4.4 Article

Evaluation and application of potential schistosome-associated morbidity markers within large-scale mass chemotherapy programmes

Journal

PARASITOLOGY
Volume 136, Issue 13, Pages 1789-1799

Publisher

CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0031182009006350

Keywords

Schistosomiasis; morbidity; diagnosis; control; Africa

Categories

Funding

  1. Bill and Melinda Gates Foundation
  2. Royal Society
  3. Medical Research Council
  4. CONTRAST project
  5. European Union [032203]

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A primary objective of schistosomiasis control programmes is to achieve, and hence also demonstrate, a quantifiable reduction in schistosome-associated morbidity as a consequence of chemotherapeutic intervention. Inherent within such an objective, it is necessary to define and validate direct and indirect indicators of schistosome-related morbidity. However, to define and thereby document Such morbidity, and its reduction following treatment, may not be straightforward, particularly for intestinal schistosomiasis-induced morbidity, which is often not apparent in all but the most severe or chronic cases. within all 'Schistosomiasis Control Initiative' activities, across selected sub-Saharan African countries since 2002, a range of standard and novel potential morbidity markets have been monitored and evaluated. Parasitological intensity measures, combined with haemoglobin/anaemia Counts and Ultrasonography, proved valuable schistosomiasis-related morbidity indicators, being both logistically practical and informative. Additional measures tested, such as albumin excretion profiles, were promising, and are Subject to ongoing research, whilst some measures, such as distended stomach/umbilical circumference, anthropometrics and health questionnaires proved less reliable. These results serve to both illustrate the Success Of Current control activities in reducing schistosome-induced morbidity, and to highlight key tools and techniques for continued application within ongoing and future mass drug administration programmes.

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