Discussion

We give a brief history of epidemiology of schistosomiasis in Lake Malawi, drawing attention to major ecological changes ongoing within the lake leading to a fulminating outbreak of intestinal schistosomiasis. Furthermore, we highlight the novel occurrence of various hybrid schistosomes placing their current importance within the need to redefine ‘OneHealth’ surveillance in Malawi. Once control interventions against schistosomiasis can resume after COVID-19, we recommend stepped-up preventive chemotherapy, with increased community-access to praziquantel treatment(s), alongside renewed efforts in appropriate environmental control of intermediate snail hosts, either with existing chemical or biological control methods.