viernes, 17 de marzo de 2017

Towards interruption of schistosomiasis transmission in sub-Saharan Africa: developing an appropriate environmental surveillance framework to guide and to support ‘end game’ interventions | Infectious Diseases of Poverty | Full Text

Towards interruption of schistosomiasis transmission in sub-Saharan Africa: developing an appropriate environmental surveillance framework to guide and to support ‘end game’ interventions | Infectious Diseases of Poverty | Full Text



Biomed Central



Infectious Diseases of Poverty

Towards interruption of schistosomiasis transmission in sub-Saharan Africa: developing an appropriate environmental surveillance framework to guide and to support ‘end game’ interventions

  • J. Russell StothardEmail authorView ORCID ID profile,
  • Suzy J. Campbell,
  • Mike Y. Osei-Atweneboana,
  • Timothy Durant,
  • Michelle C. Stanton,
  • Nana-Kwadwo Biritwum,
  • David Rollinson,
  • Dieudonné R. Eloundou Ombede and
  • Louis-Albert Tchuem-Tchuenté
Infectious Diseases of Poverty20176:10
DOI: 10.1186/s40249-016-0215-9
Received: 4 August 2016
Accepted: 12 December 2016
Published: 14 January 2017

Abstract

Schistosomiasis is a waterborne parasitic disease in sub-Saharan Africa, particularly common in rural populations living in impoverished conditions. With the scale-up of preventive chemotherapy, national campaigns will transition from morbidity- to transmission-focused interventions thus formal investigation of actual or expected declines in environmental transmission is needed as ‘end game’ scenarios arise. Surprisingly, there are no international or national guidelines to do so in sub-Saharan Africa. Our article therefore provides an introduction to key practicalities and pitfalls in the development of an appropriate environmental surveillance framework. In this context, we discuss how strategies need to be adapted and tailored to the local level to better guide and support future interventions through this transition. As detection of egg-patent infection in people becomes rare, careful sampling of schistosome larvae in freshwater and in aquatic snails with robust species-specific DNA assays will be required. Appropriate metrics, derived from observed prevalence(s) as compared with predetermined thresholds, could each provide a clearer insight into contamination- and exposure-related dynamics. Application could be twofold, first to certify areas currently free from schistosomiasis transmission or second to red-flag recalcitrant locations where extra effort or alternative interventions are needed.

Keywords

Environmental monitoring Freshwater snails eDNA WASH Zoonosis

Multilingual abstract

Please see Additional file 1 for translations of the abstract into the six official working languages of the United Nations.

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