Schistosomiasis Control: Leave No Age Group Behind

• Published in: Trends in parasitology 2020-07, Vol.36 (7), p.582-591
• Main Authors: Faust, Christina L., Osakunor, Derick N.M., Downs, Jennifer A., Kayuni, Sekeleghe, Stothard, J. Russell, Lamberton, Poppy H.L., Reinhard-Rupp, Jutta, Rollinson, David
• Format: Article
• Language: English
• Subjects: adults; Africa South of the Sahara - epidemiology; Age Distribution; Anthelmintics - therapeutic use; health inequities; Humans; mass drug administration; praziquantel; preschool-aged children; schistosomiasis; Schistosomiasis - drug therapy; Schistosomiasis - epidemiology; Schistosomiasis - prevention & control
• ISSN: 1471-4922; 1471-5007
• DOI: 10.1016/j.pt.2020.04.012

Despite accelerating progress towards schistosomiasis control in sub-Saharan Africa, several age groups have been eclipsed by current treatment and monitoring strategies that mainly focus on school-aged children. As schistosomiasis poses a threat to people of all ages, unfortunate gaps exist in current treatment coverage and associated monitoring efforts, preventing subsequent health benefits to preschool-aged children as well as certain adolescents and adults. Expanding access to younger ages through the forthcoming pediatric praziquantel formulation and improving treatment coverage in older ages is essential. This should occur alongside formal inclusion of these groups in large-scale monitoring and evaluation activities. Current omission of these age groups from treatment and monitoring exacerbates health inequities and has long-term consequences for sustainable schistosomiasis control. To date in sub-Saharan Africa, schistosomiasis treatment and monitoring focuses on school-aged children, but much less attention has been given to preschool-aged children and adults.Here, we summarize the distribution and morbidity of schistosomiasis across these age groups and highlight gaps in current control strategies.Preschool-aged children incur significant morbidity but are systematically excluded from current treatment programs; inclusion in control programs could have both short- and long-term health benefits.Mass drug administration must be improved to reach at-risk adults. Low coverage has cascading implications for health, including morbidities specific to reproductive ages, and can facilitate infection with other diseases such as HIV.Control and elimination of schistosomiasis will require future integration of all age groups into treatment programs and evaluation of progress.