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Schistosomiasis and neglected tropical diseases: towards integrated and sustainable control and a word of caution

Published online by Cambridge University Press:  11 November 2009

J. UTZINGER ,
G. RASO ,
S. BROOKER ,
D. DE SAVIGNY ,
M. TANNER ,
N. ØRNBJERG ,
B. H. SINGER  and
E. K. N'GORAN
J. UTZINGER*
Affiliation:
Department of Public Health and Epidemiology, Swiss Tropical Institute, P.O. Box, CH–4002 Basel, Switzerland
G. RASO
Affiliation:
Division of Epidemiology and Social Medicine, School of Population Health, The University of Queensland, Public Health Building, Herston Road, Brisbane, Queensland 4006, Australia Molecular Parasitology Laboratory, Queensland Institute of Medical Research, 300 Herston Road, Brisbane, Queensland 4006, Australia Centre Suisse de Recherches Scientifiques, 01 BP 1303, Abidjan 01, Côte d'Ivoire
S. BROOKER
Affiliation:
Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom Malaria Public Health and Epidemiology Group, KEMRI/Wellcome Trust Research Programme, P.O. Box 43640–00100, Nairobi, Kenya
D. DE SAVIGNY
Affiliation:
Department of Public Health and Epidemiology, Swiss Tropical Institute, P.O. Box, CH–4002 Basel, Switzerland
M. TANNER
Affiliation:
Department of Public Health and Epidemiology, Swiss Tropical Institute, P.O. Box, CH–4002 Basel, Switzerland
N. ØRNBJERG
Affiliation:
DBL – Centre for Health Research and Development, Faculty of Life Sciences, University of Copenhagen, Thorvaldsensvej 57, DK-1871 Frederiksberg C, Denmark
B. H. SINGER
Affiliation:
Office of Population Research, Princeton University, Princeton, NJ 08544, USA
E. K. N'GORAN
Affiliation:
Centre Suisse de Recherches Scientifiques, 01 BP 1303, Abidjan 01, Côte d'Ivoire UFR Biosciences, Université d'Abidjan-Cocody, 22 BP 582, Abidjan 22, Côte d'Ivoire
*
*Corresponding author: Jürg Utzinger, Department of Public Health and Epidemiology, Swiss Tropical Institute, P.O. Box, CH–4002 Basel, Switzerland. Tel.: +41 61 284-8129; Fax: +41 61 284-8105; E-mail: juerg.utzinger@unibas.ch
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Summary

In May 2001, the World Health Assembly (WHA) passed a resolution which urged member states to attain, by 2010, a minimum target of regularly administering anthelminthic drugs to at least 75% and up to 100% of all school-aged children at risk of morbidity. The refined global strategy for the prevention and control of schistosomiasis and soil-transmitted helminthiasis was issued in the following year and large-scale administration of anthelminthic drugs endorsed as the central feature. This strategy has subsequently been termed ‘preventive chemotherapy’. Clearly, the 2001 WHA resolution led the way for concurrently controlling multiple neglected tropical diseases. In this paper, we recall the schistosomiasis situation in Africa in mid-2003. Adhering to strategic guidelines issued by the World Health Organization, we estimate the projected annual treatment needs with praziquantel among the school-aged population and critically discuss these estimates. The important role of geospatial tools for disease risk mapping, surveillance and predictions for resource allocation is emphasised. We clarify that schistosomiasis is only one of many neglected tropical diseases and that considerable uncertainties remain regarding global burden estimates. We examine new control initiatives targeting schistosomiasis and other tropical diseases that are often neglected. The prospect and challenges of integrated control are discussed and the need for combining biomedical, educational and engineering strategies and geospatial tools for sustainable disease control are highlighted. We conclude that, for achieving integrated and sustainable control of neglected tropical diseases, a set of interventions must be tailored to a given endemic setting and fine-tuned over time in response to the changing nature and impact of control. Consequently, besides the environment, the prevailing demographic, health and social systems contexts need to be considered.

Keywords

Schistosomiasissoil-transmitted helminthiasisneglected tropical diseasesepidemiologycontrolburdenmorbiditypraziquantelchemotherapyintegrationhealth systemssustainabilityAfrica
Type
SECTION 5 TOWARDS FUTURE USE OF PRAZIQUANTEL
Information
Parasitology , Volume 136 , Special Issue 13: Control of schistosomiasis in sub-Saharan Africa , November 2009 , pp. 1859 - 1874
Copyright
Copyright © Cambridge University Press 2009

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