WHO launches new guideline for the control and elimination of human schistosomiasis

On 15 February 2022, the World Health Organization (WHO) launched a new guideline providing countries with evidence-based recommendations, in an effort to achieve control and elimination of schistosomiasis as a public health problem, and to move towards interruption of transmission.

The WHO hope this guideline will help achieve the 2030 target for eliminating schistosomiasis as a public health problem and the interruption of transmission in humans in selected countries, as set out in the 2021 to 2030 road map for neglected tropical diseases. There are several evidence-based recommendations towards achieving this target in countries with high or low prevalence of the disease, which are:

• an expansion of preventive chemotherapy to all in need, including adults and preschool-aged children
• a single prevalence threshold to conduct preventive chemotherapy and its frequency
• frequency of preventive chemotherapy in transmission hot spots
• safety of praziquantel in the treatment of:
  • children aged two years and over
  • adults
  • pregnant women after the first trimester
  • lactating women
• implementation of snail control as a strategy to reduce transmission
• implementation of cross-sectoral approaches, including water, sanitation and hygiene (WASH)
• diagnostic strategies for assessment of infection in humans, animals and snails, and the environment

The guideline, which was launched during a WHO-hosted webinar as part of World Neglected Tropical Diseases Day 2022, comes after years of progress and a scale-up of interventions made possible through the increased availability of donated praziquantel, the recommended medicine against all forms of schistosomiasis. Furthermore, the guideline comes at a time when the global community is integrating approaches to tackle neglected tropical diseases, which includes working closely with sectors such as WASH and One Health.

During the webinar, panellists spoke of the need to treat everyone, in both high and low prevalence settings. Discussion also focused on how to monitor and evaluate future integrated interventions and how best to use methods in making informed decisions.

Vector and zoonotic control, and interventions aimed at treating all types of morbidities associated with schistosomiasis including female genital schistosomiasis, were discussed, as well as advocacy, sustainability and domestic resource mobilization in sustaining progress towards elimination.

Schistosomiasis, also known as bilharziasis, is an acute and chronic parasitic disease caused by infection with blood flukes (trematode worms) and has been reported in 78 countries. People may become infected during routine agricultural, domestic, occupational and recreational activities, which can expose them to infested water. Lack of hygiene and certain recreational habits of school-aged children, such as swimming or fishing in infested water, make them especially vulnerable to infection.

Source: WHO, 22 February 2022