The effect of increasing water temperatures on Schistosoma mansoni transmission and Biomphalaria pfeifferi population dynamics: an agent-based modelling study

Re-assessing thermal response of schistosomiasis transmission risk: Evidence for a higher thermal optimum than previously predicted

The geographical range of schistosomiasis is affected by the ecology of schistosome parasites and their obligate host snails, including their response to temperature. Previous models predicted schistosomiasis' thermal optimum at 21.7°C, which is not compatible with the temperature in sub-Saharan Africa (SSA) regions where schistosomiasis is hyperendemic. We performed an extensive literature search for empirical data on the effect of temperature on physiological and epidemiological parameters regulating the free-living stages of S. mansoni and S. haematobium and their obligate host snails, i.e., Biomphalaria spp. and Bulinus spp., respectively. We derived nonlinear thermal responses fitted on these data to parameterize a mechanistic, process-based model of schistosomiasis. We then re-cast the basic reproduction number and the prevalence of schistosome infection as functions of temperature. We found that the thermal optima for transmission of S. mansoni and S. haematobium range between 23.1-27.3°C and 23.6-27.9°C (95% CI) respectively. We also found that the thermal optimum shifts toward higher temperatures as the human water contact rate increases with temperature. Our findings align with an extensive dataset of schistosomiasis prevalence in SSA. The refined nonlinear thermal-response model developed here suggests a more suitable current climate and a greater risk of increased transmission with future warming for more than half of the schistosomiasis suitable regions with mean annual temperature below the thermal optimum.

Re-assessing thermal response of schistosomiasis transmission risk: evidence for a higher thermal optimum than previously predicted

The geographical range of schistosomiasis is affected by the ecology of schistosome parasites and their obligate host snails, including their response to temperature. Previous models predicted schistosomiasis' thermal optimum at 21.7 °C, which is not compatible with the temperature in sub-Saharan Africa (SSA) regions where schistosomiasis is hyperendemic. We performed an extensive literature search for empirical data on the effect of temperature on physiological and epidemiological parameters regulating the free-living stages of S. mansoni and S. haematobium and their obligate host snails, i.e., Biomphalaria spp. and Bulinus spp., respectively. We derived nonlinear thermal responses fitted on these data to parameterize a mechanistic, process-based model of schistosomiasis. We then re-cast the basic reproduction number and the prevalence of schistosome infection as functions of temperature. We found that the thermal optima for transmission of S. mansoni and S. haematobium range between 23.1-27.3 °C and 23.6-27.9 °C (95 % CI) respectively. We also found that the thermal optimum shifts toward higher temperatures as the human water contact rate increases with temperature. Our findings align with an extensive dataset of schistosomiasis prevalence in SSA. The refined nonlinear thermal-response model developed here suggests a more suitable current climate and a greater risk of increased transmission with future warming for more than half of the schistosomiasis suitable regions with mean annual temperature below the thermal optimum.

Large-scale spatial drivers of avian schistosomes in Northern Michigan inland lakes

Avian schistosomes are snail-borne trematode parasites (Trichobilharzia spp.) that can cause a nasty skin rash in humans when their cercariae mistake us for their normal bird hosts. We sought to investigate drivers of the spatial distribution of Trichobilharzia cercaria abundance throughout Northern Michigan lakes. For 38 sites on 16 lakes, we assessed several dozen potential environmental predictors that we hypothesized might have direct or indirect effects on overall cercaria abundance, based on known relationships between abiotic and biotic factors in wetland ecosystems. We included variables quantifying local densities of intermediate hosts, temperature, periphyton growth rates, human land use and hydrology. We also measured daily abundance of schistosome cercariae in the water over a 5-week period, supported by community scientists who collected and preserved filtered water samples for qPCR. The strongest predictor of cercaria abundance was Lymnaea host snail density. Lymnaea density was higher in deeper lakes and at sites with more deciduous tree cover, consistent with their association with cool temperature habitats. Contrary to past studies of human schistosomes, we also found a significant negative relationship between cercaria abundance and submerged aquatic vegetation, possibly due to vegetation blocking cercaria movement from offshore snail beds. If future work shows that these effects are indeed causal, then these results suggest possible new approaches to managing swimmer's itch risk in northern MI lakes, such as modifying tree cover and shallow-water vegetation at local sites.

A Place-Based Conceptual Model (PBCM) of Neotricula aperta/Schistosoma mekongi habitat before and after dam construction in the Lower Mekong River

In 1971, scientists from Mahidol University in Thailand and the Smithsonian Institution in the USA formed a research team to study a new species of Schistosoma in the Mekong River in Thailand and Laos. The studies, completed during 1971-1973, prior to the construction of any dams or restrictions to the natural flow regime of the Mekong River, provide a unique description of the natural ecological state of the river that can serve as a baseline for current research. The natural transmission of Schistosoma japonicum, Mekong Strain, was first reported on Khong Island, Laos in 1973 using sentinel mice. The first detailed description of the habitat ecology of the snail vector Neotricula aperta was done on-site in 1971 simultaneously with that research and is unique in providing the only description of the river shoreline habitat before any dams were built and any alteration of the natural flow regime was in place. Aggregating current information in a Place-Based Conceptual Model (PBCM) as an organizing template, along with current habitat models that combine ecological data with e-flows, can be developed and used as a tool to predict suitable habitats for snails. The natural flow regime of the Mekong River prior to any impoundments is described with current updates on the potential impacts of climate change and dams with flow-related snail habitat characteristics, including sediment drift and water quality. The application of the PBCM to describe and compare descriptive information on current and potential future N. aperta/S. mekongi habitat is discussed.

Assessment of schistosomiasis transmission in the River Nile at Greater Cairo using malacological surveys and cercariometry

Continuous field studies on the abundance and distribution of freshwater snails and cercarial populations are important for schistosomiasis control programs. In the present work, snail surveys and cercariometry were conducted for four successive seasons at 12 sites on the Nile River banks in the area of Greater Cairo to identify potential transmission foci for schistosomiasis. In addition, water physicochemical parameters were recorded. The results showed that the electrical conductivity, total dissolved solids, dissolved oxygen, and pH were within the permissible levels, except that the water temperature increased, especially in the spring season. Malacological surveys identified 10 native snail species at the studied sites of the Nile River, namely Bulinus truncatus, Biomphalaria alexandrina, Lymnaea natalensis, Lanistes carinatus, Cleopatra bulimoides, Melanoides tuberculata, Helisoma duryi, Bellamya unicolor, Physa acuta, Thedoxus niloticus, and one invasive snail species, Thiara scabra. The calculated diversity index indicated that the structure of snails' habitats was poor, while Evenness index indicated that the individuals were not distributed equally. Natural infection results identified no schistosome cercariae in B. truncatus and B. alexandrina. However, the cercariometry recovered Schistosoma cercariae in all the surveyed sites during all seasons with variable distribution. The preceding data suggest that there are still some active transmission foci for schistosomiasis infection in the Nile River. Moreover, the present finding highlights the importance of cercariomety as a complementary approach to snail samplings for identifying the transmission foci for schistosomiasis.

Abundance and Annual Distribution of Freshwater Snails and Some Trematode Cercariae at Damietta Governorate, Egypt

In addition to being a good food source, freshwater snails are considered one of the positively and negatively influencing invertebrates on the environment. Several biotic and abiotic factors are thought to affect the distribution and the dynamics of these snails. Freshwater snails are the most dominant and conspicuous individuals of the freshwater biota in Damietta Governorate. In this study, freshwater snails were collected monthly from 5 geographically and environmentally different sites at Damietta Governorate at the north of Egypt during June 2017-May 2018. Seven snail species; Lanistes carinatus, Lanistes varicus, Pila wernei, Segmentorbis angustus, Melanoides tuberculata, Biomphalaria alexandrina, and Gabbiella senoriansis, were identified. Lanistes carinatus was the most abundant species (56.4%) in the collection sites. Besides, Al-Inaniyyah village had the highest snail species abundance and variety. The abundance of the most recorded species varied seasonally; the highest abundance was recorded during summer while the lowest was during winter. The abundance of some snail species correlated positively or negatively with some physico-chemical parameters; water temperature, dissolved oxygen, conductivity, total dissolved salts, and electrical conductivity. Two types of trematode cercariae; gymnocephalus cercariae and xiphidiocercariae, were harvested from Lanistes carinatus. The highest prevalence of both cercarial types was detected during summer. The correlation between the prevalence of both cercarial types and the physico-chemical parameters were determined. Xiphidiocercariae were the most predominant cercarial type in Damietta Governorate. Our findings suggest that the invasion of some freshwater snails is likely to be the cause of the low prevalence or complete absence of some medically important intermediate snail hosts. We recommend further characterization of the distribution of freshwater snails and the interrelationships among them in Egypt, and suggest a controlled use of selected snail species to combat their medically important analogues.

Schistosome infection in Senegal is associated with different spatial extents of risk and ecological drivers for Schistosoma haematobium and S. mansoni

Schistosome parasites infect more than 200 million people annually, mostly in sub-Saharan Africa, where people may be co-infected with more than one species of the parasite. Infection risk for any single species is determined, in part, by the distribution of its obligate intermediate host snail. As the World Health Organization reprioritizes snail control to reduce the global burden of schistosomiasis, there is renewed importance in knowing when and where to target those efforts, which could vary by schistosome species. This study estimates factors associated with schistosomiasis risk in 16 villages located in the Senegal River Basin, a region hyperendemic for Schistosoma haematobium and S. mansoni. We first analyzed the spatial distributions of the two schistosomes’ intermediate host snails (Bulinus spp. and Biomphalaria pfeifferi, respectively) at village water access sites. Then, we separately evaluated the relationships between human S. haematobium and S. mansoni infections and (i) the area of remotely-sensed snail habitat across spatial extents ranging from 1 to 120 m from shorelines, and (ii) water access site size and shape characteristics. We compared the influence of snail habitat across spatial extents because, while snail sampling is traditionally done near shorelines, we hypothesized that snails further from shore also contribute to infection risk. We found that, controlling for demographic variables, human risk for S. haematobium infection was positively correlated with snail habitat when snail habitat was measured over a much greater radius from shore (45 m to 120 m) than usual. S. haematobium risk was also associated with large, open water access sites. However, S. mansoni infection risk was associated with small, sheltered water access sites, and was not positively correlated with snail habitat at any spatial sampling radius. Our findings highlight the need to consider different ecological and environmental factors driving the transmission of each schistosome species in co-endemic landscapes.

Schistosome parasites infect more than 200 million people worldwide, mainly in sub-Saharan Africa, where many people are at-risk for infection by multiple schistosome species simultaneously. To reduce the global burden of schistosomiasis, control of the parasites’ intermediate host–specific species of freshwater snails–has been elevated in priority to complement mass drug administration campaigns in endemic areas. To maximize the efficacy and efficiency of snail control efforts, a better understanding of where to target intermediate host snails is badly needed. This includes a better understanding of the spatial scale at which snails in the environment contribute to human infection risk, and, in co-endemic settings, how ecological determinants of infection risk vary by schistosome species. We used quantitative snail sampling and remotely-sensed data at 16 villages in the Senegal River Basin to compare and contrast ecological correlates and spatial scales of infection risk from freshwater snails that transmit Schistosoma haematobium versus S. mansoni. We found that infection risk for S. haematobium was associated with snail habitat at a larger spatial radius than is typically considered for schistosomiasis monitoring and control, whereas infection risk for S. mansoni was not positively correlated with snail habitat at any spatial sampling radius, but was associated with small water access sites enclosed by emergent vegetation. Our findings highlight the need to consider the different ecological and environmental factors driving the transmission of each schistosome species in co-endemic landscapes.

Proteins as Targets in Anti-Schistosomal Drug Discovery and Vaccine Development

Proteins hardly function in isolation; they form complexes with other proteins or molecules to mediate cell signaling and control cellular processes in various organisms. Protein interactions control mechanisms that lead to normal and/or disease states. The use of competitive small molecule inhibitors to disrupt disease-relevant protein-protein interactions (PPIs) holds great promise for the development of new drugs. Schistosome invasion of the human host involves a variety of cross-species protein interactions. The pathogen expresses specific proteins that not only facilitate the breach of physical and biochemical barriers present in skin, but also evade the immune system and digestion of human hemoglobin, allowing for survival in the host for years. However, only a small number of specific protein interactions between the host and parasite have been functionally characterized; thus, in-depth understanding of the molecular mechanisms of these interactions is a key component in the development of new treatment methods. Efforts are now focused on developing a schistosomiasis vaccine, as a proposed better strategy used either alone or in combination with Praziquantel to control and eliminate this disease. This review will highlight protein interactions in schistosomes that can be targeted by specific PPI inhibitors for the design of an alternative treatment to Praziquantel.

The impact of climate change on neglected tropical diseases: a systematic review

Neglected tropical diseases (NTDs) are a diverse group of diseases that continue to affect >1 billion people, with these diseases disproportionately impacting vulnerable populations and territories. Climate change is having an increasing impact on public health in tropical and subtropical areas and across the world and can affect disease distribution and transmission in potentially diverse ways. Improving our understanding of how climate change influences NTDs can help identify populations at risk to include in future public health interventions. Articles were identified by searching electronic databases for reports of climate change and NTDs between 1 January 2010 and 1 March 2020. Climate change may influence the emergence and re-emergence of multiple NTDs, particularly those that involve a vector or intermediate host for transmission. Although specific predictions are conflicting depending on the geographic area, the type of NTD and associated vectors and hosts, it is anticipated that multiple NTDs will have changes in their transmission period and geographic range and will likely encroach on regions and populations that have been previously unaffected. There is a need for improved surveillance and monitoring to identify areas of NTD incursion and emergence and include these in future public health interventions.

Population Dynamics of Intermediate-Host Snails in the White Nile River, Sudan: A Year-Round Observational Descriptive Study

We aimed to explore the population dynamics of snail in 3 sites of the White Nile in Sudan. More specifically, we aimed to investigate the annual patterns of snail populations that act as intermediate hosts of schistosomes and monthly snail infection rates and ecological characteristics presumably related to snail populations. We collected snails for 1 year monthly at 3 different shore sites in the vicinity of El Shajara along the White Nile river in Khartoum State, Sudan. In addition, we measured air and water temperatures, water turbidities, vegetation coverages, and water depths and current speeds. Most of the collected snails were Biomphalaria pfeifferi and Bulinus truncatus. The population densities of snails and their infection rates varied across survey sites. The collected snails liberated S. mansoni and S. haematobium cercariae as well as Amphistome and Echinostome cercariae. Infected snails were found during March–June. The ecological characteristics found to be associated with the absence of snails population were: high turbidity, deep water, low vegetation coverage (near absence of vegetation), high water temperature, and high current speed. To our knowledge, this is the first longitudinal study of the snail population and ecological characteristics in the main basin of the White Nile river.

Modelling the present and future distribution of Biomphalaria species along the watershed of the Middle Paranapanema region, São Paulo, Brazil

The Middle Paranapanema region in the state of São Paulo, Brazil, is an area with high diversity for Biomphalaria species, with municipalities historically marked by cases of schistosomiasis transmission. The objectives of the study were to evaluate the current distribuition and predict the future distribution of habitats of Biomphalaria species at a high spatial resolution along 114 freshwater sites in the Middle Paranapanema watershed. The modelling encompassed 55 municipalities of the Middle Paranapanema region, which were analyzed through the maximum entropy algorithm. All geographic coordinates of the Biomphalaria species collected from 2015-2018 and environmental data were obtained through WorldClim, HydroSHEDS, TOPODATA and Secretaria do Meio Ambiente for the 1970-2017 period. For the 2041-2060 period we used the HadGEM2-ES climate model. Due to climate change, MaxEnt showed that there was a high probability for the maintenance of B. glabrata habitats near Ourinhos and Assis, an expansion of scattered spots, and a 50% probability that the species will spread throughout new suitable areas. The results showed that the geographical range of B. straminea will most likely expand in the future along the Middle Paranapanema hydrographic basin, especially in the municipalities near Ourinhos. For B. glabrata and B. straminea, the geographic expansion was related to the predicted increase in the annual temperature range. The habitats suitable for B. tenagophila and B. peregrina seemed to slightly expand around the west border of the Middle Paranapanema region. Biomphalaria occidentalis may have a small reduction in its distribution due to climate change. The variables that contributed the most to the future modelling for these three species were precipitation and temperature. Identifying the sites with intermediate hosts for schistosomiasis may guide public health measures to avoid or reduce future transmissions in this region.

Modeling schistosomiasis spatial risk dynamics over time in Rwanda using zero-inflated Poisson regression

The recorded clinical cases of S. mansoni at primary health facility level contain an excessive number of zero records. This could mean that no S. mansoni infection occurred (a true zero) in the health facility service area but it could also that at least one infection occurred but none were reported or diagnosed (a false zero). Standard statistical analysis, using exploratory or confirmatory spatial regression, fail to account for this type of data insufficiency. This study developed a zero-inflated Poisson model to explore the spatiotemporal variation in schistosomiasis risk at a fine spatial scale. We used environmental data generated at primary health facility service area level as explanatory variables affecting transmission risk. Identified risk factors were subsequently used to project the spatial variability of S. mansoni infection risk for 2050. The zero-inflated Poisson model shows a considerable increase of relative risk of the schistosomiasis over one decade. Furthermore, the changes between the risk in 2009 and forecasted risk by 2050 indicated both persistent and emerging areas with high relative risk of schistosomiasis infection. The risk of schistosomiasis transmission is 69%, 29%, and 50% higher in areas with rice cultivation, proximity to rice farms, and proximity to a water body respectively. The prediction and forecasting maps provide a valuable tool for monitoring schistosomiasis risk in Rwanda and planning future disease control initiatives in wetland ecosystem development context.

Heat shock increases hydrogen peroxide release from circulating hemocytes of the snail Biomphalaria glabrata

Planorbid freshwater snails are important intermediate hosts for parasitic diseases caused by parasitic worms, most notably schistosomiasis. There are numerous reports of snails, specifically Biomphalaria glabrata, having compromised defences against schistosomes after being exposed to thermal stress. Environmental modifications to the defenses of schistosome transmitting snails could have negative ramifications for human disease risk in the context of climate change. Here the effects of heat shock on the production of hydrogen peroxide, a primary anti-microbial effector in many molluscs, were examined. The present findings show that heat shock increases NADPH oxidase 2 mRNA levels and hydrogen peroxide produced by snail hemocytes, and that both of these phenotypes could be reversed by an HSP-90 inhibitor. These findings indicate that snail defense systems are altered by heat shock at a molecular level in B. glabrata, and that snail immunity to many pathogens may be altered by the rapid variations in temperature that are associated with global climate change.

Neither heat pulse, nor multigenerational exposure to a modest increase in water temperature, alters the susceptibility of Guadeloupean Biomphalaria glabrata to Schistosoma mansoni infection

There are increasing concerns regarding the role global climate change will have on many vector-borne diseases. Both mathematical models and laboratory experiments suggest that schistosomiasis risk may change as a result of the effects of increasing temperatures on the planorbid snails that host schistosomes. Heat pulse/heat shock of the BS90 strain of Biomphalaria glabrata was shown to increase the rate of infection by Schistosoma mansoni, but the result was not replicable in a follow up experiment by a different lab. We characterised the susceptibility and cercarial shedding of Guadeloupean B. glabrata after infection with S. mansoni under two temperature regimes: multigenerational exposure to small increases in temperature, and extreme heat pulse events. Neither long-term, multigenerational rearing at elevated temperatures, nor transient heat pulse modified the susceptibility of Guadeloupean B. glabrata to infection (prevalence) or shedding of schistosome cercaria (intensity of infection). These findings suggest that heat pulse-induced susceptibility in snail hosts may be dependent on the strain of the snail and/or schistosome, or on some as-yet unidentified environmental co-factor.

Direct onshore wind predicts daily swimmer's itch (avian schistosome) incidence at a Michigan beach

Swimmer's itch (SI) is a painful rash caused by skin penetration by free-swimming infectious cercariae of avian schistosomes, snail-borne helminth parasites related to the causative agents of human schistosomiasis. The goal of this study was to determine if commonly collected environmental data could be used to predict daily fluctuations in SI incidence at an inland beach in northwestern Michigan. Lifeguards collected daily data over four summers, including the number of self-reported SI cases, total swimmers, water temperature, wind speed and wind direction. Mixed-effects binomial regression revealed that wind direction, wind speed and time of day were the best predictors of daily SI risk. Swimmers entering the water in the morning or on days with direct onshore wind perpendicular to the shoreline had the greatest SI risk. However, there was a negative effect of wind speed after accounting for direction, where SI risk was greatest on days with a gentle breeze originating directly offshore. These results suggest that at this beach, direct onshore winds generate a surface-water current that causes SI cercariae to aggregate in the shallow waters used by swimmers. Data are needed from additional sites to confirm whether the onshore wind is a generally important driver of SI incidence.

GLOBAL DYNAMICS OF A SEASONAL MATHEMATICAL MODEL OF SCHISTOSOMIASIS TRANSMISSION WITH GENERAL INCIDENCE FUNCTION

In this paper, we investigate a nonautonomous and an autonomous model of schistosomiasis transmission with a general incidence function. Firstly, we formulate the nonautonomous model by taking into account the effect of climate change on the transmission. Through rigorous analysis via theories and methods of dynamical systems, we show that the nonautonomous model has a globally asymptotically stable disease-free periodic equilibrium when the associated basic reproduction ratio [Formula: see text] is less than unity. Otherwise, the system admits at least one positive periodic solutions if [Formula: see text] is greater than unity. Secondly, using the average of periodic functions, we further derive the autonomous model associated with the nonautonomous model. Therefore, we show that the disease-free equilibrium of the autonomous model is locally and globally asymptotically stable when the associated reproduction ratio [Formula: see text] is less than unity. When [Formula: see text] is greater than unity, the existence and global asymptotic stability of the endemic equilibrium is established under certain conditions. Finally, using linear and nonlinear specific incidence function, we perform some numerical simulations to illustrate our theoretical results.

Schistosomes, snails and climate change: Current trends and future expectations

The exact impact of climate change on schistosomiasis, a disease caused by a blood fluke that affects more than 250 million people mainly in tropical and subtropical countries, is currently unknown, but likely to vary with the snail-parasite species' specific ecologies and the spatio-temporal scale of investigation. Here, by means of a systematic review to identify studies reporting on impacts of climate change on the agents of schistosomiasis, we provide an updated synthesis of the current knowledge about the climate change-schistosomiasis relation. We found that, despite a recent increase in scientific studies that discuss the potential impact of climate change on schistosomiasis, only a handful of reports have applied modelling and predictive forecasting that provide a quantitative estimate of potential outcomes. The volume and type of evidence associated with climate change responses were found to be variable across geographical regions and snail-parasite taxonomic groups. Indeed, the strongest evidence stems from the People's Republic of China pertaining to Schistosoma japonicum. Some evidence is also available from eastern Africa, mainly for Schistosoma mansoni. While studies focused on the northern and southern range margins for schistosomiasis indicate an increase in transmission range as the most likely outcome, there was less agreement about the direction of outcomes from the central and eastern parts of Africa. The current lack of consensus suggests that climate change is more likely to shift than to expand the geographic ranges of schistosomiasis. A comparison between the current geographical distributions and the thermo-physiological limitations of the two main African schistosome species (Schistosoma haematobium and S. mansoni) offered additional insights, and showed that both species already exist near their thermo-physiological niche boundaries. The African species both stand to move considerably out of their "thermal comfort zone" in a future, warmer Africa, but S. haematobium in particular is likely to experience less favourable climatic temperatures. The consequences for schistosomiasis transmission will, to a large extent, depend on the parasites and snails ability to adapt or move. Based on the identified geographical trends and knowledge gaps about the climate change-schistosomiasis relation, we propose to align efforts to close the current knowledge gaps and focus on areas considered to be the most vulnerable to climate change.

Priority focus areas for a sub-national response to climate change and health: A South African provincial case study

INTRODUCTION

The intersection of health and climate change is often absent or under-represented in sub-national government strategies. This analysis of the literature, using a new methodological framework, highlights priority focus areas for a sub-national government response to health and climate change, using the Western Cape (WC) province of South Africa as a case study.

METHODS

A methodological framework was created to conduct a review of priority focus areas relevant for sub-national governments. The framework encompassed the establishment of a Project Steering Group consisting of relevant, sub-national stakeholders (e.g. provincial officials, public and environmental health specialists and academics); an analysis of local climatic projections as well as an analysis of global, national and sub-national health risk factors and impacts.

RESULTS

Globally, the discussion of health and climate change adaptation strategies in sub-national, or provincial government is often limited. For the case study presented, multiple health risk factors were identified. WC climatic projections include a warmer and potentially drier future with an increased frequency and intensity of extreme weather events. WC government priority focus areas requiring further research on health risk factors include: population migration and environmental refugees, land use change, violence and human conflict and vulnerable groups. WC government priority focus areas for further research on health impacts include: mental ill-health, non-communicable diseases, injuries, poisonings (e.g. pesticides), food and nutrition insecurity-related diseases, water- and food-borne diseases and reproductive health. These areas are currently under-addressed, or not addressed at all, in the current provincial climate change strategy.

CONCLUSIONS

Sub-national government adaptation strategies often display limited discussion on the health and climate change intersect. The methodological framework presented in this case study can be globally utilized by other sub-national governments for decision-making and development of climate change and health adaptation strategies. Additionally, due to the broad range of sectoral issues identified, a primary recommendation from this study is that sub-national governments internationally should consider a "health and climate change in all policies" approach when developing adaptation and mitigation strategies to address climate change.

Simulation of population dynamics of Bulinus globosus: Effects of environmental temperature on production of Schistosoma haematobium cercariae

Background

Temperature is an important factor that influences the biology and ecology of intermediate host (IH) snails and the schistosome parasites they transmit. Although temperature shifts due to climate change has been predicted to affect the life history traits of IH snails and parasite production, the mechanisms of how this may affect parasite abundance and disease risks are still not clear.

Materials and methods

Using data from laboratory and field experiments, we developed a deterministic compartmental simulation model based on difference equations using a weekly time step that represented the life cycle of Bulinus globosus. We simulated snail population dynamics and the associated production of cercariae assuming current environmental temperatures as well as projected temperature increases of 1 °C and 2 °C.

Results

The model generated snail fecundity and survival rates similar to those observed in the laboratory and also produced reasonable snail population dynamics under seasonally varying temperatures representative of generally favorable environmental conditions. Simulated relative abundances of both snails and cercariae decreased with increasing environmental temperatures, with maximum snail abundances decreased by 14% and 27%, and maximum cercariae productions decreased by 8% and 17%, when temperatures were increased by 1 °C and 2 °C, respectively.

Conclusion

The results indicate that future rise in temperature due to climate change may alter the abundance of B. globosus and impact on the prevalence of schistosomiasis. Furthermore, increased temperatures may not linearly influence the abundance of S. haematobium. These results may have important implications for schistosomiasis control programmes in view of temperature driven changes in the life history traits of B. globosus and S. haematobium. Our study recommends that the use of deterministic models incorporating the effects of temperature on the life history traits of IH snails would be vital in understanding the potential impact of climate change on schistosomiasis incidences and prevalence.

The implementation of schistosomiasis control/elimination strategies depend on accurate estimations and predictions of the changes in the snail and parasite population. This is essential especially in the allocation of limited resources. The simulation model and the results presented here provide useful information on Bulinus globosus, the main intermediate host snail of Schistosoma haematobium in southern Africa. The predicted changes in the abundance of B. globosus and S. haematobium due to changes in temperature may be vital in the fight against schistosomiasis. The model predicts the current and future abundance of intermediate hosts snails by considering the future predicted temperature increases. These results may be useful in evaluating the snail-trematode interactions within the natural systems in which changes in the environmental conditions such a temperature may affect the population size of Bulinus globosus and disease incidences. These effects of temperature on B. globosus may play an important role in the implementation of snail control programmes.

Climate Change and the Neglected Tropical Diseases

Climate change is expected to impact across every domain of society, including health. The majority of the world's population is susceptible to pathological, infectious disease whose life cycles are sensitive to environmental factors across different physical phases including air, water and soil. Nearly all so-called neglected tropical diseases (NTDs) fall into this category, meaning that future geographic patterns of transmission of dozens of infections are likely to be affected by climate change over the short (seasonal), medium (annual) and long (decadal) term. This review offers an introduction into the terms and processes deployed in modelling climate change and reviews the state of the art in terms of research into how climate change may affect future transmission of NTDs. The 34 infections included in this chapter are drawn from the WHO NTD list and the WHO blueprint list of priority diseases. For the majority of infections, some evidence is available of which environmental factors contribute to the population biology of parasites, vectors and zoonotic hosts. There is a general paucity of published research on the potential effects of decadal climate change, with some exceptions, mainly in vector-borne diseases.

Epidemiology of intestinal helminthiasis among school children with emphasis on Schistosoma mansoni infection in Wolaita zone, Southern Ethiopia

Background

Intestinal helminth infections are major parasitic diseases causing public health problems in Ethiopia. Although the epidemiology of these infections are well documented in Ethiopia, new transmission foci for schistosomiasis are being reported in different parts of the country. The objective of this study was to assess the prevalence of Schistosoma mansoni and other intestinal helminth infections among school children and determine the endemicity of schistosomiasis in Wolaita Zone, southern Ethiopia.

Methods

Cross-sectional parasitological and malacological surveys were conducted by collecting stool samples for microscopic examination and snails for intermediate host identification. Stool samples were collected from 503 children and processed for microscopic examination using Kato-Katz and formalin-ether concentration methods. Snails collected from aquatic environments in the study area were identified to species level and Biomphalaria pfeifferi snails, the intermediate host of S. mansoni,, were individually exposed to artificial light in order to induce cercariae shedding. Cercariae shed from snails were used to infect laboratory-bred Swiss albino mice in order to identify the schistosome to species level.

Results

The overall prevalence of intestinal helminth infections was 72.2% among school children. S. mansoni infection prevalence was 58.6%. The prevalence and intensity of S. mansoni infections varied among schools and sex of children. Swimming was the only factor reported to be significantly associated with S. mansoni infection (AOR = 2.954, 95% CI:1.962-4.449). Other intestinal helminth species identified were hookworms (27.6%), Ascaris lumbricoides (8.7%), E. vermicularis (2.8%), Taenia species (2.6%), T. trichiura (1.2%) and H. nana (0.6%). Only B. pfeifferi snails collected from streams shed schistosome cercariae and 792 adult S. mansoni worms were harvested from mice exposed to cercariae shed from B. pfeifferi on the 6th week post-exposure.

Conclusion

The present study found high level of intestinal helminth infections in the study area. The study also confirmed autochthonous transmission and endemicity of S. mansoni as evidenced by both parasitological and malacological findings as well as by further establishing infections in lab-bred mice. Therefore, there is a need to include the area in the control programs with anti-helminth drugs and also consider other complementary measures including sanitation, provision of clean water supply, and snail control.

Effect of temperature on the Bulinus globosus - Schistosoma haematobium system

Background

Given that increase in temperature may alter host-parasite relationships, the anticipated rise in temperature due to global warming might change transmission patterns of certain diseases. However, the extent to which this will happen is not well understood.

Methods

Using a host-parasite system involving Bulinus globosus and Schistosoma haematobium, we assessed the effect of temperature on snail fecundity, growth, survival and parasite development under laboratory conditions.

Results

Our results show that temperature may have a non-linear effect on snail fecundity and snail growth. Snails maintained at 15.5 °C and 36.0 °C did not produce egg masses while those maintained at 25.8 °C laid 344 and 105 more egg masses than snails at 31.0 °C and 21.2 °C, respectively. Attainment of patency led to a reduction in egg mass production among the snails. However, the reduction in fecundity for snails maintained at 21.2 °C occurred before snails started shedding cercariae. Parasite development was accelerated at high temperatures with snails maintained at 31.0 °C reaching patency after three weeks. Furthermore, snail growth rate was highest at 25.8 °C while it was inhibited at 15.5 °C and reduced at 31.0 °C. Increase in temperature increased snail mortality rates. Snails maintained at 36.0 °C had the shortest survival time while those maintained at 15.5 °C had the longest survival time.

Conclusions

We concluded that temperature influences fecunxdity, growth, survival and parasite development in the snail and thus dictates the time it takes the parasite to complete the life cycle. This has implications on transmission of schistosomiasis in the context of global warming.

Electronic supplementary material

The online version of this article (doi:10.1186/s40249-017-0260-z) contains supplementary material, which is available to authorized users.

The Biomphalaria glabrata DNA methylation machinery displays spatial tissue expression, is differentially active in distinct snail populations and is modulated by interactions with Schistosoma mansoni

BACKGROUND

The debilitating human disease schistosomiasis is caused by infection with schistosome parasites that maintain a complex lifecycle alternating between definitive (human) and intermediate (snail) hosts. While much is known about how the definitive host responds to schistosome infection, there is comparably less information available describing the snail's response to infection.

METHODOLOGY/PRINCIPLE FINDINGS

Here, using information recently revealed by sequencing of the Biomphalaria glabrata intermediate host genome, we provide evidence that the predicted core snail DNA methylation machinery components are associated with both intra-species reproduction processes and inter-species interactions. Firstly, methyl-CpG binding domain protein (Bgmbd2/3) and DNA methyltransferase 1 (Bgdnmt1) genes are transcriptionally enriched in gonadal compared to somatic tissues with 5-azacytidine (5-AzaC) treatment significantly inhibiting oviposition. Secondly, elevated levels of 5-methyl cytosine (5mC), DNA methyltransferase activity and 5mC binding in pigmented hybrid- compared to inbred (NMRI)- B. glabrata populations indicate a role for the snail's DNA methylation machinery in maintaining hybrid vigour or heterosis. Thirdly, locus-specific detection of 5mC by bisulfite (BS)-PCR revealed 5mC within an exonic region of a housekeeping protein-coding gene (Bg14-3-3), supporting previous in silico predictions and whole genome BS-Seq analysis of this species' genome. Finally, we provide preliminary evidence for parasite-mediated host epigenetic reprogramming in the schistosome/snail system, as demonstrated by the increase in Bgdnmt1 and Bgmbd2/3 transcript abundance following Bge (B. glabrata embryonic cell line) exposure to parasite larval transformation products (LTP).

CONCLUSIONS/SIGNIFICANCE

The presence of a functional DNA methylation machinery in B. glabrata as well as the modulation of these gene products in response to schistosome products, suggests a vital role for DNA methylation during snail development/oviposition and parasite interactions. Further deciphering the role of this epigenetic process during Biomphalaria/Schistosoma co-evolutionary biology may reveal key factors associated with disease transmission and, moreover, enable the discovery of novel lifecycle intervention strategies.

Experimental and modelling investigations of Opisthorchis viverrini miracidia transmission over time and across temperatures: implications for control

Transmissibility is a significant factor in parasite fitness. The rate and magnitude of parasite transmission affect prevalence and infection intensity in individual hosts and are influenced by environmental factors. In this context, the objectives of this study were: (i) to experimentally assess Opisthorchis viverrini miracidia survival and infectivity over time and across temperatures; and (ii) to combine these experimental results with environmental data to build a key component of a transmission model, identifying seasonal windows of transmission risk in hyper-endemic northeastern Thailand. Five replicates of 50 O. viverrini eggs were randomly distributed and maintained under four temperature conditions (25°C, 30°C, 35°C, 40°C). Microscopic observations were performed on all experimental units over a period of 3months to record miracidia motility and mortality trends. Six infection trials were also conducted to assess infectivity of miracidia over time and across temperatures, using observations of egg hatching success and infection rates. Upon completion of experiments, data were integrated into a transmission model to create a transmission risk index and to simulate seasonal transmission risk. Miracidia survival rate and motility decreased steadily with 50% mortality observed after 2weeks. Hatching and infection success also decreased significantly after 3weeks. Temperatures over 30°C were associated with increased mortality and decreased infectivity. When incorporating local environmental parameters into our model, we observed low transmission risk during the dry season and increasing transmission risk at the onset of the rainy season, culminating with the highest risk in September. We believe that our results provide the first estimates of O. viverrini miracidia survival and transmission potential under variable temperature conditions and suggest that high temperature treatment (>40°C) of fecal waste could be an efficient control strategy.

Implications of Changing Temperatures on the Growth, Fecundity and Survival of Intermediate Host Snails of Schistosomiasis: A Systematic Review

Climate change has been predicted to increase the global mean temperature and to alter the ecological interactions among organisms. These changes may play critical roles in influencing the life history traits of the intermediate hosts (IHs). This review focused on studies and disease models that evaluate the potential effect of temperature rise on the ecology of IH snails and the development of parasites within them. The main focus was on IH snails of schistosome parasites that cause schistosomiasis in humans. A literature search was conducted on Google Scholar, EBSCOhost and PubMed databases using predefined medical subject heading terms, Boolean operators and truncation symbols in combinations with direct key words. The final synthesis included nineteen published articles. The studies reviewed indicated that temperature rise may alter the distribution, optimal conditions for breeding, growth and survival of IH snails which may eventually increase the spread and/or transmission of schistosomiasis. The literature also confirmed that the life history traits of IH snails and their interaction with the schistosome parasites are affected by temperature and hence a change in climate may have profound outcomes on the population size of snails, parasite density and disease epidemiology. We concluded that understanding the impact of temperature on the growth, fecundity and survival of IH snails may broaden the knowledge on the possible effects of climate change and hence inform schistosomiasis control programmes.

Universal Stress Proteins as New Targets for Environmental and Therapeutic Interventions of Schistosomiasis

In spite of various control measures and eradication methods that have been in progress, schistosomiasis still prevails as one of the most prevalent debilitating parasitic diseases, typically affecting the poor and the underprivileged that are predominantly concentrated in sub-Saharan Africa. The parasitic schistosome blood fluke responsible for causing the disease completes its complex developmental cycle in two hosts: humans and freshwater snails, where they physically undergo gross modifications to endure the different conditions associated with each host. Just like any other organism, the worm possesses mechanisms that help them respond to environmental insults. It has been hypothesized that a special class of proteins known as Universal Stress Proteins (USPs) are up-regulated during sudden environmental changes, thus assisting the worm to tolerate the unfavourable conditions associated with its developmental cycle. The position of praziquantel as the drug of choice against all schistosome infections has been deemed vulnerable due to mounting concerns over drug pressure and so the need for alternative treatment is now a matter of urgency. Therefore, this review seeks to explore the associations and possible roles of USPs in schistosomiasis as well as the functioning of these proteins in the schistosomulae stage in order to develop new therapeutic interventions against this disease.

The temporal patterns of disease severity and prevalence in schistosomiasis

Schistosomiasis is one of the most widespread public health problems in the world. In this work, we introduce an eco-epidemiological model for its transmission and dynamics with the purpose of explaining both intra- and inter-annual fluctuations of disease severity and prevalence. The model takes the form of a system of nonlinear differential equations that incorporate biological complexity associated with schistosome's life cycle, including a prepatent period in snails (i.e., the time between initial infection and onset of infectiousness). Nonlinear analysis is used to explore the parametric conditions that produce different temporal patterns (stationary, endemic, periodic, and chaotic). For the time-invariant model, we identify a transcritical and a Hopf bifurcation in the space of the human and snail infection parameters. The first corresponds to the occurrence of an endemic equilibrium, while the latter marks the transition to interannual periodic oscillations. We then investigate a more realistic time-varying model in which fertility of the intermediate host population is assumed to seasonally vary. We show that seasonality can give rise to a cascade of period-doubling bifurcations leading to chaos for larger, though realistic, values of the amplitude of the seasonal variation of fertility.

Predicting the effects of climate change on Schistosoma mansoni transmission in eastern Africa

BACKGROUND

Survival and fitness attributes of free-living and sporocyst schistosome life-stages and their intermediate host snails are sensitive to water temperature. Climate change may alter the geographical distribution of schistosomiasis by affecting the suitability of freshwater bodies for hosting parasite and snail populations.

METHODS

We have developed an agent-based model of the temperature-sensitive stages of the Schistosoma mansoni and intermediate host snail lifecycles. The model was run using low, moderate and high warming climate projections over eastern Africa. For each climate projection, eight model scenarios were used to determine the sensitivity of predictions to different relationships between air and water temperature, and different snail mortality rates. Maps were produced showing predicted changes in risk as a result of increasing temperatures over the next 20 and 50 years.

RESULTS

Baseline model output compared to prevalence data indicates suitable temperatures are necessary but not sufficient for both S. mansoni transmission and high infection prevalences. All else being equal, infection risk may increase by up to 20% over most of eastern Africa over the next 20 and 50 years. Increases may be higher in Rwanda, Burundi, south-west Kenya and eastern Zambia, and S. mansoni may become newly endemic in some areas. Results for 20-year projections are robust to changes in simulated intermediate host snail habitat conditions. There is greater uncertainty about the effects of different habitats on changes in risk in 50 years' time.

CONCLUSIONS

Temperatures are likely to become suitable for increased S. mansoni transmission over much of eastern Africa. This may reduce the impact of control and elimination programmes. S. mansoni may also spread to new areas outside existing control programmes. We call for increased surveillance in areas defined as potentially suitable for emergent transmission.

Effect of water temperature and population density on the population dynamics of Schistosoma mansoni intermediate host snails

Background

Mathematical models can be used to identify areas at risk of increased or new schistosomiasis transmission as a result of climate change. The results of these models can be very different when parameterised to different species of host snail, which have varying temperature preferences. Currently, the experimental data needed by these models are available for only a few species of snail. The choice of density-dependent functions can also affect model results, but the effects of increasing densities on Biomphalaria populations have only previously been investigated in artificial aquariums.

Methods

Laboratory experiments were conducted to estimate Biomphalaria sudanica mortality, fecundity and growth rates at ten different constant water temperatures, ranging from 13-32°C. Snail cages were used to determine the effects of snail densities on B. sudanica and B. stanleyi mortality and fecundity rates in semi-natural conditions in Lake Albert.

Results

B. sudanica survival and fecundity were highest at 20°C and 22°C respectively. Growth in shell diameter was estimated to be highest at 23°C in small and medium sized snails, but the relationship between temperature and growth was not clear. The fecundity of both B. sudanica and B. stanleyi decreased by 72-75% with a four-fold increase in population density. Increasing densities four-fold also doubled B. stanleyi mortality rates, but had no effect on the survival of B. sudanica.

Conclusions

The optimum temperature for fecundity was lower for B. sudanica than for previously studied species of Biomphalaria. In contrast to other Biomphalaria species, B. sudanica have a distinct peak temperature for survival, as opposed to a plateau of highly suitable temperatures. For both B. stanleyi and B. sudanica, fecundity decreased with increasing population densities. This means that snail populations may experience large fluctuations in numbers, even in the absence of any external factors such as seasonal temperature changes. Survival also decreased with increasing density for B. stanleyi, in contrast to B. sudanica and other studied Biomphalaria species where only fecundity has been shown to decrease.

Electronic supplementary material

The online version of this article (doi:10.1186/s13071-014-0503-9) contains supplementary material, which is available to authorized users.

The effect of simulating different intermediate host snail species on the link between water temperature and schistosomiasis risk

INTRODUCTION

A number of studies have attempted to predict the effects of climate change on schistosomiasis risk. The importance of considering different species of intermediate host snails separately has never previously been explored.

METHODS

An agent-based model of water temperature and Biomphalaria pfeifferi population dynamics and Schistosoma mansoni transmission was parameterised to two additional species of snail: B. glabrata and B. alexandrina.

RESULTS

Simulated B. alexandrina populations had lower minimum and maximum temperatures for survival than B. pfeifferi populations (12.5-29.5°C vs. 14.0-31.5°C). B. glabrata populations survived over a smaller range of temperatures than either B. pfeifferi or B. alexandrina (17.0°C-29.5°C). Infection risk peaked at 16.5°C, 25.0°C and 19.0°C respectively when B. pfeifferi, B. glabrata and B. alexandrina were simulated. For all species, infection risk increased sharply once a minimum temperature was reached.

CONCLUSIONS

The results from all three species suggest that infection risk may increase dramatically with small increases in temperature in areas at or near the currents limits of schistosome transmission. The effect of small increases in temperature in areas where schistosomiasis is currently found will depend both on current temperatures and on the species of snail acting as intermediate host(s) in the area. In most areas where B. pfeifferi is the host, infection risk is likely to decrease. In cooler areas where B. glabrata is the host, infection risk may increase slightly. In cooler areas where B. alexandrina is the host, infection risk may more than double with only 2°C increase in temperature. Our results show that it is crucial to consider the species of intermediate host when attempting to predict the effects of climate change on schistosomiasis.