Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
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Visclosky T, Hashikawa A, Kroner E. Discovery of a Hidden Schistosomiasis Endemic in the Salamat Region of Chad, Africa. GLOBAL HEALTH: SCIENCE AND PRACTICE 2022; 10:GHSP-D-20-00703. [PMID: 35294372 PMCID: PMC8885350 DOI: 10.9745/ghsp-d-20-00703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 01/05/2022] [Indexed: 11/15/2022]
Affiliation(s)
- Timothy Visclosky
- Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA.
| | - Andrew Hashikawa
- Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Eric Kroner
- The Evangelical Alliance Mission, Grapevine, TX, USA
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Nigo MM, Odermatt P, Salieb–Beugelaar GB, Morozov O, Battegay M, Hunziker PR. Epidemiology of Schistosoma mansoni infection in Ituri Province, north-eastern Democratic Republic of the Congo. PLoS Negl Trop Dis 2021; 15:e0009486. [PMID: 34855748 PMCID: PMC8638996 DOI: 10.1371/journal.pntd.0009486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 05/14/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Schistosomiasis, caused by Schistosoma mansoni, is of great significance to public health in sub-Saharan Africa. In the Democratic Republic of Congo (DRC), information on the burden of S. mansoni infection is scarce, which hinders the implementation of adequate control measures. We assessed the geographical distribution of S. mansoni infection across Ituri province in north-eastern DRC and determined the prevailing risk factors. METHODS/PRINCIPAL FINDINGS Two province-wide, community-based studies were conducted. In 2016, a geographical distribution study was carried out in 46 randomly selected villages across Ituri. In 2017, an in-depth study was conducted in 12 purposively-selected villages, across the province. Households were randomly selected, and members were enrolled. In 2016, one stool sample was collected per participant, while in 2017, several samples were collected per participant. S. mansoni eggs were detected using the Kato-Katz technique. In 2017, a point-of-care circulating cathodic S. mansoni antigen (POC-CCA) urine test was the second used diagnostic approach. Household and individual questionnaires were used to collect data on demographic, socioeconomic, environmental, behavioural and knowledge risk factors. Of the 2,131 participants in 2016, 40.0% were positive of S. mansoni infection. Infection prevalence in the villages ranged from 0 to 90.2%. Of the 707 participants in 2017, 73.1% were tested positive for S. mansoni. Prevalence ranged from 52.8 to 95.0% across the health districts visited. Infection prevalence increased from north to south and from west to east. Exposure to the waters of Lake Albert and the villages' altitude above sea level were associated with the distribution. Infection prevalence and intensity peaked in the age groups between 10 and 29 years. Preschool children were highly infected (62.3%). Key risk factors were poor housing structure (odds ratio [OR] 2.1, 95% 95% confidence interval [CI] 1.02-4.35), close proximity to water bodies (OR 1.72, 95% CI 1.1-2.49), long-term residence in a community (OR 1.41, 95% CI 1.11-1.79), lack of latrine in the household (OR 2.00, 95% CI 1.11-3.60), and swimming (OR 2.53, 95% CI 1.20-5.32) and washing (OR 1.75, 95% CI 1.10-2.78) in local water bodies. CONCLUSIONS/SIGNIFICANCE Our results show that S. mansoni is highly endemic and a major health concern in Ituri province, DRC. Infection prevalence and intensity, and the prevailing socioeconomic, environmental, and behavioural risk factors in Ituri reflect intense exposure and alarming transmission rates. A robust plan of action is urgently needed in the province.
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Affiliation(s)
- Maurice M. Nigo
- Nanomedicine Translation Group, Intensive Care Unit, University Hospital Basel, University of Basel, Basel, Switzerland
- CLINAM–European Foundation for Clinical Nanomedicine, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Institut Supérieur des Techniques Médicales (ISTM) Nyankunde, Bunia, Democratic Republic of Congo
| | - Peter Odermatt
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Georgette B. Salieb–Beugelaar
- Nanomedicine Translation Group, Intensive Care Unit, University Hospital Basel, University of Basel, Basel, Switzerland
- CLINAM–European Foundation for Clinical Nanomedicine, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Oleksii Morozov
- Nanomedicine Translation Group, Intensive Care Unit, University Hospital Basel, University of Basel, Basel, Switzerland
- CLINAM–European Foundation for Clinical Nanomedicine, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Manuel Battegay
- University of Basel, Basel, Switzerland
- Department of Infectiology & Hospital Hygiene, University Hospital Basel, Basel, Switzerland
| | - Patrick R. Hunziker
- Nanomedicine Translation Group, Intensive Care Unit, University Hospital Basel, University of Basel, Basel, Switzerland
- CLINAM–European Foundation for Clinical Nanomedicine, Basel, Switzerland
- University of Basel, Basel, Switzerland
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11
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Bisetegn H, Eshetu T, Erkihun Y. Prevalence of Schistosoma mansoni infection among children in Ethiopia: a systematic review and meta-analysis. Trop Dis Travel Med Vaccines 2021; 7:30. [PMID: 34847958 PMCID: PMC8638414 DOI: 10.1186/s40794-021-00156-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 09/07/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Schistosomiasis is a neglected tropical disease caused by mainly Schistosoma mansoni and Schistosoma hematobium. The disease is very common in Africa including Ethiopia. Schistosoma mansoni is a major public health problem in Ethiopia especially among children. This review is aimed to indicate the prevalence of Schistosoma mansoni among children at the national and regional levels. METHODS AND MATERIAL The PRISMA guidelines were followed. An electronic search of PubMed, Google Scholar, Web of Science, Scopus, MEDLINE, and Google search were carried out using key terms. Articles published from the proceeding of professional associations such as the Ethiopian medical laboratory association, the Ethiopian public health association, and annual national research conferences were also searched to find additional eligible studies. Data were extracted independently by two investigators, and cross-checked by a third reviewer. The quality of included studies was assessed using JBI quality assessment criteria. Data were extracted using Microsoft excel and finally analyzed using STATA version 12. The pooled prevalence was done using a random-effects model. RESULT Overall 49 studies involving 20,493 children (10,572 male and 9, 921 females) were included in this meta-analysis. The pooled prevalence of Schistosoma mansoni infection was 37.13% (95%CI:30.02-44.24). High heterogeneity was observed with I2 of 99.4%, P < 0.000. According to subgroup analysis, the pooled prevalence was high in the SNNPR (41.49%: 95%CI: 19.52-63.46) followed by the Amhara region (41.11%: 95%CI: 30.41-51.8), the Tigray region (31.40%: 95%CI:11.72-51.09), and the Oromia region (28.98%: 95%CI: 18.85-39.1). Year from 2011 to 2015 contributed to the highest prevalence of Schistosoma mansoni infection among children (46.31%: 95%:34.21-59.05). CONCLUSION This study revealed a 37.13% prevalence of Schistosoma mansoni infection among children. This is an alert to improve and implement appropriate control strategies such as mass drug administration in Ethiopia.
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Affiliation(s)
- Habtye Bisetegn
- College of Medicine and Health Sciences, Department of Medical Laboratory Sciences, Wollo University, Dessie, Ethiopia
| | - Tegegne Eshetu
- College of Medicine and Health Sciences, School of Biomedical and Laboratory Sciences, Department of Medical Parasitology, University of Gondar, Gondar, Ethiopia
| | - Yonas Erkihun
- College of Medicine and Health Sciences, Department of Medical Laboratory Sciences, Wollo University, Dessie, Ethiopia
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12
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Fusco D, Rakotozandrindrainy R, Rakotoarivelo RA, Andrianarivelo MR, Rakotozandrindrainy N, Rasamoelina T, Puradiredja DI, Klein P, Stahlberg K, Dechenaud M, Lorenz E, Jaeger A, Kreidenweiss A, Hoekstra PT, Adegnika AA, Sicuri E, Corstjens PLAM, van Dam GJ, May J, Schwarz NG. A cluster randomized controlled trial for assessing POC-CCA test based praziquantel treatment for schistosomiasis control in pregnant women and their young children: study protocol of the freeBILy clinical trial in Madagascar. Trials 2021; 22:822. [PMID: 34801082 PMCID: PMC8605548 DOI: 10.1186/s13063-021-05769-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 10/27/2021] [Indexed: 01/16/2023] Open
Abstract
Background Mass drug administration (MDA) of praziquantel is one of the main control measures against human schistosomiasis. Although there are claims for including pregnant women, infants and children under the age of 5 years in high-endemic regions in MDA campaigns, they are usually not treated without a diagnosis. Diagnostic tools identifying infections at the primary health care centre (PHCC) level could therefore help to integrate these vulnerable groups into control programmes. freeBILy (fast and reliable easy-to-use-diagnostics for eliminating bilharzia in young children and mothers) is an international consortium focused on implementing and evaluating new schistosomiasis diagnostic strategies. In Madagascar, the study aims to determine the effectiveness of a test-based schistosomiasis treatment (TBST) strategy for pregnant women and their infants and children up until the age of 2 years. Methods A two-armed, cluster-randomized, controlled phase III trial including 5200 women and their offspring assesses the impact of TBST on child growth and maternal haemoglobin in areas of medium to high endemicity of Schistosoma mansoni. The participants are being tested with the point of care-circulating cathodic antigen (POC-CCA) test, a commercially available urine-based non-invasive rapid diagnostic test for schistosomiasis. In the intervention arm, a POC-CCA-TBST strategy is offered to women during pregnancy and 9 months after delivery, for their infants at 9 months of age. In the control arm, study visit procedures are the same, but without the POC-CCA-TBST procedure. All participants are being offered the POC-CCA-TBST 24 months after delivery. This trial is being integrated into the routine maternal and child primary health care programmes at 40 different PHCC in Madagascar’s highlands. The purpose of the trial is to assess the effectiveness of the POC-CCA-TBST for controlling schistosomiasis in young children and mothers. Discussion This trial assesses a strategy to integrate pregnant women and their children under the age of 2 years into schistosomiasis control programmes using rapid diagnostic tests. It includes local capacity building for clinical trials and large-scale intervention research. Trial registration Pan-African Clinical Trial Register PACTR201905784271304. Retrospectively registered on 15 May 2019
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Affiliation(s)
- Daniela Fusco
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Strasse 74, D-20359, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Borstel-, Lübeck, Riems, Germany
| | | | - Rivo Andry Rakotoarivelo
- Department of Infectious Diseases, University of Fianarantsoa Andrainjato, 301, Fianarantsoa, Madagascar
| | - Mala Rakoto Andrianarivelo
- Centre d'Infectiologie Charles Mérieux (CICM), University of Antananarivo, PO Box 4299, 101, Antananarivo, Madagascar
| | - Njary Rakotozandrindrainy
- Department of Microbiology and Parasitology, University of Antananarivo, 101, Antananarivo, Madagascar.,UPFR in Parasitology-Mycology of University Hospital Joseph Ravoahangy Andrianavalona Ampefiloha, 101, Antananarivo, Madagascar
| | - Tahinamandranto Rasamoelina
- Centre d'Infectiologie Charles Mérieux (CICM), University of Antananarivo, PO Box 4299, 101, Antananarivo, Madagascar
| | - Dewi Ismajani Puradiredja
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Strasse 74, D-20359, Hamburg, Germany
| | - Philipp Klein
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Strasse 74, D-20359, Hamburg, Germany
| | - Karl Stahlberg
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Strasse 74, D-20359, Hamburg, Germany
| | - Marie Dechenaud
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Strasse 74, D-20359, Hamburg, Germany
| | - Eva Lorenz
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Strasse 74, D-20359, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Borstel-, Lübeck, Riems, Germany.,Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Anna Jaeger
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Strasse 74, D-20359, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Borstel-, Lübeck, Riems, Germany
| | - Andrea Kreidenweiss
- Institut für Tropenmedizin, Universität Tübingen, Wilhelmstrasse 27, D-72074, Tübingen, Germany.,German Center for Infection Research (DZIF), partner site Tübingen, Wilhelmstrasse 27, D-72074, Tübingen, Germany
| | - Pytsje T Hoekstra
- Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
| | - Akim Ayola Adegnika
- Institut für Tropenmedizin, Universität Tübingen, Wilhelmstrasse 27, D-72074, Tübingen, Germany.,German Center for Infection Research (DZIF), partner site Tübingen, Wilhelmstrasse 27, D-72074, Tübingen, Germany.,Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands.,Centre de Recherches Médicales de Lambaréné, 242, Lambarene, BP, Gabon
| | - Elisa Sicuri
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Spain C/ Rosselló, 132, 5th 2nd, 08036, Barcelona, Spain
| | - Paul L A M Corstjens
- Department of Cell and Chemical Biology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
| | - Govert J van Dam
- Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
| | - Jürgen May
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Strasse 74, D-20359, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Borstel-, Lübeck, Riems, Germany
| | - Norbert Georg Schwarz
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Strasse 74, D-20359, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Borstel-, Lübeck, Riems, Germany
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13
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Sublethal concentrations of usnic acid potassium salt impairs physiological parameters of Biomphalaria glabrata (Say, 1818) (Pulmonata: Planorbidae) infected and not infected with Schistosoma mansoni. Acta Trop 2021; 222:106067. [PMID: 34303689 DOI: 10.1016/j.actatropica.2021.106067] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 07/07/2021] [Accepted: 07/18/2021] [Indexed: 12/13/2022]
Abstract
Schistosomiasis is a public health problem in many developing countries. The mollusc Biomphalaria glabrata is the most important vector of Schistosoma mansoni in South America. The population control of this vector to prevent the spread of schistosomiasis is currently done with the application of highly toxic molluscicide to the environment. The screening of substances in sublethal concentrations that have deleterious effects on physiological parameters is very relevant for the control of schistosomiasis, since the effectiveness of disease prevention increases if it acts on population control of the vector and on reproduction and elimination in S. mansoni cercariae. The objective of this study was to evaluate the reproductive parameters (fecundity and fertility), intra-mollusk effect (sporocysts I (72 h) and II (14 days after)) on the development of cercariae of S. mansoni and the immune cell profile of B. glabrata exposed to sublethal concentrations (LC25 - 0.5 µg/mL and LC50 - 0.92 µg/mL) of the usnic acid potassium salt (potassium usnate). LC 25 and LC 50 significantly reduced (p < 0.05) the fecundity of B. glabrata when treated infected and/or not exposed to infection, while unviable embryos were not observed in sporocyst stage I, being only significant (p < 0.05) for mollusks infected and treated with LC50 on sporocyst II. LC25 and LC50 of the potassium usnate caused significant reductions (p < 0.05) in the production and cercarial shedding when evaluated on sporocysts I and II. In addition, the mortality of infected and treated B. glabrata in the sporocyst II phase was quite marked after the 9th week of infection. Regarding the immunological cell profile of uninfected B. glabrata, both concentrations led to immunomodulatory responses, with significant morphological changes predominant of hemocytes that entered programmed cell death (apoptosis). It was concluded that the application of LC25 and LC50 from the potassium usnate could be useful in the population control of B. glabrata, since it interferes both in their biology and physiology and in the reproduction of the infectious agent of schistosomiasis mansoni.
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14
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Kalinda C, Mindu T, Chimbari MJ. A systematic review and meta-analysis quantifying schistosomiasis infection burden in pre-school aged children (PreSAC) in sub-Saharan Africa for the period 2000-2020. PLoS One 2020; 15:e0244695. [PMID: 33373405 PMCID: PMC7771669 DOI: 10.1371/journal.pone.0244695] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 12/14/2020] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Following the adoption of the World Health Assembly Resolution WHA 65.21 and Neglected Tropical Diseases road map 2021-2030, schistosomiasis control programmes have shifted from morbidity control to disease elimination. However, several gaps continue to be observed in the implementation of control programmes with certain age groups omitted from these campaigns increasing health inequalities and risks of reinfections to previously treated groups. We used the Inverse Variance Heterogeneity (IVhet) model to estimate the prevalence of schistosomiasis infection among preschool-aged children. METHODS We did a systematic review of peer-reviewed literature on schistosomiasis in sub-Saharan Africa for the period January 1, 2000 to November 30, 2020. Quantitative data for cases of schistosomiasis infection were extracted, including country and region where the studies were done, year of publication and specific schistosome species observed. The IVhet model was used to estimate the pooled prevalence estimate (PPE), the heterogeneity and publication bias. RESULTS We screened 2601 articles to obtain 47 eligible studies containing quantitative data on preschool-aged children. Of the selected studies, 44.7% (n = 22) were from East Africa while the least number of studies obtained (2.1%, n = 1) was from Central Africa. 21712 subjects were screened for infection due to Schistosoma spp; 13924 for S. mansoni and 7788 for S. haematobium. The PPE for schistosomiasis among PreSAC was 19% (95% CI: 11-28). Infection due to S. mansoni (IVhet PPE: 22% (95% CI: 9-36) was higher than that due to S. haematobium (15%; 95% CI: 6-25). A Luis Furuya-Kanamori index of 1.83 indicated a lack of publication bias. High level of heterogeneity was observed (I2 > 90%) and this could not be reduced through subgroup analysis. CONCLUSION Schistosomiasis infection among pre-school aged children 6 years old and below is high. This indicates the importance of including this age group in treatment programmes to reduce infection prevalence and long-term morbidities associated with prolonged schistosome infection.
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Affiliation(s)
- Chester Kalinda
- University of Namibia, Katima Mulilo, Namibia
- Department of Public Health, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Tafadzwa Mindu
- Department of Public Health, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Moses John Chimbari
- Department of Public Health, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
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15
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Colley DG, Fleming FM, Matendechero SH, Knopp S, Rollinson D, Utzinger J, Castleman JD, Kittur N, King CH, Campbell CH, Kabole FM, Kinung'hi S, Ramzy RMR, Binder S. Contributions of the Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) to Schistosomiasis Control and Elimination: Key Findings and Messages for Future Goals, Thresholds, and Operational Research. Am J Trop Med Hyg 2020; 103:125-134. [PMID: 32400345 PMCID: PMC7351304 DOI: 10.4269/ajtmh.19-0787] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Herein, we summarize what we consider are major contributions resulting from the Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) program, including its key findings and key messages from those findings. Briefly, SCORE's key findings are as follows: i) biennial mass drug administration (MDA) with praziquantel can control schistosomiasis to moderate levels of prevalence; ii) MDA alone will not achieve elimination; iii) to attain and sustain control throughout endemic areas, persistent hotspots need to be identified following a minimal number of years of annual MDA and controlled through adaptive strategies; iv) annual MDA is more effective than biennial MDA in high-prevalence areas; v) the current World Health Organization thresholds for decision-making based on the prevalence of heavy infections should be redefined; and vi) point-of-care circulating cathodic antigen urine assays are useful for Schistosoma mansoni mapping in low-to-moderate prevalence areas. The data and specimens collected and curated through SCORE efforts will continue to be critical resource for future research. Besides providing useful information for program managers and revision of guidelines for schistosomiasis control and elimination, SCORE research and outcomes have identified additional questions that need to be answered as the schistosomiasis community continues to implement effective, evidence-based programs. An overarching contribution of SCORE has been increased cohesiveness within the schistosomiasis field-oriented community, thereby fostering new and productive collaborations. Based on SCORE's findings and experiences, we propose new approaches, thresholds, targets, and goals for control and elimination of schistosomiasis, and recommend research and evaluation activities to achieve these targets and goals.
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Affiliation(s)
- Daniel G Colley
- Department of Microbiology, University of Georgia, Athens, Georgia.,Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Fiona M Fleming
- Department of Infectious Disease Epidemiology, Schistosomiasis Control Initiative, London, United Kingdom
| | - Sultani H Matendechero
- Division of Communicable Disease Prevention and Control, Neglected Tropical Diseases Unit, Ministry of Health, Nairobi, Kenya
| | - Stefanie Knopp
- University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland.,Department of Life Sciences, Wolfson Wellcome Biomedical Laboratories, Natural History Museum, London, United Kingdom
| | - David Rollinson
- Department of Life Sciences, Wolfson Wellcome Biomedical Laboratories, Natural History Museum, London, United Kingdom
| | - Jürg Utzinger
- University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Jennifer D Castleman
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Nupur Kittur
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Charles H King
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio.,Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Carl H Campbell
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Fatma M Kabole
- Neglected Diseases Programme, Ministry of Health of Zanzibar, Zanzibar, United Republic of Tanzania
| | - Safari Kinung'hi
- National Institute for Medical Research (NIMR), Mwanza Centre, Mwanza, United Republic of Tanzania
| | - Reda M R Ramzy
- National Nutrition Institute, General Organization for Teaching Hospitals and Institutes, Cairo, Egypt
| | - Sue Binder
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
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16
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Oliveira LC, Porto TS, Junior AHC, Santos MFC, Ramos HP, Braun GH, de Lima Paula LA, Bastos JK, Furtado NAJC, Parreira RLT, Veneziani RCS, Magalhães LG, Ambrósio SR. Schistosomicidal activity of kaurane, labdane and clerodane-type diterpenes obtained by fungal transformation. Process Biochem 2020. [DOI: 10.1016/j.procbio.2020.07.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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Wells N, Chappuis F, Beran D. Spotlight on experiences of medicine unavailability: access to medicines challenges for NCDs and NTDs - the contrasting cases of insulin and praziquantel. Expert Rev Clin Pharmacol 2020; 13:341-353. [DOI: 10.1080/17512433.2020.1740589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Nadya Wells
- Global Health Centre, Graduate Institute of International and Development Studies, Geneva, Switzerland
| | - François Chappuis
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - David Beran
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland
- Division of Tropical and Humanitarian Medicine, University of Geneva, Geneva, Switzerland
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18
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Ma L, Zhao W, Hou X, Liu M, Li Y, Shen L, Xu X. Identification of linear epitopes in SjSP-13 of Schistosoma japonicum using a GST-peptide fusion protein microplate array. Parasit Vectors 2019; 12:507. [PMID: 31666115 PMCID: PMC6822365 DOI: 10.1186/s13071-019-3767-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 10/23/2019] [Indexed: 12/16/2022] Open
Abstract
Background The identification and characterization of epitopes facilitate the discovery and development of new therapeutics, vaccines and diagnostics for infectious diseases. In this study, we developed a glutathione S-transferase (GST)-peptide fusion protein microplate array for the identification of linear B-cell epitopes and applied this novel method to the identification of linear B-cell epitopes of SjSP-13, an immunodiagnostic biomarker of schistosomiasis japonica. Methods SjSP-13 was divided into 17 overlapped peptides (p1-17), and the coding sequence of each peptide was obtained by annealing two complementary oligonucleotides. SjSP-13 peptides were expressed by fusion with an N-terminal GST tag and a C-terminal 6xHis tag. The GST-peptide-His fusion protein was specifically bound to the Immobilizer Glutathione MicroWell 96-well plates without purification. SjSP-13 peptides and core epitopes that could be recognized by sera from schistosomiasis patients were identified by ELISA and confirmed by Western blot analysis. The receiver operating characteristic (ROC) analysis was performed to determine the diagnostic validity of the identified peptide. Results Full-length GST-peptide-His fusion proteins were successfully expressed and specifically bound to the Immobilizer Glutathione MicroWell 96-well plates. Two adjacent peptides (p7 and p8) were found to be highly immunogenic in humans. The core epitope of p7 and p8 is an 11-aa peptide (80KCLDVTDNLPE90) and an 8-aa peptide (90EKIIQFAE97), respectively. The area under the ROC curve (AUC) value of the peptide which contains the two identified epitopes is 0.947 ± 0.019. The diagnostic sensitivity and specificity of the peptide is 76.7% (95% CI: 68.8–84.5%) and 100%, respectively. Conclusions 90EKIIQFAE97 and 80KCLDVTDNLPE90 are the two linear epitopes of SjSP-13 recognized by patient sera, and could be potential serological markers for schistosomiasis japonica.![]()
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Affiliation(s)
- Li Ma
- Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Wenrong Zhao
- Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xunya Hou
- Hunan Institute of Parasitic Diseases, Yueyang, China
| | - Mengmeng Liu
- Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yanna Li
- Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Li Shen
- Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xindong Xu
- Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
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19
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Gouveia MJ, Brindley PJ, Azevedo C, Gärtner F, da Costa JMC, Vale N. The antioxidants resveratrol and N-acetylcysteine enhance anthelmintic activity of praziquantel and artesunate against Schistosoma mansoni. Parasit Vectors 2019; 12:309. [PMID: 31221193 PMCID: PMC6585032 DOI: 10.1186/s13071-019-3566-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 06/15/2019] [Indexed: 01/13/2023] Open
Abstract
Background Treatment of schistosomiasis has relied on the anthelmintic drug praziquantel (PZQ) for more than a generation. Despite its celebrated performance for treatment and control of schistosomiasis and other platyhelminth infections, praziquantel has some shortcomings and the inability of this drug to counteract disease sequelae prompts the need for novel therapeutic strategies. Methods Using a host-parasite model involving Biomphalaria glabrata and Schistosoma mansoni we established mechanical transformation of S. mansoni cercariae into newly transformed schistosomula (NTS) and characterized optimal culture conditions. Thereafter, we investigated the antischistosomal activity and ability of the antioxidants N-acetylcysteine (NAC) and resveratrol (RESV) to augment the performance of praziquantel and/or artesunate (AS) against larval stages of the parasite. Drug effects were evaluated by using an automated microscopical system to study live and fixed parasites and by transmission electron microscopy (TEM). Results Transformation rates of cercariae to schistosomula reached ~ 70% when the manipulation process was optimized. Several culture media were tested, with M199 supplemented with HEPES found to be suitable for S. mansoni NTS. Among the antioxidants studied, RESV alone or combined with anthelminthic drugs achieved better results rather N-acetylcysteine (NAC). TEM observations demonstrated that the combination of AS + RESV induced severe, extensive alterations to the tegument and subtegument of NTS when compared to the constituent compounds alone. Two anthelmintic–antioxidant combinations, praziquantel-resveratrol [combination index (CI) = 0.74] and artesunate-resveratrol (CI = 0.34) displayed moderate and strong synergy, respectively. Conclusions The use of viability markers including staining with propidium iodide increased the accuracy of drug screening assays against S. mansoni NTS. The synergies observed might be the consequence of increased action by RESV on targets of AS and PZQ and/or they may act through concomitantly on discrete targets to enhance overall antischistosomal action. Combinations of active agents, preferably with discrete modes of action including activity against developmental stages and/or the potential to ameliorate infection-associated pathology, might be pursued in order to identify novel therapeutic interventions. Electronic supplementary material The online version of this article (10.1186/s13071-019-3566-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maria João Gouveia
- Center for the Study of Animal Science, CECA-ICETA, University of Porto, Praça Gomes Teixeira, Apartado 55142, 4051-401, Porto, Portugal.,i3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal.,ICBAS-UP, Institute of Biomedical Sciences Abel Salazar, University of Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-343, Porto, Portugal
| | - Paul J Brindley
- Department of Microbiology, Immunology and Tropical Medicine and Research Center for Neglected Diseases of Poverty, School of Medicine and Health Sciences, George Washington University, 20037, Washington, DC, USA
| | - Carlos Azevedo
- Laboratory of Cell Biology, Institute of Biomedical Sciences (ICBAS/UP), University of Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal
| | - Fátima Gärtner
- Center for the Study of Animal Science, CECA-ICETA, University of Porto, Praça Gomes Teixeira, Apartado 55142, 4051-401, Porto, Portugal.,ICBAS-UP, Institute of Biomedical Sciences Abel Salazar, University of Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-343, Porto, Portugal.,Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Rua Júlio Amaral de Carvalho, 45, 4200-135, Porto, Portugal
| | - José M C da Costa
- Center for the Study of Animal Science, CECA-ICETA, University of Porto, Praça Gomes Teixeira, Apartado 55142, 4051-401, Porto, Portugal.,National Health Institute Dr. Ricardo Jorge (INSA), Rua Alexandre Herculano, 321, 4000-055, Porto, Portugal
| | - Nuno Vale
- i3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal. .,ICBAS-UP, Institute of Biomedical Sciences Abel Salazar, University of Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-343, Porto, Portugal. .,Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Rua Júlio Amaral de Carvalho, 45, 4200-135, Porto, Portugal. .,Laboratory of Pharmacology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Rua de Jorge Viterbo Ferreira 228, 4050-313, Porto, Portugal.
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Lalaye D, de Bruijn ME, de Jong TP. Prevalence of Schistosoma Haematobium Measured by a Mobile Health System in an Unexplored Endemic Region in the Subprefecture of Torrock, Chad. JMIR Public Health Surveill 2019; 5:e13359. [PMID: 31215519 PMCID: PMC6604508 DOI: 10.2196/13359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 04/08/2019] [Accepted: 04/23/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Schistosoma haematobium is a parasitic digenetic trematode responsible for schistosomiasis (also known as bilharzia). The disease is caused by penetration of the skin by the parasite, spread by intermediate host molluscs in stagnant waters, and can be treated by administration of praziquantel. Schistosomiasis is considered to be an important but neglected tropical disease. OBJECTIVE The aim of this pilot study was to investigate the prevalence of schistosomiasis in the subprefecture of Torrock, an endemic area in Chad where no earlier investigation had been conducted and no distribution system for pharmacotherapy has ever existed. METHODS This study examined 1875 children aged 1 to 14 years over a period of 1 year. After centrifugation, urine examination was performed by a direct microscopic investigation for eggs. The investigation was conducted with a mobile health (mHealth) approach, using short message service (SMS) for communication among parents, local health workers, a pharmacist, and a medical doctor. An initial awareness campaign requested parents to have their children examined for schistosomiasis. Urine was then collected at home by the parents following the SMS request. Urine results that proved positive were sent to a medical doctor by SMS, who in turn ordered a pharmacist by SMS to distribute praziquantel to the infected children. RESULTS Direct microscopic examination of urine found 467 positive cases (24.9% of the total sample). Of all male and female samples, 341 (34%) and 127 (14.4%) samples were positive, respectively. The infection rate was equally distributed over age groups. The newly developed mHealth system had a limited level of participation (8%) from an estimated total of 25,000 children in the target group. CONCLUSIONS The prevalence of schistosomiasis in children in the subprefecture of Torrock is moderately high. Efforts will be required to enhance the awareness of parents and to reach a larger percentage of the population. Systematic governmental measures should be put in place as soon as possible to increase awareness in the area and to diagnose and treat cases of schistosomiasis.
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Affiliation(s)
- Didier Lalaye
- Julius Global Health Center, University Medical Center Utrecht, Utrecht, Netherlands
| | | | - Tom Pvm de Jong
- Department of Pediatric Urology, University Children's Hospitals University Medical Center Utrecht and Amsterdam University Medical Center, Utrecht, Netherlands
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McDonald S, Fabbri A, Parker L, Williams J, Bero L. Medical donations are not always free: an assessment of compliance of medicine and medical device donations with World Health Organization guidelines (2009–2017). Int Health 2019; 11:379-402. [DOI: 10.1093/inthealth/ihz004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/07/2018] [Accepted: 01/21/2019] [Indexed: 11/14/2022] Open
Abstract
Abstract
Medicine and medical device donations have the potential to improve access to healthcare in some of the poorest parts of the world, but can do more harm than good. World Health Organization guidelines advise donors on how to make effective and useful donations. Our objective was to assess compliance of recent medicine or medical device donations with WHO guidelines from 2009 onwards. We searched media, academic and gray literature, including industry and organizational documents, to identify reports describing specific incidences of the donation of medicines or devices. We collected data on donation characteristics and guideline compliance. We identified 88 reports describing 53 donations. Most did not comply with at least some items in WHO guidelines and no reports provided sufficient information to assess compliance against all items. Donations that fail to comply with guidelines may be excessive, expired and/or burden recipient countries with storage and disposal costs. It was estimated that 40–70% of donated medical devices are not used as they are not functional, appropriate, or staff lack training. More effective donations involved needs assessments, training and the use of existing distribution networks. The donation of medicines and medical devices is frequently inadequately reported and at times inappropriate. Guidelines need to be enforced to ensure effective donations.
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Affiliation(s)
- Sally McDonald
- Charles Perkins Centre and School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, D17, The Hub, Sydney, 2006 Australia
| | - Alice Fabbri
- Charles Perkins Centre and School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, D17, The Hub, Sydney, 2006 Australia
| | - Lisa Parker
- Charles Perkins Centre and School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, D17, The Hub, Sydney, 2006 Australia
| | - Jane Williams
- Charles Perkins Centre and School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, D17, The Hub, Sydney, 2006 Australia
| | - Lisa Bero
- Charles Perkins Centre and School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, D17, The Hub, Sydney, 2006 Australia
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22
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Strategy for a globally coordinated response to a priority neglected tropical disease: Snakebite envenoming. PLoS Negl Trop Dis 2019; 13:e0007059. [PMID: 30789906 PMCID: PMC6383867 DOI: 10.1371/journal.pntd.0007059] [Citation(s) in RCA: 225] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Weber CJ, Hargan-Calvopiña J, Graef KM, Manner CK, Dent J. WIPO Re:Search-A Platform for Product-Centered Cross-Sector Partnerships for the Elimination of Schistosomiasis. Trop Med Infect Dis 2019; 4:E11. [PMID: 30634429 PMCID: PMC6473617 DOI: 10.3390/tropicalmed4010011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 12/26/2018] [Accepted: 01/02/2019] [Indexed: 02/06/2023] Open
Abstract
Schistosomiasis is an acute and chronic disease that affects over 200 million people worldwide, and with over 700 million people estimated to be at risk of contracting this disease, it is a pressing issue in global health. However, research and development (R&D) to develop new approaches to preventing, diagnosing, and treating schistosomiasis has been relatively limited. Praziquantel, a drug developed in the 1970s, is the only agent used in schistosomiasis mass drug administration (MDA) campaigns, indicating a critical need for a diversified therapeutic pipeline. Further, gaps in the vaccine and diagnostic pipelines demonstrate a need for early-stage innovation in all areas of schistosomiasis product R&D. As a platform for public-private partnerships (PPPs), the WIPO Re:Search consortium engages the private sector in early-stage R&D for neglected diseases by forging mutually beneficial collaborations and facilitating the sharing of intellectual property (IP) assets between the for-profit and academic/non-profit sectors. The Consortium connects people, resources, and ideas to fill gaps in neglected disease product development pipelines by leveraging the strengths of these two sectors. Using WIPO Re:Search as an example, this article highlights the opportunities for the PPP model to play a key role in the elimination of schistosomiasis.
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Affiliation(s)
- Callie J Weber
- BIO Ventures for Global Health, 2101 Fourth Avenue, Suite 1950, Seattle, WA 98121, USA.
| | | | - Katy M Graef
- BIO Ventures for Global Health, 2101 Fourth Avenue, Suite 1950, Seattle, WA 98121, USA.
| | - Cathyryne K Manner
- BIO Ventures for Global Health, 2101 Fourth Avenue, Suite 1950, Seattle, WA 98121, USA.
| | - Jennifer Dent
- BIO Ventures for Global Health, 2101 Fourth Avenue, Suite 1950, Seattle, WA 98121, USA.
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Dong Y, Du CH, Zhang Y, Wang LF, Song J, Wu MS, Yang WC, Lv S, Zhou XN. Role of ecological approaches to eliminating schistosomiasis in Eryuan County evaluated by system modelling. Infect Dis Poverty 2018; 7:129. [PMID: 30593286 PMCID: PMC6309097 DOI: 10.1186/s40249-018-0511-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 12/06/2018] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Schistosomiasis was severely prevalent in Yunnan Province, and it is difficult to achieve its elimination by convention approaches due to complexity of the nature. We explored the comprehensive model to eliminate schistosomiasis in Eryuan County, Yunnan Province, the People's Republic of China, through integration with the ecological protection programme in Erhai Lake, in order to promote an efficient elimination strategy. We expected that this model is able to be tailored to other local settings, which help achieve the goal of precisely eliminating the disease in Yunnan Province. METHODS Eryuan County of Yunnan Province was chosen as the study area, where the data on environmental protection activities in Erhai Lake and on the schistosomiasis control programme were collected through different departments of Erhai County government since 2015. System modelling was performed using system dynamics software to establish a simulation model in order to evaluate the effectiveness of intervention activities. RESULTS Ecological approaches to control schistosomiasis in Eryuan County consist of three major components: (i) implementing precise interventions to stop schistosomiasis transmission by means of controlling the source of infection, blocking the biological transmission chains and cutting off the route of disease transmission; (ii) employing ecological approaches to improve the co-effectiveness of environmental protection and schistosomiasis prevention in the study area; and (iii) strengthening the professional skills of personnel involving in the schistosomiasis control programme. Simulation results showed that this strategy could speed up the progress of schistosomiasis control programme moving from the control stage to the elimination stage. CONCLUSIONS Ecological approaches implemented in schistosomiasis endemic areas of the Eryuan region are able to improve the co-effectiveness of environmental protection and schistosomiasis control, providing a new avenue for eliminating schistosomiasis thanks to the application of precise interventions.
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Affiliation(s)
- Yi Dong
- Yunnan Institute of Endemic Diseases Control and Prevention, Dali, 671000, Yunnan, China
| | - Chun-Hong Du
- Yunnan Institute of Endemic Diseases Control and Prevention, Dali, 671000, Yunnan, China
| | - Yun Zhang
- Yunnan Institute of Endemic Diseases Control and Prevention, Dali, 671000, Yunnan, China
| | - Li-Fang Wang
- Yunnan Institute of Endemic Diseases Control and Prevention, Dali, 671000, Yunnan, China
| | - Jing Song
- Yunnan Institute of Endemic Diseases Control and Prevention, Dali, 671000, Yunnan, China
| | - Ming-Shou Wu
- Yunnan Institute of Endemic Diseases Control and Prevention, Dali, 671000, Yunnan, China
| | - Wen-Can Yang
- Eryuan Station of Schistosomiasis Control and Prevention, Eryuan, 671200, Yunnan, China
| | - Shan Lv
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, China.,Chinese Center for Tropical Diseases Research, Shanghai, 200025, China.,WHO Collaborating Centre for Tropical Diseases, Shanghai, 200025, China.,National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, 200025, China.,Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, China
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, China. .,Chinese Center for Tropical Diseases Research, Shanghai, 200025, China. .,WHO Collaborating Centre for Tropical Diseases, Shanghai, 200025, China. .,National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, 200025, China. .,Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, China.
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Liang S, Abe EM, Zhou XN. Integrating ecological approaches to interrupt schistosomiasis transmission: opportunities and challenges. Infect Dis Poverty 2018; 7:124. [PMID: 30541611 PMCID: PMC6291957 DOI: 10.1186/s40249-018-0506-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 11/16/2018] [Indexed: 11/10/2022] Open
Abstract
Background The development of agenda for global schistosomiasis elimination as a public health problem generates enthusiasms among global health communities, motivating great interests in both research and practice. Recent China-Africa schistosomiasis control initiatives, aiming to enhance collaboration on disease control in African countries, reflect in part that momentum. Yet there is a pressing need to know whether the Chinese experiences can be translated and applied in African settings. Main body China’s remarkable achievements in schistosomiasis control programme, associated experiences and lessons, have much to offer to those combating the disease. Central to the success of China’s control programmes is a strategy termed “integrated control” – integrating environmental approaches (e.g. improved sanitation, agricultural and hydrological development and management), which target different phases of the parasite transmission system, to chemical-based drug treatment and mollusciciding. Yet, despite significant measurable public health benefits, such integration is usually based on field experience and remains largely uncharacterized in an ecological context. This has limited our knowledge on relative contributions of varying components of the integrated control programme to the suppression of disease transmission, making it challenging to generalize the strategy elsewhere. In this opinion article, we have described and discussed these challenges, along with opportunities and research needs to move forward. Conclusions There is an urgent need to formalize an ecological framework for the integrated control programme that would allow research towards improved mechanistic understanding, quantification, and prediction of the control efforts. Electronic supplementary material The online version of this article (10.1186/s40249-018-0506-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Song Liang
- Department of Environmental and Global Health, College of Public Health and Health Professions, and Emerging Pathogens Institute, University of Florida, Gainesville, FL, 32610, USA
| | - Eniola Michael Abe
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, China.,National Center for International Research on Tropical Diseases, Ministry of Science and Technology; Chinese Center for Tropical Diseases Research; WHO Collaborating Centre for Tropical Diseases, Shanghai, 200025, China
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, China. .,National Center for International Research on Tropical Diseases, Ministry of Science and Technology; Chinese Center for Tropical Diseases Research; WHO Collaborating Centre for Tropical Diseases, Shanghai, 200025, China.
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De Neve JW, Andriantavison RL, Croke K, Krisam J, Rajoela VH, Rakotoarivony RA, Rambeloson V, Schultz L, Qamruddin J, Verguet S. Health, financial, and education gains of investing in preventive chemotherapy for schistosomiasis, soil-transmitted helminthiases, and lymphatic filariasis in Madagascar: A modeling study. PLoS Negl Trop Dis 2018; 12:e0007002. [PMID: 30589847 PMCID: PMC6307713 DOI: 10.1371/journal.pntd.0007002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 11/15/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Neglected tropical diseases (NTDs) account for a large disease burden in sub-Saharan Africa. While the general cost-effectiveness of NTD interventions to improve health outcomes has been assessed, few studies have also accounted for the financial and education gains of investing in NTD control. METHODS We built on extended cost-effectiveness analysis (ECEA) methods to assess the health gains (e.g. infections, disability-adjusted life years or DALYs averted), household financial gains (out-of-pocket expenditures averted), and education gains (cases of school absenteeism averted) for five NTD interventions that the government of Madagascar aims to roll out nationally. The five NTDs considered were schistosomiasis, lymphatic filariasis, and three soil-transmitted helminthiases (Ascaris lumbricoides, Trichuris trichiura, and hookworm infections). RESULTS The estimated incremental cost-effectiveness for the roll-out of preventive chemotherapy for all NTDs jointly was USD125 per DALY averted (95% uncertainty range: 65-231), and its benefit-cost ratio could vary between 5 and 31. Our analysis estimated that, per dollar spent, schistosomiasis preventive chemotherapy, in particular, could avert a large number of infections (176,000 infections averted per $100,000 spent), DALYs (2,000 averted per $100,000 spent), and cases of school absenteeism (27,000 school years gained per $100,000 spent). CONCLUSION This analysis incorporates financial and education gains into the economic evaluation of health interventions, and therefore provides information about the efficiency of attainment of three Sustainable Development Goals (SDGs). Our findings reveal how the national scale-up of NTD control in Madagascar can help address health (SDG3), economic (SDG1), and education (SDG4) goals. This study further highlights the potentially large societal benefits of investing in NTD control in low-resource settings.
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Affiliation(s)
- Jan-Walter De Neve
- Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston MA, United States of America
| | | | - Kevin Croke
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston MA, United States of America
- World Bank, Washington DC NW, Washington, DC, United States of America
| | - Johannes Krisam
- Institute of Medical Biometry and Informatics, Heidelberg University, Heidelberg, Germany
| | | | | | | | - Linda Schultz
- World Bank, Washington DC NW, Washington, DC, United States of America
| | - Jumana Qamruddin
- World Bank, Washington DC NW, Washington, DC, United States of America
| | - Stéphane Verguet
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston MA, United States of America
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A systematic review with epidemiological update of male genital schistosomiasis (MGS): A call for integrated case management across the health system in sub-Saharan Africa. Parasite Epidemiol Control 2018; 4:e00077. [PMID: 30662962 PMCID: PMC6324017 DOI: 10.1016/j.parepi.2018.e00077] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 10/16/2018] [Accepted: 10/16/2018] [Indexed: 02/03/2023] Open
Abstract
Male genital schistosomiasis (MGS) is a gender specific manifestation of urogenital schistosomiasis (UGS) first described in 1911 by Madden in Egypt. Today, while affecting millions of men and boys worldwide, MGS receives insufficient attention, especially in sub-Saharan Africa (SSA). To provide a systematic review with an epidemiological update of MGS, we inspected both online and hardcopy resources in our appraisal. A total of 147 articles were eventually identified, only 31 articles were exclusively focused on MGS with original or targeted research. From these, we discuss pertinent clinico-pathological features of MGS, highlight the possible connection and interplay with HIV, and assess current diagnostic techniques alongside consideration of their use and application in SSA. To appreciate the burden of MGS more fully, especially in endemic areas, there is a clear need for better surveillance and longitudinal population research to investigate the best point-of-care (POC) diagnostic and its performance through time. Furthermore, to optimise individual case management, exploration of alternative praziquantel dosing regimens is needed for MGS in men with or without HIV co-infection.
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Qian C, Zhang Y, Zhang X, Yuan C, Gao Z, Yuan H, Zhong J. Effectiveness of the new integrated strategy to control the transmission of Schistosoma japonicum in China: a systematic review and meta-analysis. ACTA ACUST UNITED AC 2018; 25:54. [PMID: 30444486 PMCID: PMC6238655 DOI: 10.1051/parasite/2018058] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 11/04/2018] [Indexed: 12/30/2022]
Abstract
Since 2004, the national schistosomiasis control strategy in China has shifted from the morbidity control strategy (conventional strategy) to an integrated strategy (new strategy). We investigated the effectiveness of the new strategy and compared it against the conventional strategy. We retrieved from electronic databases the literature regarding the new strategy published from 2000 to 2017. The effect of the new or conventional strategy on infection by Schistosoma japonicum of humans and snails (Oncomelania hupensis) was evaluated with pooled log relative risk (logRR). A total of only eight eligible publications were included in the final meta-analysis. The results showed that implementation of the new strategy reduced the infection risk by 3–4 times relative to the conventional strategy. More specifically, the conventional strategy caused a reduction in both human (logRR = 0.56, 95% CI: 0.12–0.99) and snail infections (logRR = 0.34, 95% CI: −0.69–1.37), while the new strategy also significantly reduced both human (logRR = 1.89, 95% CI: 1.33–2.46) and snail infections (logRR = 1.61, 95% CI: 1.06–2.15). In contrast to the conventional strategy, the new strategy appeared more effective to control both human (logRR difference = 1.32, 95% CI: 0.78–1.86) and snail infections (logRR difference = 1.53, 95% CI: 0.76–2.31). Our data demonstrate that the new integrated strategy is highly effective to control the transmission of S. japonicum in China, and this strategy is recommended for schistosomiasis elimination in other affected regions across the world, with adaptation to local conditions.
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Affiliation(s)
- Chunyan Qian
- Yuhang Branch, The Second Affiliated Hospital of Zhejiang University, Hangzhou 311100, Zhejiang Province, PR China - School of Life Sciences, Fudan University, Shanghai 200433, PR China
| | - Yuefeng Zhang
- Yuhang Branch, The Second Affiliated Hospital of Zhejiang University, Hangzhou 311100, Zhejiang Province, PR China
| | - Xinyan Zhang
- Department of Clinical Laboratory, The Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200001, PR China
| | - Chao Yuan
- Shanghai Skin Disease Hospital, Shanghai 200443, PR China
| | - Zhichao Gao
- Yuhang Branch, The Second Affiliated Hospital of Zhejiang University, Hangzhou 311100, Zhejiang Province, PR China
| | - Hong Yuan
- Yuhang Branch, The Second Affiliated Hospital of Zhejiang University, Hangzhou 311100, Zhejiang Province, PR China
| | - Jiang Zhong
- School of Life Sciences, Fudan University, Shanghai 200433, PR China
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Low Praziquantel Treatment Coverage for Schistosoma mansoni in Mayuge District, Uganda, Due to the Absence of Treatment Opportunities, Rather Than Systematic Non-Compliance. Trop Med Infect Dis 2018; 3:tropicalmed3040111. [PMID: 30297642 PMCID: PMC6306755 DOI: 10.3390/tropicalmed3040111] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 09/25/2018] [Accepted: 09/26/2018] [Indexed: 12/26/2022] Open
Abstract
The World Health Organization (WHO) recommends praziquantel mass drug administration (MDA) to control schistosomiasis in endemic regions. We aimed to quantify recent and lifetime praziquantel coverage, and reasons for non-treatment, at an individual level to guide policy recommendations to help Uganda reach WHO goals. Cross-sectional household surveys (n = 681) encompassing 3208 individuals (adults and children) were conducted in 2017 in Bugoto A and B, Mayuge District, Uganda. Participants were asked if they had received praziquantel during the recent MDA (October 2016) and whether they had ever received praziquantel in their lifetime. A multivariate logistic regression analysis with socio-economic and individual characteristics as covariates was used to determine factors associated with praziquantel uptake. In the MDA eligible population (≥5 years of age), the most recent MDA coverage was 48.8%. Across individuals’ lifetimes, 31.8% of eligible and 49.5% of the entire population reported having never taken praziquantel. Factors that improved individuals’ odds of taking praziquantel included school enrolment, residence in Bugoto B and increasing years of village-residency. Not being offered (49.2%) and being away during treatment (21.4%) were the most frequent reasons for not taking the 2016 praziquantel MDA. Contrary to expectations, chronically-untreated individuals were rarely systematic non-compliers, but more commonly not offered treatment.
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Towards elimination of schistosomiasis after 5000 years of endemicity in Egypt. Acta Trop 2018; 181:112-121. [PMID: 29453950 DOI: 10.1016/j.actatropica.2018.02.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 01/29/2018] [Accepted: 02/11/2018] [Indexed: 11/21/2022]
Abstract
Schistosomiasis is a snail-transmitted infectious disease caused by a long lasting infection with a blood fluke of the genus Schistosoma. S. haematobium and S. mansoni are the species endemic in Egypt. The country has been plagued and seriously suffered from schistosomiasis over the past 5000 years. Great strides had been done in controlling the disease since 1922. The history, epidemiology and the different control approaches were reviewed. Currently, Egypt is preparing towards schistosomiasis elimination by 2020. The new strategy depends on four main axes; large scale treatment in all areas of residual transmission by targeting entire populations with PZQ, intensified snail control, heath education and behavioral changes and expansion of the complementary public health interventions. While on the road towards elimination, we addressed here the important challenges, lessons and the key issues from the different control strategies to help the achievement of our goal. Notably, frangibility of the drug based control, emergence of resistance against PZQ, persistence of some hot spots areas, the need of further control efforts to the high risk individuals and community involvement in the control programs, reconsideration of diagnostic tests used in surveillance, and continous monitoring of the field to detect changes in the snail intermediate host. Importantly, the adaptation between the parasite and its intermediate snail host throughout water bodies in Egypt merits attention as Schistosoma infection can be introduced to the new reclaimed areas. This review may help supplying information for the policy makers to tailor control measures suitable to the local context that could help in the transfer from control to elimination.
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Surveillance of intestinal schistosomiasis during control: a comparison of four diagnostic tests across five Ugandan primary schools in the Lake Albert region. Parasitology 2018; 145:1715-1722. [PMID: 29560841 PMCID: PMC6533640 DOI: 10.1017/s003118201800029x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Programmatic surveillance of intestinal schistosomiasis during control can typically use four diagnostic tests, either singularly or in combination, but these have yet to be cross-compared directly. Our study assembled a complete diagnostic dataset, inclusive of infection intensities, from 258 children from five Ugandan primary schools. The schools were purposely selected as typical of the endemic landscape near Lake Albert and reflective of high- and low-transmission settings. Overall prevalence was: 44.1% (95% CI 38.0–50.2) by microscopy of duplicate Kato-Katz smears from two consecutive stools, 56.9% (95% CI 50.8–63.0) by urine-circulating cathodic antigen (CCA) dipstick, 67.4% (95% CI 61.6–73.1) by DNA-TaqMan® and 75.1% (95% CI 69.8–80.4) by soluble egg antigen enzyme-linked immunosorbent assay (SEA-ELISA). A cross-comparison of diagnostic sensitivities, specificities, positive and negative predictive values was undertaken, inclusive of a latent class analysis (LCA) with a LCA-model estimate of prevalence by each school. The latter ranged from 9.6% to 100.0%, and prevalence by school for each diagnostic test followed a static ascending order or monotonic series of Kato-Katz, urine-CCA dipstick, DNA-TaqMan® and SEA-ELISA. We confirm that Kato-Katz remains a satisfactory diagnostic standalone in high-transmission settings but in low-transmission settings should be augmented or replaced by urine-CCA dipsticks. DNA-TaqMan® appears suitable in both endemic settings though is only implementable if resources permit. In low-transmission settings, SEA-ELISA remains the method of choice to evidence an absence infection. We discuss the pros and cons of each method concluding that future surveillance of intestinal schistosomiasis would benefit from a flexible, context-specific approach both in choice and application of each diagnostic method, rather than a single one-size fits all approach.
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Mariz Gomes da Silva LM, de Oliveira JF, Silva WL, da Silva AL, de Almeida Junior ASA, Barbosa dos Santos VH, Alves LC, Brayner dos Santos FA, Costa VMA, Aires ADL, de Lima MDCA, Albuquerque MCPDA. New 1,3-benzodioxole derivatives: Synthesis, evaluation of in vitro schistosomicidal activity and ultrastructural analysis. Chem Biol Interact 2018; 283:20-29. [DOI: 10.1016/j.cbi.2018.01.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 12/24/2017] [Accepted: 01/18/2018] [Indexed: 12/22/2022]
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Bergquist R, Zhou XN, Rollinson D, Reinhard-Rupp J, Klohe K. Elimination of schistosomiasis: the tools required. Infect Dis Poverty 2017; 6:158. [PMID: 29151362 PMCID: PMC5694902 DOI: 10.1186/s40249-017-0370-7] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 10/19/2017] [Indexed: 11/13/2022] Open
Abstract
Background Historically, the target in the schistosomiasis control has shifted from infection to morbidity, then back to infection, but now as a public health problem, before moving on to transmission control. Currently, all endemic countries are encouraged to increase control efforts and move towards elimination as required by the World Health Organization (WHO) roadmap for the global control of the neglected tropical diseases (NTDs) and the WHA65.21 resolution issued by the World Health Assembly. However, schistosomiasis prevalence is still alarmingly high and the global number of disability-adjusted life years (DALYs) due to this infection has in fact increased due to inclusion of some ‘subtle’ clinical symptoms not previously counted. Main body There is a need to restart and improve efforts to reach the elimination goal. To that end, the first conference of the Global Schistosomiasis Alliance (GSA) Research Working Group was held in mid-June 2016 in Shanghai, People’s Republic of China. It reviewed current progress in schistosomiasis control and elimination, identified pressing operational research gaps that need to be addressed and discussed new tools and strategies required to make elimination a reality. The articles emanating from the lectures and discussions during this meeting, together with some additional invited papers, have been collected as a special issue of the ‘Infectious Diseases of Poverty’ entitled ‘Schistosomiasis Research: Providing the Tools Needed for Elimination’, consisting of 26 papers in all. This paper refers to these papers and discusses critical questions arising at the conference related to elimination of schistosomiasis. Conclusion The currently most burning questions are the following: Can schistosomiasis be eliminated? Does it require better, more highly sensitive diagnostics? What is the role of preventive chemotherapy at the elimination stage? Is praziquantel sufficient or do we need new drugs? Contemplating these questions, it is felt that the heterogeneity of the endemic areas in the world requires WHO policies to be upgraded instituting new, differentiated guidelines. Electronic supplementary material The online version of this article (doi: 10.1186/s40249-017-0370-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases Chinese Center for Disease Control and Prevention, Shanghai, 200025, China.
| | - David Rollinson
- Department of Life Sciences, The Natural History Museum, London, SW7 5BD, UK
| | | | - Katharina Klohe
- Global Schistosomiasis Alliance, Westenriederstrasse 10, 80331, Munich, Germany
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