Schistosomiasis Control Program - Articles by Carter Center Experts

September 2024
Integrated Serosurveillance for Onchocerciasis, Lymphatic Filariasis, and Schistosomiasis in North Darfur, Sudan
Published by The American Journal of Tropical Medicine and Hygiene.
Authors: Jenna E. Coalson, Gregory S. Noland, Andrew W. Nute, Erica Brook Goodhew, Diana L. Martin, Zeinab Abdalla, Isam Zarroug, Soheir Gabralla, Hassan Ahmed Hassan Ahmed Ismail, William Evan Secor, Elizabeth Kelly Callahan, Angelia M. Sanders, Balgesa Elshafie, and Scott D. Nash
Description: Sudan is endemic for multiple neglected tropical diseases, including trachoma, onchocerciasis (OV), lymphatic filariasis (LF), and schistosomiasis (SCH). In 2019, dried blood spot samples were collected for a baseline trachoma serosurvey in three localities (El Seraif, Kotom, and Saraf Omrah) in North Darfur State. None were classified previously as OV- or LF-endemic, although low levels of SCH had been identified in all three. Approximately 30 households from 25 communities in each locality were selected by multistage cluster random sampling. Collections of DBSs were analyzed by multiplex bead assay for antibodies to multiple pathogens. This paper presents data on OV (Ov16), LF (Wb123, Bm14, Bm33), and SCH (soluble egg antigen [SEA], Sm25) antibodies among 8,322 individuals from 2,119 households. The survey-adjusted seroprevalence estimates for Ov16 were <0.3% in all localities. Lymphatic filariasis–antigen seroprevalences were discordant. Seroprevalence estimates ranged from 4.6–6.0% (Wb123), 0.99–1.4% (Bm14), and 29.2–33.3% (Bm33). Schistosomiasis seroprevalence estimates among school-aged children ranged from 2.7–8.0% (SEA) and 10.9–15.6% (Sm25). Ov16 seropositivity was low and supported the localities’ classification as nonendemic. The results suggested LF exposure, but discordance between antigens, challenges defining seropositivity thresholds, and the absence of programmatic guidance based on antibody serology alone for Wuchereria bancrofti indicate a need for remapping surveys to confirm transmission. Schistosomiasis antibody levels were high enough to warrant further mapping to guide treatment decisions. The lack of gold standards limited interpretation of results, particularly for LF, but in resource-challenged areas, integrated serological surveillance offers the possibility of efficient monitoring of exposure to multiple diseases.

September 2024
A Mixed-Methods Evaluation of Mainstreaming Mass Drug Administration for Schistosomiasis and Soil-Transmitted Helminthiasis in Four Districts of Nigeria
Published by The American Journal of Tropical Medicine and Hygiene.
Authors: Emily Griswold, Abel Eigege, Emmanuel C. Emukah, Jayden Pace Gallagher, Jenna Coalson, Lindsay Rakers, Bulus Mancha, Okocha Ndudi, Paul Ugbadamu, Philomena Dikedi, Happiness Poko, Jacob Danboyi, Philemon Dagwa, Vincent Anighoro, Christiana Davou Gwong, Esther Otabor, Goodluck James Amayat, Regina Ese Unukopia, Emmanuel S. Miri, and Gregory S. Noland
Description: In Nigeria, mass drug administration (MDA) for schistosomiasis (SCH) and soil-transmitted helminthiasis (STH) has often been coordinated with other programs that receive greater external funding. As these programs reach stop MDA milestones, SCH and STH programs will likely need to transition implementation, or “mainstream,” to domestic support. A mixed-methods study was conducted in four districts before (2021) and after (2022) mainstreaming to evaluate its impact on MDA coverage. Household surveys were done in 30 villages per district pre- and post-mainstreaming. Respondents were deeply pessimistic about the future of MDA after mainstreaming and strongly supported a gradual transition to full government ownership. Participants formulated recommendations for effective mainstreaming: clear budget allocation by governments, robust and targeted training, trust building, and comprehensive advocacy. Although participants lacked confidence that SCH and STH programs could be sustained after reductions in external support, initial results indicate that MDA coverage can remain high 1 year into mainstreaming.

May 16, 2022
Impact of Three to Five Rounds of Mass Drug Administration on Schistosomiasis and Soil-Transmitted Helminths in School-Aged Children in North-Central Nigeria
Published by The American Journal of Tropical Medicine and Hygiene; 107(1):132-142. doi: 10.4269/ajtmh.21-1207.
Authors: Emily Griswold, Abel Eigege, Solomon Adelamo, Bulus Mancha, Nwodu Kenrick, Yohana Sambo, Joseph Ajiji, Gideon Zam, Jacob Solomon, Rita Urude, Jonathan Kadimbo, Jacob Danboyi, Emmanuel S. Miri, Andrew W. Nute, Lindsay Rakers, Obiageli Nebe, Chukwuma Anyaike, Paul Weiss, Gregory S. Noland, and Frank O. Richards Jr.
Nasarawa and Plateau states of north-central Nigeria have implemented programs to control schistosomiasis (SCH) and soil-transmitted helminths (STH) in children since the 1990s. Statewide mapping surveys were conducted in 2013, when 11,332 school-aged children were sampled from 226 schools. The local government areas (LGAs) then received varying combinations of mass drug administration (MDA) for the next 5 years.

January 2018
Blood Trematodes: Schistosomiasis (PDF)
Published in Etiologic Agents of Infectious Diseases.
Authors: Susan P. Montgomery and Frank O. Richards, Jr.
Schistosomiasis (i.e., bilharzia or snail fever) is a parasitic infection caused by trematodes that reside in the circulatory system. More than 230 million people worldwide suffer from schistosomiasis, which causes a range of clinical disease from overt clinical manifestations to subtle hindrance of day-to-day activities. Infected children can have impaired growth and development.

July 18, 2013
The Presumptive Treatment of All School-aged Children is The Least Costly Strategy for Schistosomiasis Control in Plateau and Nasarawa States, Nigeria
Published in Ann Trop Med Parasitol. Sep 2009: 103(6): 501-11.
Authors: Gutman J, Richards FO Jr, Eigege A, Umaru J, Alphonsus K, Miri ES.
The results of previous studies in Nigeria indicate that 81% of the villages in Plateau and Nasarawa states probably qualify for the mass administration of praziquantel (PZQ) because of Schistosoma haematobium (SH) and/or S. mansoni (SM) infection. To determine the best strategy, relative costs were modelled for four different programmatic approaches to mass drug administration (MDA) at village level.

Feb. 4, 2013
Assessing the WHO 50% Prevalence Threshold in School-Aged Children as Indication for Treatment of Urogenital Schistosomiasis in Adults in Central Nigeria (PDF)
Published in American Journal of Tropical Medicine and Hygiene, 2013 doi: 10.4269/ajtmh.12-0511.
Authors: Darin S. Evans,* Jonathan D. King, Abel Eigege, John Umaru, William Adamani, Kal Alphonsus, Yohanna Sambo, Emmanual S. Miri, Danjuma Goshit, Gladys Ogah, and Frank O. Richards, Jr.
Preventive chemotherapy with praziquantel is recommended in adults by the World Health Organization when prevalence of schistosomiasis in school-aged children (SAC) is ³ 50%. This study ascertained the value of this threshold in predicting prevalence and intensity of Schistosoma hematobium (SH) infection in adults in central Nigeria.

Nov. 1, 2009
Integrating NTD Mapping Protocols: Can Surveys for Trachoma and Urinary Schistosomiasis Be Done Simultaneously (PDF)
Published in American Journal of Tropical Medicine and Hygiene, 2009 Doi:10.4269/ajtmh.2009.09-0236.
Authors: Jonathan D. King*, Abel Eigege, Frank O. Richards, Jr, Nimzing Jip, John Umaru, Michael Deming, Emmanuel Miri, Deborah McFarland and Paul M. Emerson.
We determined whether the school-based "disease mapping" methodology used to assess urinary schistosomiasis (SCH) is useful for determining trachoma interventions and whether the district-based approach recommended for trachoma is useful for SCH control programs. We conducted two separate integrated surveys in eight districts of central Nigeria: school based and district based. A total of 17,189 children were examined for trachoma and 16,238 children were examined for hematuria from 363 schools and 2,149 households.

June 1, 2008
Dracunculiasis, Onchocerciasis, Schistosomiasis, and Trachoma (PDF)
Published in Annals of the New York Academy of Sciences, 1136: 45-52 (2008), Issue - Reducing the Impact of Poverty on Health and Human Development: Scientific Approaches.
Authors: Donald R. Hopkins, Frank O. Richards, Jr, Ernesto Ruiz-Tiben, Paul Emerson, P. Craig Withers, Jr. Published Online: 25 Jul 2008. The definitive version is available at wiley.com.
The four diseases discussed in this chapter (dracunculiasis, onchocerciasis, schistosomiasis, and trachoma) are among the officially designated "Neglected Tropical Diseases," and each is also both the result of and a contributor to the poverty of many rural populations.

Aug. 1, 2006
Integration of Mass Drug Administration Programs in Nigeria: The Challenge of Schistosomiasis
Published in the Bulletin of the World Health Organization, August 2006, Volume 84, Issue 8.
Authors: Frank O. Richards, Jr., Abel Eigege, Emmanuel S. Miri, MY Jinadu, and Donald R. Hopkins.
Annual mass drug administration (MDA) with safe oral anthelminthic drugs (praziquantel, ivermectin and albendazole) is the strategy for control of onchocerciasis, lymphatic filariasis (LF) and schistomiasis. District health officers seek to integrate treatment activities in areas of overlapping disease endemicity, but they are faced with having to merge different programmatic guidelines.