Authors

GC Milne¹; R Oettle²; JP Webster¹; M Walker¹; S Wilson²;  ¹ Royal Veterinary College, UK;  ² University of Cambridge, UK

Discussion

Schistosomiasis is a neglected tropical disease of profound medical importance, infecting approximately 240 million people, 90% living in Sub-Saharan Africa. Severe schistosomiasis is associated with periportal fibrosis and portal hypertension which can cause death without appropriate disease management. A cornerstone of international efforts to eliminate schistosomiasis as a public health problem is mass drug administration (MDA) with praziquantel. However, despite nearly two decades of MDA, the prevalence of infection and the incidence of periportal fibrosis remains high in communities along the shore of Lake Albert in Uganda, representing a conspicuous failure of the current intervention strategy. The FibroScHot Consortium is addressing this urgent public health need by conducting a randomised controlled trial to evaluate the effectiveness of delivering MDA at frequencies of up to four times per year. Reporting on research conducted as part of the Consortium, this talk presents progress from mathematical model-based analyses of the historical impact of MDA on the infection and morbidity dynamics of Schistosoma mansoni along the shore of Late Albert and discusses how severe schistosomiasis may be tackled in transmission hotspots.