title: Schistosomiasis elimination: lessons from the past guide the future.
abstract: Schistosomiasis is a major neglected tropical disease, with more than 200 million people infected and close to 800 million at risk. The disease burden is estimated to exceed 70 million disability-adjusted life-years. The anthelmintic drug praziquantel is highly effective in killing adult schistosome worms, but it is unable to kill developing schistosomes and so does not prevent reinfection. As a result, current praziquantel-based control programmes in Asia and sub-Saharan Africa are not effective or sustainable in the long term. The control of neglected tropical diseases, including schistosomiasis, is a funding priority for several donor agencies, with over US$350 million committed until 2013. Here we put forward an argument that donor funds would be more effectively spent on the development of a multi-faceted, integrated control programme, which would have a greater and longer lasting effect on disease transmission than the current chemotherapy-based programmes. The development of a transmission-blocking vaccine is also of great importance. A multi-faceted integrated control programme that incorporates a vaccine, even if only partly effective, has the potential to eliminate schistosomiasis. This integrated-approach model has the potential to improve the health of a billion of the world's poorest people and its effect cannot be underestimated.
authors: Griffith University, Meadowbrook, Queensland, Australia. d.gray@griffith.edu.au
authors: Darren J
authors: DJ
authors: Gray
authors: Donald P
authors: DP
authors: McManus
authors: Yuesheng
authors: Y
authors: Li
authors: Gail M
authors: GM
authors: Williams
authors: Robert
authors: R
authors: Bergquist
authors: Allen G
authors: AG
authors: Ross
mesh_terms: D017954:Africa South of the Sahara; D001208:Asia; D003140:Communicable Disease Control / Q000379:methods*; D006801:Humans; D012552:Schistosomiasis / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control*