title: A new global strategy for the elimination of schistosomiasis.
abstract: Mass drug administration utilising a single oral dose of 40mg/kg of praziquantel (PZQ) has been endorsed and advocated by the World Health Organisation (WHO) for the global control and elimination of schistosomiasis. However, this strategy is failing primarily because the drugs are not getting to the people who need them the most. The current global coverage is 20%, the drug compliance rate is less than 50%, and the drug efficacy is approximately 50%. Thus in reality, only about 5% of the reservoir human population is actually receiving intermittent chemotherapy. Despite claims that more of the drug will soon be made available the current strategy is inherently flawed and will not lead to disease elimination. We discuss the many practical issues related to this global strategy, and advocate for an integrated control strategy targeting the life cycle and the most at-risk. Moreover, we discuss how an integrated control package for schistosomiasis should fit within a larger integrated health package for rural and remote villages in the developing world. A holistic health system approach is required to achieve sustainable control and ultimately disease elimination.
authors.affiliation: Menzies Health Institute Queensland, Griffith University, Australia. Electronic address: a.ross@griffith.edu.au.
authors.forename: Allen G P
authors.initials: AG
authors.lastname: Ross
authors.affiliation: Discipline of Public Health, Flinders University, Australia.
authors.forename: Thao N
authors.initials: TN
authors.lastname: Chau
authors.affiliation: Research Institute for Tropical Medicine, Department of Health, the Philippines.
authors.forename: Marianette T
authors.initials: MT
authors.lastname: Inobaya
authors.affiliation: Research Institute for Tropical Medicine, Department of Health, the Philippines.
authors.forename: Remigio M
authors.initials: RM
authors.lastname: Olveda
authors.affiliation: QIMR Berghofer Medical Research Institute, Australia; Hunan Institute of Parasitic Diseases, Peoples Republic of China.
authors.forename: Yuesheng
authors.initials: Y
authors.lastname: Li
authors.affiliation: Centre for Tropical and Emerging Global Health Diseases, University of Georgia, USA.
authors.forename: Donald A
authors.initials: DA
authors.lastname: Harn
mesh_terms: D000871:Anthelmintics / Q000627:therapeutic use*; D014943:Global Health; D006801:Humans; D017053:Infection Control; D044382:Population Groups; D011223:Praziquantel / Q000627:therapeutic use; D012424:Rural Population; D012552:Schistosomiasis / Q000188:drug therapy / Q000517:prevention & control* / Q000523:psychology
chemical_list: D000871:Anthelmintics; D011223:Praziquantel
keywords: Mass Drug Administration (MDA); Schistosomiasis; artemether; community development; dosage; integrated control; praziquantel