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Providing the Evidence Base and Tools for Prioritising and Implementing Paediatric Schistosomiasis Control to Enhance Early Childhood Development

Providing the Evidence Base and Tools for Prioritising and Implementing Paediatric Schistosomiasis Control to Enhance Early Childhood Development

Principal Investigator: Professor Francisca Mutapi, University of Edinburgh

Over 2 billion people, most of whom are children, are infected with parasitic worms with currently over 4 billion at risk of infection. Schistosomes (commonly known as blood flukes) are responsible for the greatest helminth-related morbidity and pathology in Africa. Urogenital schistosomiasis caused by Schistosoma haematobium is a chronic disease acquired primarily in childhood by exposure to freshwater contaminated with the parasites released from freshwater snails. Infection with the parasites causes haematuria, dysuria, nutritional deficiencies, anaemia, growth retardation, decreased physical performance and impaired memory and cognition. If left untreated, the disease can progress to bladder wall pathology, hydronephrosis and hepatosplenomegaly. In adulthood, chronic schistosomiasis can also affect reproductive health, with manifestations including lesions of the cervix and vagina, vaginal bleeding, nodules in the vulva in women while in males symptoms include pathology of the seminal vesicles, prostate and other genital organs. Schistosomiasis is controlled by treatment of infected people with the drug praziquantel, which is cheap, efficacious and safe. Our studies and those of others indicate that these irreversible disease symptoms can be prevented by treating infection early in childhood, when pathology is still reversible. The World Health Organisation treatment guidelines exclude preschool children (PSAC) (< 5 years old) from schistosomiasis treatment programmes despite the growing body of studies reporting high schistosome infection levels and significant morbidity in these children. An estimated 50M African PSAC need treatment, but remain excluded from national schistosome control programs. We will quantify the impact of PSAC schistosomiasis and its treatment on child health and development, evaluate diagnostic tools for PSAC schistosomiasis, and identify community engagement strategies for accessing PSAC for treatment. Our results will provide the evidence base and tools for prioritising and implementing paediatric schistosomiasis control to enhance early childhood development. 

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