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Schistosomiasis is more prevalent than previously thought: what does it mean for public health goals, policies, strategies, guidelines and intervention programs?

Overview of attention for article published in Infectious Diseases of Poverty, March 2017
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Title
Schistosomiasis is more prevalent than previously thought: what does it mean for public health goals, policies, strategies, guidelines and intervention programs?
Published in
Infectious Diseases of Poverty, March 2017
DOI 10.1186/s40249-017-0275-5
Pubmed ID
Authors

Daniel G. Colley, Tamara S. Andros, Carl H. Campbell

Abstract

Mapping and diagnosis of infections by the three major schistosome species (Schistosoma haematobium, S. mansoni and S. japonicum) has been done with assays that are known to be specific but increasingly insensitive as prevalence declines or in areas with already low prevalence of infection. This becomes a true challenge to achieving the goal of elimination of schistosomiasis because the multiplicative portion of the life-cycle of schistosomes, in the snail vector, favors continued transmission as long as even a few people maintain low numbers of worms that pass eggs in their excreta. New mapping tools based on detection of worm antigens (circulating cathodic antigen - CCA; circulating anodic antigen - CAA) in urine of those infected are highly sensitive and the CAA assay is reported to be highly specific. Using these tools in areas of low prevalence of all three of these species of schistosomes has demonstrated that more people harbor adult worms than are regularly excreting eggs at a level detectable by the usual stool assay (Kato-Katz) or by urine filtration. In very low prevalence areas this is sometimes 6- to10-fold more. Faced with what appears to be a sizable population of "egg-negative/worm-positive schistosomiasis" especially in areas of very low prevalence, national NTD programs are confounded about what guidelines and strategies they should enact if they are to proceed toward a goal of elimination. There is a critical need for continued evaluation of the assays involved and to understand the contribution of this "egg-negative/worm-positive schistosomiasis" condition to both individual morbidity and community transmission. There is also a critical need for new guidelines based on the use of these more sensitive assays for those national NTD programs that wish to move forward to strategies designed for elimination.

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The data shown below were compiled from readership statistics for 176 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 176 100%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 36 20%
Student > Master 31 18%
Student > Bachelor 17 10%
Researcher 14 8%
Student > Postgraduate 11 6%
Other 23 13%
Unknown 44 25%
Readers by discipline Count As %
Agricultural and Biological Sciences 24 14%
Medicine and Dentistry 23 13%
Biochemistry, Genetics and Molecular Biology 23 13%
Immunology and Microbiology 16 9%
Nursing and Health Professions 11 6%
Other 22 13%
Unknown 57 32%