Schistosomiasis elimination: lessons from the past guide the future.
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.
Gray
Darren J
DJ
Griffith University, Meadowbrook, Queensland, Australia. d.gray@griffith.edu.au
McManus
Donald P
DP
Li
Yuesheng
Y
Williams
Gail M
GM
Bergquist
Robert
R
Ross
Allen G
AG
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*