Schistosomiasis is an infection that affects the liver, bladder, and other internal organs. One of the most devastating parasitic diseases in sub-Saharan Africa, schistosomiasis causes an estimated 200,000 deaths a year. The disease is caused by flatworms carried by fresh water snails. People are infected while swimming, fishing, or participating in other activities in rivers and lakes when the flatworm larvae penetrate human skin and attack internal organs. A neglected tropical disease (NTD), schistosomiasis disproportionately affects children, resulting in stunted growth, learning disabilities, and anemia. More than 230 million people globally are at risk for the disease.
Schistosomiasis is most common in Africa, which carries the burden of 9 out of every 10 cases globally. The global strategy to control schistosomiasis is based upon mass drug administration (MDA) of praziquantel, an anti-parasitic drug. Water, sanitation, and hygiene improvements are also part of comprehensive programs to eliminate the disease. The World Health Organization’s (WHO) schistosomiasis target is to reach at least 75 percent of school children in endemic areas with periodic praziquantel treatment by 2020.
Schistosomiasis is one of five NTDs that The Task Force for Global Health is working to control or eliminate as a public health problem. The Task Force’s NTD Support Center (NTD-SC) contributes to the elimination of schistosomiasis by driving operational research to improve programmatic outcomes.
Driving Operational Research to Strengthen Control and Elimination Programs
NTD-SC serves as the hub for a coalition of scientists, donors, and implementing partners working to bridge knowledge gaps about schistosomiasis and other NTDs. This group, the Coalition for Operational Research on Neglected Tropical Diseases (COR-NTD), supports research to overcome barriers to eliminating the morbidity due to schistosomiasis. NTD-SC has supported multi-country operational research studies to strengthen programs and protocols for schistosomiasis control. These studies have helped measure prevalence of the disease and evaluate strategies and diagnostics tests to combat it. Access to accurate and real-time data on schistosomiasis prevalence and MDA coverage is critical to success. NTD-SC and WHO collaborated to complete mapping of NTDs, including schistosomiasis, in Africa. NTD-SC also supported assessments of innovative technologies including mHealth Platforms that monitor coverage of MDA activities. These automated phone and text-based systems also measure and communicate the size of drug inventories over the course of large-scale treatment programs. Other NTD-SC sponsored studies have assessed protocols for measuring MDA coverage, comparing the accuracy of school-based to community-based monitoring. Sensitive and rapid diagnostic tests are also needed to measure the success of praziquantel treatments. NTD-SC is helping to assess the effectiveness of diagnostic tools for sensitivity and specificity, including their ability to distinguish active cases of schistosomiasis from historic, but cured, exposures. The focus of these studies is on point-of-care, urine-based or blood-based circulating cathodic antigen rapid diagnostic tests.
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Header photo caption: An epidemiologist points out the snails on a rock from the river that carry the parasitic disease that causes schistosomiasis.