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Towards control of schistosomiasis in sub-Saharan Africa

Published online by Cambridge University Press:  22 February 2007

V.R. Southgate*
Affiliation:
Parasitology Division, Wolfson Wellcome Biomedical Laboratories, Department of Zoology, The Natural History Museum, South Kensington, London, SW7 5BD, UK
D. Rollinson
Affiliation:
Parasitology Division, Wolfson Wellcome Biomedical Laboratories, Department of Zoology, The Natural History Museum, South Kensington, London, SW7 5BD, UK
L.A. Tchuem Tchuenté
Affiliation:
National Programme for Control of Schistosomiasis and Soil Transmitted Helminths, Centre of Schistosomiasis and Parasitology, PO Box 7244, Yaoundé, Cameroon
P. Hagan
Affiliation:
Division of Infection and Immunity, IBLS Joseph Black Building, University of Glasgow, Glasgow, G12 8QQ, UK
*
*Author for correspondence Fax: 0044 207942 5518 E-mail: V.Southgate@nhm.ac.uk

Abstract

Approximately 80% of the 200 million people infected with schistosomiasis inhabit sub-Saharan Africa, and the annual mortality is estimated to be 280,000. Praziquantel is the drug of choice in the treatment of schistosomiasis and pregnant women may now be treated. It was agreed at the World Health Assembly in 2001 that at least 75% of school-aged children in high burden areas should be treated for schistosomiasis and soil-transmitted helminth infections by 2010 to reduce morbidity. A grant from the Bill and Melinda Gates Foundation to the Schistosomiasis Control Initiative, Imperial College of Science, Technology and Medicine, London has enabled control programmes to be initiated in Uganda, Tanzania, Zambia, Burkina Faso, Niger and Mali. Additional programmes have recently commenced in Zanzibar with a grant from the Health Foundation to The Natural History Museum, London and in Cameroon. Combination treatment for schistosomiasis, gastrointestinal helminths and filariasis reduces costs of control programmes. The EC Concerted Action Group on ‘Praziquantel: its central role in the chemotherapy of schistosome infection’ met in Yaoundé Cameroon in 2004 to discuss recent developments in laboratory and field studies. The use of standard operating procedures will enable data on drug action on schistosomes produced in different laboratories to be compared. With the ever increasing use of praziquantel there is a possibility of the development of resistance by schistosomes to the drug, hence the necessity to explore the activities of other compounds. Artemether, unlike praziquantel, is effective against immature schistosomes. The effectiveness of mirazid, an extract of myrrh, is controversial as data from different laboratories are equivocal. It is suggested that an independent body such as the World Health Organization should determine whether mirazid should be used in the treatment of schistosomiasis.

Type
Review Article
Copyright
Cambridge University Press 2015

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