Changing Policy and Practice in the Control of Pediatric Schistosomiasis

F. Mutapi*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Schistosomiasis is a chronic disease that affects ∼200 million people. The extended health impact of the disease has been estimated to exceed that of malaria or tuberculosis and to be nearer to that of HIV/AIDS. Within endemic areas, children carry the heaviest burden of infection. Infection/disease is controlled by the treatment of infected subjects with the anthelminthic drug praziquantel. Global initiatives from Partners of Parasite Control, including the World Health Organization (WHO), advocate regular school-based deworming strategies to reduce the development of severe morbidity, promote school–child health and development, and improve the cognitive potential of children. Until recently, preschool-aged children were excluded from schistosome treatment, creating a health inequity in affected populations. In 2010, the WHO updated their recommendations for the treatment of schistosomiasis in preschool-aged children (ie, children aged ≤5 years). This change was the culmination of several decades of research on schistosome epidemiology, immunology, and pathology in this age group. The recent development of a pediatric formulation of praziquantel (soon to enter clinical trials) should advance control efforts in preschool-aged children, with the goal of including these children in preventative chemotherapy (as currently occurs for soil-transmitted helminths). This review discusses the research work supporting the WHO revision of recommendations for treating preschool-aged children, as well as current barriers and knowledge gaps in pediatric schistosomiasis control.
Original languageEnglish
Pages (from-to)536-544
Number of pages9
JournalPediatrics
Volume135
Issue number3
DOIs
Publication statusPublished - 1 Mar 2015

Keywords

  • Schistosoma haematobium
  • Schistosoma mansoni
  • World Health Organization
  • bilharzia
  • mass drug administration
  • pediatric
  • praziquantel
  • preventative chemotherapy
  • schistosomiasis
  • urogenital schistosomiasis

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