Snail control strategies for reduction of schistosomiasis transmission

As intermediate hosts, molluscs play a major role in the transmission of schistosomes; they are the sites of an intense multiplication of parasites. Thus, snail control strategies are considered a priority for the reduction of schistosomiasis transmission. Here, Vinca Lardans and Colette Dissous review the efficacy of environmental management and the use of molluscicides and biological agents to control snail populations. They then describe the development of diagnostic tests, based on the detection of parasite antigens or specific parasite DNA sequences in snail tissues, to detect the early infection of snails. Finally, they discuss progress in studying the molecular basis of susceptibility and resistance phenotypes, and the possible application of the genetic manipulation of molluscs.     

Low transmission areas of schistosomiasis in Venezuela: consequences on the diagnosis, treatment, and control

Schistosomiasis low transmission areas as Venezuela, can be defined as those where the vector exists, the prevalence of active cases is under 25%, individuals with mild intensity of infection predominate and are mostly asymptomatic. These areas are the consequence of effective control programs, however, "silent" epidemiological places are difficult to trace, avoiding the opportune diagnosis and treatment of infected persons. Clinic and abdominal ultrasound have not shown to discriminate infected from uninfected persons in areas where besides Schistosoma mansoni, intestinal parasites are the rule. Under these conditions, serology remains as a very valuable diagnostic tool, since it gives a closer approximation to the true prevalence. In this sense, circumoval precipitin test, ELISA-SEA with sodium metaperiodate, and alkaline phosphatase immunoassay joined to coprology allow the identification of the "schistosomiasis cases". In relation to public health, schistosomiasis has been underestimated by the sanitary authorities and the investment on its control is being transferred to other diseases of major social and political relevance neglecting sanitary efforts and allowing growth of snail population. Some strategies of diagnosis and control should be done before schistosomiasis reemergence occurs in low transmission areas.     

A model of bi-mode transmission dynamics of hepatitis C with optimal control

In this paper, we present a rigorous mathematical analysis of a deterministic model for the transmission dynamics of hepatitis C. The model is suitable for populations where two frequent modes of transmission of hepatitis C virus, namely unsafe blood transfusions and intravenous drug use, are dominant. The susceptible population is divided into two distinct compartments, the intravenous drug users and individuals undergoing unsafe blood transfusions. Individuals belonging to each compartment may develop acute and then possibly chronic infections. Chronically infected individuals may be quarantined. The analysis indicates that the eradication and persistence of the disease is completely determined by the magnitude of basic reproduction number R _c. It is shown that for the basic reproduction number R _c < 1, the disease-free equilibrium is locally and globally asymptotically stable. For R _c > 1, an endemic equilibrium exists and the disease is uniformly persistent. In addition, we present the uncertainty and sensitivity analyses to investigate the influence of different important model parameters on the disease prevalence. When the infected population persists, we have designed a time-dependent optimal quarantine strategy to minimize it. The Pontryagin’s Maximum Principle is used to characterize the optimal control in terms of an optimality system which is solved numerically. Numerical results for the optimal control are compared against the constant controls and their efficiency is discussed.     

A hybrid model of schistosomiasis with snail latency

A hybrid model (i.e., a model with both stochastic and deterministic ingredients) is established for the transmission of schistosomiasis in a community. The model allows for latency and differential mortality in the snail population. An important threshold behavior is predicted. It gives conditions under which the infection will be eradicated. The efficiencies of various methods of control or eradication are studied.     

A schistosomiasis model with mating structure and time delay

A system of homogeneous equations with a time delay is used to model the population dynamics of schistosomes. The model includes the parasite’s mating structure, multiple resistant schistosome strains, and biological complexity associated with the parasite’s life cycle. Invasion criteria of resistant strains and coexistence threshold conditions are derived. These results are used to explore the impact of drug treatment on resistant strain survival. Numerical simulations indicate that the dynamical behaviors of the current model are not qualitatively different from those derived from an earlier model that ignores the impact of time delays associated with the multiple stages in parasite’s life cycle. However, quantitatively the time delays make it more likely for drug-resistant strains to invade in a parasite population.     

Cercariometry for detection of transmission sites for schistosomiasis

Cercariometry provided information on diurnal fluctuation, seasonal and spatial distribution of cercariae in the suitable natural water bodies. There was an apparent mismatch between the results of cercariometry and snail sampling. Water, which cercariometry showed to contain cercariae was potentially infective, although the resultant worm load of sentinel rodents may not bear a linear relationship with cercarial density. Cercariometry has some weakness in practices and analysis of data, however, it provides the valuable information on the active transmission sites of schistosomiasis.     

Endemicity, focality and seasonality of transmission of human schistosomiasis in Amagunze Village, eastern Nigeria

The pattern of transmission of human schistosomiasis was studied in Amagunze Village, eastern Nigeria, during 1986-1987. The prevalence of Schistosoma haematobium in 119 schoolboys aged 5-12 years was 79%. The geometric mean of intensity of infection was 49 eggs/10 ml urine and the frequency of visible haematuria was 25.2%. No S. mansoni infections were demonstrated. A marked seasonality in population density of Bulinus truncatus, B. forskalii and Biomphalaria pfeifferi was demonstrated with reduced densities during the late rainy and early dry seasons. Schistosoma sp. infected B. truncatus were found in the late dry and early rainy seasons in 2 out of 7 major human water contact sites studied. Seasonality and focality of transmission of S. haematobium and its high endemicity in the area were thus demonstrated.     

The epidemiology and control of cattle schistosomiasis

Schistosomiasis remains a major health problem in much of the developing world. Despite decades of research, many fundamental questions on the dynamics of infection and immunity development remain unanswered. Schistosomiasis is also a common parasitic infection in cattle, and studies on livestock exposed to their own species of schistosome may help in understanding some aspects of the host-parasite relationship. Here, Jan De Bont and Jozef Vercruysse review the current knowledge on the epidemiology and control of cattle schistosomiasis.     

On eradication of schistosomiasis

Eradication of schistosomiasis from an isolated community is discussed. A mathematical model is used to derive conditions under which eradication results from the administration of a single dose of drugs to the human population. It is shown that this mode of eradication is facilitated by a control program that is directed at such changes of the biological-environmental parameters that reduce the parasite population.     

Predicting the impact of long-term temperature changes on the epidemiology and control of schistosomiasis: a mechanistic model

Background

Many parasites of medical and veterinary importance are transmitted by cold-blooded intermediate hosts or vectors, the abundance of which will vary with ambient temperatures, potentially altering disease prevalence. In particular, if global climate change will increase mean ambient temperature in a region endemic with a human pathogen then it is possible that the incidence of disease will similarly increase. Here we examine this possibility by using a mathematical model to explore the effects of increasing long-term mean ambient temperature on the prevalence and abundance of the parasite Schistosoma mansoni, the causative agent of schistosomiasis in humans.

Principal Findings

The model showed that the impact of temperature on disease prevalence and abundance is not straightforward; the mean infection burden in humans increases up to 30°C, but then crashes at 35°C, primarily due to increased mortalities of the snail intermediate host. In addition, increased temperatures changed the dynamics of disease from stable, endemic infection to unstable, epidemic cycles at 35°C. However, the prevalence of infection was largely unchanged by increasing temperatures. Temperature increases also affected the response of the model to changes in each parameter, indicating certain control strategies may become less effective with local temperature changes. At lower temperatures, the most effective single control strategy is to target the adult parasites through chemotherapy. However, as temperatures increase, targeting the snail intermediate hosts, for example through molluscicide use, becomes more effective.

Conclusions

These results show that S. mansoni will not respond to increased temperatures in a linear fashion, and the optimal control strategy is likely to change as temperatures change. It is only through a mechanistic approach, incorporating the combined effects of temperature on all stages of the life-cycle, that we can begin to predict the consequences of climate change on the incidence and severity of such diseases.     

Achievements of schistosomiasis control in China

The control of schistosomiasis has been spectacularly successful in terms of controlling endemicity and severity of the disease during the last 50 years. It can be categorized into two stages. From 1955 through 1980, the transmission-control strategy had been widely and successfully carried out. By the end of 1980, the epidemic of schistosomiasis was successfully circumscribed in certain core regions including areas at the middle and low reaches of the Yangtze River and some mountainous areas in Sichuan and Yunnan provinces, where control of schistosomiasis had been demonstrated to be very difficult to be sustained. Therefore, since 1980, schistosomiasis control in China has been modified to employ a stepwise strategy, based on which morbidity control has been given priorities and if possible transmission control has been pursued. However, since snail-ridden areas remain unchanged so far, reinfections occur frequently. This necessitates a maintenance phase to consolidate the achievements in the control of schistosomiasis. In the mean time, we are challenged with some environmental, social and economical changes in terms of controlling schistosomiasis. Successfully controlling schistosomiasis in China is still a long-term task but will be achieved without doubt along with the economic development and the promotion of living and cultural standard of people.     

The Organization of schistosomiasis control programmes

A major constraint to the control of communicable diseases in developing countries is the lack of adequate institutionalization of public health activities. The usual political perception is that the public will benefit more from economic and social development than from public health interventions. Planners and politicians generally hold that investment in rural electrification, roads and education will bring more long-term benefit than equivalent investments in public health. Sadly therefore, public health interventions have usually been designed and implemented as short-term, high-return activities in an atmosphere of unrealistic optimism. This criticism can be applied to most tropical diseases, but the potential of new weapons against many of the most widespread parasitic diseases places some urgency on an analysis of the most effective way to implement these interventions. In an attempt to identify and begin to resolve some of these issues, The World Bank, WHO and McConnell Clark Foundation sponsored a workshop on the Organization and Management of Schistosomiasis and other Tropical Disease Control Programmes. The meeting addressed general issues of the organization of public health services, but focused on schistosomiasis where the development of effective, single oral dose chemotherapy (using oxamniquine or praziquantel) is seen as a realistic intervention for large-scale control throughout the 74 endemic countries. In this article, Bernhard Liese reviews the institutional questions, drawing examples from the often cited control programmes in Brazil, Ghana, Egypt, Morocco, Sudan and the Philippines.