Discussion

Over 240 million people are infected with schistosomiasis. The World Health Organization recommends community wide praziquantel mass drug administration (MDA) to control schistosomiasis associated morbidity, and ultimately transmission. I have identified regions in Uganda where high prevalence and intensities of Schistosoma mansoni remain despite over a decade of MDA. My group’s research addresses two key questions: ‘How can we improve individual treatment success?’ and ‘How can we reduce transmission at a community level?’ Our research is interdisciplinary, working with epidemiologists, population geneticists, molecular biologists, anthropologists, economists and engineers. In this talk I will discuss results on who is reinfecting whom? And how best we might reduce this? Alongside findings on what type of water, sanitation and hygiene (WASH) interventions community members find acceptable and are willing to work or pay for. Findings will combine to help characterise reinfection risk and optimize intervention trials. There are key limitations of MDA, and it alone will not reduce schistosomiasis. We need a more integrated approach to schistosomiasis control. Additional interventions need to be officially endorsed alongside improving WASH facilities. This will ensure a steady path towards control and ultimately eradiation of this debilitating disease.