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Table of Contents   
LETTER TO THE EDITOR  
Year : 2016  |  Volume : 9  |  Issue : 6  |  Page : 431-432
Strengthening and expanding the targeted interventions to accomplish schistosomiasis elimination


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Kancheepuram, Tamil Nadu, India

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Date of Web Publication14-Nov-2016
 

How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Strengthening and expanding the targeted interventions to accomplish schistosomiasis elimination. Ann Trop Med Public Health 2016;9:431-2

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Strengthening and expanding the targeted interventions to accomplish schistosomiasis elimination. Ann Trop Med Public Health [serial online] 2016 [cited 2017 Mar 30];9:431-2. Available from: http://www.atmph.org/text.asp?2016/9/6/431/193966
Dear Sir,

Schistosomiasis is a neglected tropical disease caused by a trematode worm, with the disease being prevalent in close to eighty nations.[1] In fact, the recent global estimate for the year 2014 suggest that close to 258 million people required prophylactic therapy, nevertheless only 62 million people actually got treated.[1] This clearly reflects the failure of the health system to extend the therapy to all the affected people.[2] Further, the disease has been prevalent in the tropical and subtropical regions, with African region, accounting for close to 90% of the people who are in need of the treatment.[1],[3]

It is considered as a neglected disease, as the disease generally affects people from poorer communities who are still struggling to have easy access to safe drinking water and adequate sanitation services.[2] Thus, any activity which promotes contact of people with the infested water can result in the potential transmission of the disease.[1],[2] Although, the disease can affect anyone, occupationally it is more common among agricultural/fishing populations, and among women (while doing routine domestic work), school children (while swimming or playing in water), and travelers during their recreational activities.[1],[3] Further, among the impending urbanization and the resulting migration of people from rural to urban regions has even enabled the spread of the disease to newer settings.[2]

The disease can present in both acute and chronic forms, with symptoms primarily resulting because of the immune response to the eggs of the worm.[1] It not only leads to damage of internal organs (depending on whether it is intestinal or urogenital), but even enhances the risk of acquisition of HIV infection-bladder cancer-infertility, results in a significant economic burden for the management of the consequences of the disease, and a negative impact on the development (if the child is affected).[1],[2],[4] Further, the disease has also been associated with disability and fatality, averaging up to 0.2 million each year.[1]

Acknowledging the magnitude of the disease, associated systemic complications, high fatality rates, and burden on the family as well as the health system, there is a significant need to involve all the stakeholders and aim toward the reduction in the incidence/elimination of the disease.[1],[3] The comprehensive package of intervention comprises periodic and targeted treatment of all who are at-risk (viz., school-aged children, adults who are at potential risk of being exposed to infested water, entire community in highly endemic regions), with praziquantel, increasing access to potable water, improving sanitation, educating people on hygiene, and taking steps to ensure snail control.[1],[2],[3]

Moreover, the decision to periodically administer praziquantel over the number of years is eventually determined by the prevalence of infection in the school-age children.[4] Further, monitoring is extremely essential to assess the impact of control interventions and plan any corrective measures.[3] However, the crucial limitation to the control efforts is the limited availability of the drug praziquantel, and almost 80% of the people in the year 2014 had no access, which indirectly highlights the need for more global coordination.[1] Definitive evidence is available to suggest interruption in the transmission of the disease in Morocco and even a gradual decline in the incidence of disease in some of the African nations.[3],[4]

To conclude, the need of the hour is to strengthen and expand the existing efforts to eventually reduce the incidence and minimize the risk development of severe and late-stage chronic disease.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
World Health Organization. Schistosomiasis – Fact Sheet; 2016. Available from: http://www.who.int/mediacentre/factsheets/fs115/en/. [Last accessed on 2016 Feb 25].  Back to cited text no. 1
    
2.
Dawaki S, Al-Mekhlafi HM, Ithoi I, Ibrahim J, Abdulsalam AM, Ahmed A, et al. The menace of schistosomiasis in Nigeria: Knowledge, attitude, and practices regarding schistosomiasis among rural communities in Kano State. PLoS One 2015;10:e0143667.  Back to cited text no. 2
    
3.
Savioli L, Fenwick A, Rollinson D, Albonico M, Ame SM. An achievable goal: Control and elimination of schistosomiasis. Lancet 2015;386:739.  Back to cited text no. 3
    
4.
Ouedraogo H, Drabo F, Zongo D, Bagayan M, Bamba I, Pima T, et al. Schistosomiasis in school-age children in Burkina Faso after a decade of preventive chemotherapy. Bull World Health Organ 2016;94:37-45.  Back to cited text no. 4
    

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Correspondence Address:
Saurabh RamBihariLal Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, 3rd Floor, Ammapettai, Thiruporur–Guduvancherry Main Road, Sembakkam Post, Kancheepuram - 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.193966

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