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Schistosomiasis, caused by schistosome parasites, is a neglected tropical disease affecting humans and animals. There is no vaccine available yet, and fear of upcoming resistance against the only widely used drug, praziquantel, is omnipresent. Previously, we showed that imatinib (Gleevec), an anticancer drug, affected schistosome physiology and caused the death of adult Schistosoma mansoni in vitro. Here, we present the first known evidence that one effect of imatinib is the induction of autophagy in S. mansoni. Furthermore, worms co-treated with imatinib and bafilomycin A1, a late-phase autophagy inhibitor, reversed imatinib-induced autophagy and its antischistosomal effects as revealed by phenotypic and molecular analyses.

The purpose of this study was to evaluate the genetic variation of the PIK3CA gene and the histopathological changes in liver tissue of patients with chronic Schistosomiasis to predict hepatocellular carcinoma. In this retrospective, the study samples were taken from 20 patients, divided into chronic schistosomiasis infected group of people (S) and chronic schistosomiasis uninfected group of people (C). The liver tissue biopsy samples for histological examinations were obtained only from chronic Schistosomiasis patients (n = 9). The blood samples were obtained from groups S and C for the mutational analysis of the PIK3CA and TP53 genes. The results suggest that the patients diagnosed with chronic Schistosomiasis were 9 (55%), and healthy patients without Schistosomiasis were 11 (45%). Histological results found that proliferation of fibrosis was observed in the hepatocytes of schistosomiasis patients. A total of 8 mutations (5 male, 3 female) were detected in PIK3CA and TP53 genes. Including 1634 A > G substitution mutations in PIK3CA, which was the only mutation found in males and females among the 8 mutations, accounting 22.22%. PIK3CA gene mutations were found more predominant in male groups as compared to other TP53 gene mutations. In conclusion, this study found that patients with chronic Schistosomiasis are at risk of PIK3CA gene mutations, eventually leading to hepatocytes fibrosis and liver cancer.

Summary Background Over the past 20 years, schistosomiasis control has been scaled up. Preventive chemotherapy with praziquantel is the main intervention. We aimed to assess the effect of preventive chemotherapy on schistosomiasis prevalence in sub-Saharan Africa, comparing 2000–10 with 2011–14 and 2015–19. Methods In this spatiotemporal modelling study, we analysed survey data from school-aged children (aged 5–14 years) in 44 countries across sub-Saharan Africa. The data were extracted from the Global Neglected Tropical Diseases database and augmented by 2018 and 2019 survey data obtained from disease control programmes. Bayesian geostatistical models were fitted to Schistosoma haematobium and Schistosoma mansoni survey data. The models included data on climatic predictors obtained from satellites and other open-source environmental databases and socioeconomic predictors obtained from various household surveys. Temporal changes in Schistosoma species prevalence were estimated by a categorical variable with values corresponding to the three time periods (2000–10, 2011–14, and 2015–19) during which preventive chemotherapy interventions were scaled up. Findings We identified 781 references with relevant geolocated schistosomiasis survey data for 2000–19. There were 19 166 unique survey locations for S haematobium and 23 861 for S mansoni, of which 77% (14 757 locations for S haematobium and 18 372 locations for S mansoni) corresponded to 2011–19. Schistosomiasis prevalence among school-aged children in sub-Saharan Africa decreased from 23·0% (95% Bayesian credible interval 22·1–24·1) in 2000–10 to 9·6% (9·1–10·2) in 2015–19, an overall reduction of 58·3%. The reduction of S haematobium was 67·9% (64·6–71·1) and that of S mansoni 53·6% (45·2–58·3) when comparing 2000–10 with 2015–19. Interpretation Our model-based estimates suggest that schistosomiasis prevalence in sub-Saharan Africa has decreased considerably, most likely explained by the scale-up of preventive chemotherapy. There is a need to consolidate gains in the control of schistosomiasis by means of preventive chemotherapy, coupled with other interventions to interrupt disease transmission. Funding European Research Council and WHO.

Background Schistosomiasis is a neglected tropical disease caused by mainly Schistosoma mansoni and Schistosoma hematobium. The disease is very common in Africa including Ethiopia. Schistosoma mansoni is a major public health problem in Ethiopia especially among children. This review is aimed to indicate the prevalence of Schistosoma mansoni among children at the national and regional levels. Methods and material The PRISMA guidelines were followed. An electronic search of PubMed, Google Scholar, Web of Science, Scopus, MEDLINE, and Google search were carried out using key terms. Articles published from the proceeding of professional associations such as the Ethiopian medical laboratory association, the Ethiopian public health association, and annual national research conferences were also searched to find additional eligible studies. Data were extracted independently by two investigators, and cross-checked by a third reviewer. The quality of included studies was assessed using JBI quality assessment criteria. Data were extracted using Microsoft excel and finally analyzed using STATA version 12. The pooled prevalence was done using a random-effects model. Result Overall 49 studies involving 20,493 children (10,572 male and 9, 921 females) were included in this meta-analysis. The pooled prevalence of Schistosoma mansoni infection was 37.13% (95%CI:30.02–44.24). High heterogeneity was observed with I2 of 99.4%, P Schistosoma mansoni infection among children (46.31%: 95%:34.21–59.05). Conclusion This study revealed a 37.13% prevalence of Schistosoma mansoni infection among children. This is an alert to improve and implement appropriate control strategies such as mass drug administration in Ethiopia.

Background. Schistosoma mansoni remains a significant health problem in low-income countries. Praziquantel (PZQ) is the only drug available to treat schistosomiasis, and PZQ resistance is a potential threat towards control of the disease although PZQ is currently effective against all species of schistosomes. Moreover, PZQ is less efficacious against larval stages. In response to these challenges, multiple in vivo/in vitro studies evaluated the anti-S. mansoni activity of crude plant extracts in a bid for novel drug(s). However, these studies appear fragmented and patchy. This systematic review explored the extent of such studies in the past 11 years (2010-2020). Methods. A systematic web search analysis and review of the literature on crude plant extracts tested against S. mansoni was done. Data from 17 articles meeting eligibility criteria were extracted and analyzed. Forty-three plant species have been tested by the 17 studies. The leaves, barks, stems, flowers, rhizomes, and roots of the plants as well as the whole plant part were used for the experiments. Conclusion. Nearly all of the plants significantly reduced schistosome egg output, killed adult worms, and improved liver histology and function. Further studies are required to assess the therapeutic potential of more promising plant species.

Background Schistosomiasis is a parasitic disease caused by hematodes of genus Schistosoma. This review evaluated the available nucleic acid amplification techniques for diagnosing S. mansoni infections in humans, intermediate host snails, and presumed rodent reservoirs. Methods Sensitivity, specificity, diagnostic odds ratio (DOR), and 95% CI were calculated based on available literature. The potential of PCR, nPCR, PCR-ELISA, qPCR, and LAMP was compared for diagnosing S. mansoni infections. Results A total of 546 published records were identified. Quality assessment by QUADAS-2 revealed an uncertain risk in most studies, and 21 references were included in the final. For human samples, the four nucleic acid amplification techniques showed an overall sensitivity of 89.79% (95% CI: 83.92%-93.67%), specificity of 87.70% (95% CI: 72.60%-95.05%), and DOR of 37.73 (95% CI: 21.79-65.33). LAMP showed the highest sensitivity, followed by PCR-ELISA, PCR, and qPCR, while this order was almost reversed for specificity; qPCR had the highest AUC. For rodent samples, qPCR showed modest sensitivity (68.75%, 95% CI: 43.32%-86.36%) and high specificity (92.45%, 95% CI: 19.94%-99.83%). For snail samples, PCR and nPCR assays showed high sensitivity of 90.06% (95% CI: 84.39%-93.82%) and specificity of 85.51% (95% CI: 54.39%-96.69%). Conclusion Nucleic acid amplification techniques had high diagnostic potential for identifying S. mansoni infections in humans.

The WHO guidelines for monitoring and evaluating Schistosoma mansoni control programs are based on the Kato-Katz (KK) fecal examination method; however, there are limitations to its use, particularly in low prevalence areas. The point-of-care urine circulating cathodic antigen (POC-CCA) assay has emerged as a useful tool for mapping schistosomiasis prevalence, but its use in monitoring and evaluating control programs has not been evaluated. Before POC-CCA can be used for these programs, it must be determined how previous guidance based on the KK method can be translated to the POC-CCA assay; furthermore, its performance in different endemicity settings must be evaluated. Urine and stool specimens were collected from students attending public primary schools in western Kenya before mass treatment with praziquantel at baseline (51 schools), year 1 (45 schools), year 2 (34 schools), and year 3 (20 schools). Prevalence and infection intensity were determined by the KK method and POC-CCA assay. Changes in prevalence and intensity were compared within the strata of schools grouped according to the baseline prevalence determined by the KK method (0–10%, > 10–20%, > 20%). The prevalence determined by the POC-CCA assay was higher than that determined by the KK method at all time points for all strata. The prevalence determined by the KK method decreased from baseline to 2 and 3 years, as did infection intensity (with one exception). A corresponding decrease was not always replicated by the POC-CCA assay results. The POC-CCA assay did not perform as expected, and the concordance of results of the two tests was poor. Furthermore, there are emerging concerns regarding the specificity of the POC-CCA assay. Therefore, it is impossible to translate historical data and programmatic guidelines based on the KK method results to the POC-CCA assay.

Background “Schistosomiasis” is a highly recurrent parasitic disease that affects a wide range of areas and a large number of people worldwide. In China, schistosomiasis has seriously affected the life and safety of the people and restricted the economic development. Schistosomiasis is mainly distributed along the Yangtze River and in southern China. Anhui Province is located in the Yangtze River Basin of China, with dense water system, frequent floods and widespread distribution of Oncomelania hupensis that is the only intermediate host of schistosomiasis, a large number of cattle, sheep and other livestock, which makes it difficult to control schistosomiasis. It is of great significance to monitor and analyze spatiotemporal risk of schistosomiasis in Anhui Province, China. We compared and analyzed the optimal spatiotemporal interpolation model based on the data of schistosomiasis in Anhui Province, China and the spatiotemporal pattern of schistosomiasis risk was analyzed. Methods In this study, the root-mean-square-error (RMSE) and absolute residual (AR) indicators were used to compare the accuracy of Bayesian maximum entropy (BME), spatiotemporal Kriging (STKriging) and geographical and temporal weighted regression (GTWR) models for predicting the spatiotemporal risk of schistosomiasis in Anhui Province, China. Results The results showed that (1) daytime land surface temperature, mean minimum temperature, normalized difference vegetation index, soil moisture, soil bulk density and urbanization were significant factors affecting the risk of schistosomiasis; (2) the spatiotemporal distribution trends of schistosomiasis predicted by the three methods were basically consistent with the actual trends, but the prediction accuracy of BME was higher than that of STKriging and GTWR, indicating that BME predicted the prevalence of schistosomiasis more accurately; and (3) schistosomiasis in Anhui Province had a spatial autocorrelation within 20 km and a temporal correlation within 10 years when applying the optimal model BME. Conclusions This study suggests that BME exhibited the highest interpolation accuracy among the three spatiotemporal interpolation methods, which could enhance the risk prediction model of infectious diseases thereby providing scientific support for government decision making.

Background In 2004, Mali implemented mass drug administration (MDA) aimed at controlling schistosomiasis and soil-transmitted helminths. Despite several rounds of MDA, the health district of Bankass reported low coverage (64.8%) for praziquantel and albendazole in 2017, meaning that this district was still facing challenges in accomplishing the targeted 75% coverage. This study aimed to explore the barriers and gaps that hindered MDA implementation in Bankass. Methods A cross-sectional study was performed. Questionnaires were administrated to all school-aged children in randomly selected villages. Technical directors of community health centers and community drug distributors in the selected villages were included in the interviews. Results A total of 2128 children and 52 health workers were interviewed. Coverage rates were 93.51% (1990/2128) for praziquantel and 95.25% (2027/2128) for albendazole. Among the untreated children, 31.63% (31/98) reported being unaware of the campaign and 26.53% (26/98) were unable to reach the distribution points. Most of the health workers suggested increasing incentives. Conclusion The data showed satisfactory coverage >90%, in contrast with lower rates initially reported by the district health information system. These results raise concerns about the reliability of programmatic data and highlight the importance of population-based surveys for the evaluation of control interventions.

Background: Sensitive diagnostics are needed for effective management and surveillance of schistosomiasis so that current transmission interruption goals set by WHO can be achieved. We aimed to screen the Schistosoma haematobium secretome to find antibody biomarkers of schistosome infection, validate their diagnostic performance in samples from endemic populations, and evaluate their utility as point of care immunochromatographic tests (POC-ICTs) to diagnose urogenital schistosomiasis in the field. Methods: We did a biomarker identification study, in which we constructed a proteome array containing 992 validated and predicted proteins from S haematobium and screened it with serum and urine antibodies from endemic populations in Gabon, Tanzania, and Zimbabwe. Arrayed antigens that were IgG-reactive and a select group of antigens from the worm extracellular vesicle proteome, predicted to be diagnostically informative, were then evaluated by ELISA using the same samples used to probe arrays, and samples from individuals residing in a low-endemicity setting (ie, Pemba and Unguja islands, Zanzibar, Tanzania). The two most sensitive and specific antigens were incorporated into POC-ICTs to assess their ability to diagnose S haematobium infection from serum in a field-deployable format. Findings: From array probing, in individuals who were infected, 208 antigens were the targets of significantly elevated IgG responses in serum and 45 antigens were the targets of significantly elevated IgG responses in urine. Of the five proteins that were validated by ELISA, Sh-TSP-2 (area under the curve [AUC]serum=0·98 [95% CI 0·95-1·00]; AUCurine=0·96 [0·93-0·99]), and MS3_01370 (AUCserum=0·93 [0·89-0·97]; AUCurine=0·81 [0·72-0·89]) displayed the highest overall diagnostic performance in each biofluid and exceeded that of S haematobium-soluble egg antigen in urine (AUC=0·79 [0·69-0·90]). When incorporated into separate POC-ICTs, Sh-TSP-2 showed absolute specificity and a sensitivity of 75% and MS3_01370 showed absolute specificity and a sensitivity of 89%. Interpretation: We identified numerous biomarkers of urogenital schistosomiasis that could form the basis of novel antibody diagnostics for this disease. Two of these antigens, Sh-TSP-2 and MS3_01370, could be used as sensitive, specific, and field-deployable diagnostics to support schistosomiasis control and elimination initiatives, with particular focus on post-elimination surveillance. This study received financial support from Merck Global Health Institute and the Australian Trade and Investment Commission (Australian Tropical Medicine Commercialisation grants programme ATMC50322). Research for the Zanzibar Elimination of Schistosomiasis Transmission project was funded by the University of Georgia Research Foundation, which is funded by the Bill & Melinda Gates Foundation for the Schistosomiasis Consortium for Operational Research and Evaluation projects (prime award number 50816, sub-award number RR374-053/4893206). SK received financial support by sub-award number RR374-053/4893196 and via direct grants from the Gates Foundation (investment identification numbers OPP1191423 and OPP1198086). AL was funded by a National Health and Medical Research Council Senior Principal Research Fellowship (number APP1117504). BAT was funded by a James Cook University Postgraduate Scholarship. GGM was funded by an Australian Institute of Tropical Health and Medicine postgraduate scholarship. Funding was granted to AAA by a European and Developing Countries Clinical Trials Partnership senior fellowship training award (number TA_11_40200). FM was funded by the Thrasher Research Fund (number 12440) and the Wellcome Trust (number 108061/Z/15/Z). Sí

Background Treatment and control of schistosomiasis rely on a single drug, praziquantel. New orally active antischistosomals featuring novel molecular scaffolds are urgently needed to prevent the emergence of resistance. Methods We screened 400 drug-like compounds contained in the open-access Pandemic Response Box (PRB) against newly transformed schistosomula (NTS) at a concentration of 10 µM scoring death, changes in motility, and morphological alterations. Compounds displaying an activity ≥66% at 72 h underwent testing against adult Schistosoma mansoni in vitro. Fast-acting (≥66% at 24 h), nontoxic drugs focusing on late-stage and approved drugs were investigated in the patent S. mansoni mouse model. Results We identified 26 hits active against NTS, of which 17 elicited ≥66% activity against adult S. mansoni following 24 h of drug exposure. The highest activity against adult S. mansoni was observed with MMV1581558 (EC50 value of 0.18 ± 0.01 µM) and nitazoxanide (0.47 ± 0.07 µM). Of the five compounds tested in vivo, MMV1581558 and the approved drug ozanimod reduced average worm burden versus controls by 42 % and 36 %, respectively, after a single oral dose of 200 mg/kg bodyweight in mice harboring a chronic S. mansoni infection. Conclusion MMV1581558 discovered from screening the PRB represents a novel antischistosomal scaffold with high in vitro antischistosomal activity amenable to chemical modification for drug development.

Urinary schistosomiasis is considered a major public health parasitic disease in African communities. Prior to this study, Nsugbe community was not considered endemic for the disease and as such was not involved in Praziquantel-Preventive Chemotherapy (PC). Longitudinal study of 281 consented pupils aged 5-16 years was carried out with aim of determining the status of urinary schistosomiasis. Urinalysis laboratory test strip, urine filtration technique and syndromic diagnosis were used for the confirmation of the presence of haematuria in urine samples, identification of Schistosoma haematobium ova and the confirmation of female genital schistosomiasis (FGS), respectively. Risk factors for urinary schistosomiasis infection were determined using pre-tested structured questionnaire. Data were analyzed using Minitab 17 software and intensity of infection categorized following World Health Organization (WHO) recommendations. Of the 281 pupils, 117 (42%) were males and 164 (58%) were females with mean age of 9 years. At baseline, an overall prevalence of 0.4% (1/281) which was of light intensity was established. At follow-up, an overall prevalence of 2.1% (6/281) which was of both light (16.7%) and heavy infection (83.3%) was established. The result of the clinical examination showed eggs of S. haematobium in and around the vaginal area indicating FGS of a female pupil aged 12 years. This was treated. Identified risk factors for S. haematobium infection in the community include water-contact activities, ignorance, source of water supply among others. The study revealed the need for an all inclusive mass administration of Praziquantel-PC in the study community for effective control and possible elimination.

Schistosomiasis is a major public health problem that afflicts more than 240 million individuals globally, particularly in poor communities. Treatment of schistosomiasis relies heavily on a single oral drug, praziquantel, and there is interest in the search for new antischistosomal drugs. This study reports the anthelmintic evaluation of carvacryl acetate, a derivative of the terpene carvacrol, against Schistosoma mansoni ex vivo and in a schistosomiasis animal model harboring either adult (patent infection) or juvenile (prepatent infection) parasites. For comparison, data obtained with gold standard antischistosomal drug praziquantel are also presented. Initially in vitro effective concentrations of 50% (EC50) and 90% (EC90) were determined against larval and adult stages of S. mansoni. In an animal with patent infection, a single oral dose of carvacryl acetate (100, 200, or 400 mg/kg) caused a significant reduction in worm burden (30–40%). S. mansoni egg production, a process responsible for both life cycle and pathogenesis, was also markedly reduced (70–80%). Similar to praziquantel, carvacryl acetate 400 mg/kg had low efficacy in pre-patent infection. In tandem, although carvacryl acetate had interesting in vitro schistosomicidal activity, the compound exhibited low efficacy in terms of reduction of worm load in S. mansoni-infected mice.

Schistosomiasis is caused by dioecious helminths of the genus Schistosoma. Recent work indicated that unpaired female and male schistosomes can survive within their definitive host for at least 1 year, although the viability or fertility of these worms after subsequent pairing remained untested. We performed two experiments on laboratory mice, one with female Schistosoma japonicum exposure first and male schistosomes second and another vice versa. After surviving as single-sex unpaired forms for up to 1 year, 58.5% of male and 70% of female schistosomes were able to mate and produce viable eggs. This highlights an additional biological challenge in achieving elimination of schistosomiasis.

Background Diagnosis of schistosomiasis depends mainly on stool or urine microscopy for Schistosoma egg detection as well as immunoassays. The low sensitivity of these conventional tests makes molecular detection the diagnostic method of choice. The study aimed to detect the molecular prevalence of urine schistosomiasis and evaluate microscopic examination vs. PCR technique for detection of Schistosoma haematobium (S. haematobium) in urine of patients with suggestive symptoms or previous history of urine schistosomiasis coming from endemic regions. Results This cross-sectional study was performed on eighty patients attending the urology clinic of Sohag University Teaching Hospital from August 2016 to July 2018. Socio-demographic data and clinical data were collected. Urine samples from all study individuals were collected and examined microscopically for S. haematobium eggs as well as detection of S. haematobium DNA of using PCR assay. Microscopic examination and PCR were positive among (68.8%) and (87.5%) of cases, respectively. There was 60% agreement between microscopy and molecular assay. Microscopy was a good test to rule in cases of urine schistosomiasis, with 100% specificity and 100% PPV, but was of limited sensitivity (NPV = 40%) and missed 12.5% of positive cases. Among studied patient variables, only hematuria showed association with urine schistosomiasis with statistical significance. Conclusion Urine schistosomiasis was highly prevalent in studied population. Considering the high sensitivity and specificity of PCR, it should be implemented as the test of choice, especially in chronic urinary schistosomiasis with low infection setting. In our study population, patients presenting hematuria were likely to have S. haematobium.

Background Schistosomiasis is a debilitating and neglected tropical disease for which praziquantel (PZQ) remains the first-choice drug for treatment and control of the disease. In our previous studies, we found that the patented compound DW-3-15 (patent no. ZL201110142538.2) displayed significant and stabilized antiparasitic activity through a mechanism that might be distinct from PZQ. Here, we investigated the antischistosomal efficacy of PZQ combined with DW-3-15 against schistosomula and adult worms of Schistosoma japonicum in vitro and in vivo, to verify whether there was a synergistic effect of the two compounds. Methods The antischistosomal efficacy of PZQ combined with DW-3-15 in comparison with an untreated control and monotherapy group against schistosomula and adult worms was assessed both in vitro and in vivo. Parasitological studies, scanning electron microscopy, combination index, and histopathological analysis were used for the assessment. Results The results showed significantly reduced viability of schistosomes, achieving 100% viability reduction for juveniles and males by combination chemotherapy using PZQ together with DW-3-15 in vitro. The combination index was 0.28, 0.27, and 0.53 at the higher concentration of PZQ combined with DW-3-15 against juveniles, males, and females, respectively, indicating that the two compounds display strong synergism. Scanning electron microscopy observations also demonstrated that the compound combination induced more severe and extensive alterations to the tegument and subtegument of S. japonicum than those with each compound alone. In vivo, compared with the single-compound-treated group, the group treated with the higher-dose combination demonstrated the best schistosomicidal efficacy, with significantly reduced worm burden, egg burden, and granuloma count and area, which was evident against schistosomula and adult worms. Conclusions Our study provides a potential novel chemotherapy for schistosomiasis caused by S. japonicum. It would improve the antischistosomal effect on schistosomula and adult worms of S. japonicum, and decrease individual dosages. Graphical Abstract

The present study was focused to examine diversity and distributional pattern of freshwater snails and to identify the schistosome infected snails in ten different ponds of Madurai district, Tamil Nadu, South India. Snails were collected from native substrates in ponds using dip net from Madurai North, Tamil Nadu province of south India and microscopic examination for detecting cercariae larvae in snails were assessed. In total, 1250 individuals belonging to six species under five families of freshwater snails were collected. The alpha and beta diversity analyses were calculated for estimating the diversity of snails. The cercariae infection was observed in four collected freshwater snail species. Of four infected snails, Lymnaea luteola had the highest percentage of cercariae infection. Statistical tests showed that the environmental factors of total dissolved solids, pH and salinity were significantly related with snail distribution and cercariae infection rather than spatial factor. The study demonstrated that the salinity, conductivity and total dissolved solids of pond water play a key factor for the distribution of snails and cercariae infection. The findings of our study will improve the understanding of the dynamics of schistosomiasis transmission and would ease the implementation of integrated disease control measures based on ecological knowledge of schistosomiasis vector in Madurai and Tamil Nadu zones.

Background Health related quality of life measurements are vital elements of public health surveillance that uncover unmet health needs and predict the success of health interventions. We described health related quality of life measurements using the EuroQoL 5-dimension (EQ-VAS/EQ-5D) instrument and associated factors among patients with upper gastrointestinal bleeding (UGIB) and hepatic schistosomiasis at a rural health facility in the Albert Nile Basin, Uganda. Methods and materials This was a cross-sectional study at Pakwach Health Centre IV. Participants included adult inpatients and outpatients with a history of UGIB and ultrasound evidence of hepatic schistosomiasis. We evaluated and recorded each participant’s medical history, physical examination, laboratory tests results, ultrasound results, and endoscopy findings. We also recorded health related quality of life measurements using the EuroQoL 5-dimension instrument and derived disability weights from EQ-VAS and EQ-5D measurements. These were our dependent variables. Descriptive and inferential statistics were generated summarizing our findings. Results We found 103 participants had a history of upper gastrointestinal bleeding and hepatosplenic schistosomiasis. Sixty percent were between the ages of 30–49 years, 59% were females, 74% were farmers, 92% had splenomegaly, 88% had varices at endoscopy, 22% were medical emergencies with acute variceal upper gastrointestinal bleeding, and 62% had anemia. Measures of the different dimensions of health from 101 participants with patient reported outcomes revealed 77 (76%) participants experienced problems in self-care, 89 (88%) participants reported anxiety or depression, and 89 (88%) participants experienced pain or discomfort. The median EQ-VAS derived disability weights and median EQ-5D index-derived disability weights were 0.3 and 0.34, respectively. Acute upper gastrointestinal bleeding, praziquantel drug treatment, and age by decade predicted higher EQ-VAS derived disability weights (p value p value Conclusion Adult patients with upper gastrointestinal bleeding and hepatic schistosomiasis from this primary health facility experience poor health and considerable health loss. Several factors predicted increased health loss. These factors probably represent key areas of health intervention towards mitigating increased health loss in this population.

Rapid diagnostics provide actionable information for patient care at the time and site of an encounter with the health care system. The mainstay of infectious diseases care is early detection (case finding) and treatment completion, but for many, it is hard to identify positive individuals, as is the case of infection with low burden in schistosomiasis, a parasitic disease common in the tropics and subtropics. We developed a new, accurate, and fast Dot blot methodology (iDot) to indirectly detect Schistosoma mansoni in individuals with very low parasite burden using urine samples. Accuracy of 0.74 was obtained with a significant difference between negative and positive patients and a substantial agreement was found when iDot was compared with five available methods. Our analysis also revealed the superiority of iDot in detecting negative individuals from non-endemic sites, thus, presenting the lowest rate of false positives. This new method called iDot is convenient and suitable for qualitative and quantitative detection of schistosomiasis in individuals with low parasite burden.

Schistosomiasis is a waterborne tropical disease caused by infection with parasitic worms of the Schistosoma genus resulting in significant morbidity in the Middle East, South America, Southeast Asia and, mostly, in sub-Saharan Africa. For over 30 decades, this disease has been on a gradual rise, claiming thousands of lives and disfiguring its sufferers. Currently, over 280 000 mortalities per annum are attributed to this disease, with about 207 million reported cases of infection worldwide. In addition to these overwhelming statistics, infection caused by S. haematobium has been reported to predispose its sufferers to cancer of the bladder. Bladder cancer is regarded as the most common type of cancer in the urinary system, with relatively high incidence, progression and mortality rates despite the efforts put into providing optimal treatment for the disease. Despite the diagnostic and treatment options already put into place, there is still a growing need to develop alternative strategies to combat these diseases. The high expression levels of a group of molecular chaperones, known as heat shock proteins, can be used as biomarkers of infection and can consequently play a role in the development of alternative treatment methods.

Schistosomiasis, a neglected tropical disease (NTD), is one of the most prevalent parasitoses in the World. Certain freshwater snail species are the intermediate host in the life cycle of schistosome species. Controlling snails employing molluscicides is an effective, quick, and convenient intervention strategy to prevent the spread of Schistosoma species in endemic regions. Advances have been made in developing both synthetic molluscicides and molluscicides derived from plants. However, at present, the development of molluscicides is not adapted to the actual demand for snails and schistosoma controlling. We undertake a systematic review of exploitation and application of synthetic molluscicides and molluscicides derived from plants to combat intermediate host snails. The detailed molluscicidal activity, structure–activity relationship, structural feature, and possible mechanism of some molluscicides are also highlighted, which may afford an important reference for the design of new, more effective molluscicides with low environmental impact and realize the aim of controlling schistosome at transmission stages. Supplementary Information The online version contains supplementary material available at 10.1007/s00436-021-07288-4.

Schistosomiasis is an important fresh-water-borne parasitic disease caused by trematode worms of the genus Schistosoma. With > 250 million people infected worldwide and approximately 800 million people at risk, the World Health Organization considers schistosomiasis to be the most important human helminth infection. Several prophylactic non-living vaccines are in pre-clinical and clinical development, but only one has been assessed for therapeutic effect in an animal model with modest results. Live attenuated Salmonella have multiple potential advantages as vaccine vectors. We have engineered an attenuated Salmonella enterica Typhimurium strain (YS1646) to produce a vaccine that targets the parasite digestive enzyme Cathepsin B (CatB). A multi-modality immunization schedule was used in chronically infected mice that included three oral (PO) doses of this CatB-bearing YS1646 strain on days one, three, and five as well as an intramuscular (IM) dose of recombinant CatB on day one. Parasite burden (worm count, intestinal and liver egg numbers) were 46.5 – 50.3% lower than in control animals 1 month post-vaccination and relative reductions further increased to 63.9 – 73.3% at 2 months. Serum anti-CatB IgG increased significantly after vaccination with the development of a more balanced TH1/TH2 pattern of response (ie: a shift in the IgG1:IgG2c ratio). Compared to control animals, a broad and robust CatB-specific cytokine/chemokine response was seen in splenocytes isolated 1 month post-vaccination. A vaccine that has both prophylactic and therapeutic activity would be ideal for use in conjunction with mass treatment campaigns with praziquantel in schistosome-endemic countries.

Praziquantel pharmacokinetics studies in schistosomiasis infected children are scarce partly due to the challenges/complexity of intensive blood sampling in the target population. This study was aimed to investigate the optimal single sampling time-point for monitoring praziquantel exposure. This was intensive pharmacokinetic study conducted among 32 Schistosoma mansoni infected children treated with an oral standard single-dose 40 mg/kg praziquantel. Plasma samples were collected at 0, 1, 2, 4, 6 and 8 h post-praziquantel administration. Quantification of praziquantel and its enantiomers (R- and S-praziquantel) concentrations was done by Liquid chromatography-tandem mass spectrometer (LC–MS/MS). The correlation between area under the plasma concentration–time curve from 0 to 8 h (AUC8) and plasma concentrations at each specific sampling time-point was determined by Pearson’s correlation coefficient (r2). The median age (range) of the study population was 12.5 years (10–17). The study participants were 17 males and 15 females. Both total praziquantel and its enantiomers (R- and S-praziquantel) displayed a wide inter-individual pharmacokinetic variability. Regression analysis indicated that, plasma concentrations collected at 4 h post-dose had a significantly highest correlation with the AUC8 for both total praziquantel (r2 = 0.81, p S-praziquantel (r2 = 0.84, p R-praziquantel, plasma concentrations collected at 6 h sampling time-point had a significantly highest correlation with the AUC8 (r2 = 0.79, p R-praziquantel enantiomer.

Background Zoonotic schistosomiasis, caused by Schistosoma japonicum, remains a major public health problem in the Philippines. This study aimed to evaluate the commercially available rapid diagnostic point-of-care circulating cathodic antigen (POC-CCA) test in detecting individuals infected with S. japonicum in a human cohort from an endemic area for schistosomiasis japonica in the Philippines. Methods Clinical samples were collectedin 18 barangays endemic for S. japonicum infection in Laoang and Palapag municipalities, Northern Samar, the Philippines, in 2015. The presence of CCA in filter-concentrated urine samples (n = 412) was evaluated using the commercial kits and the results were converted to images, which were further analyzed by ImageJ software to calculate R values. The diagnostic performance of the immunochromatographic POC-CCA test was compared using the Kato-Katz (KK) procedure, in-house enzyme-linked immunosorbent assays (ELISAs) and droplet digital (dd) PCR assays as reference. Results The POC-CCA test was able to detect S. japonicum-infected individuals in the cohort with an eggs per gram of faeces (EPG) more than or equal to 10 with sensitivity/specificity values of 63.3%/93.3%. However, the assay showed an inability to diagnose schistosomiasis japonica infections in all cohort KK-positive individuals, of which the majority had an extremely low egg burden (EPG: 1–9). The prevalence of S. japonicum infection in the total cohort determined by the POC-CCA test was 12.4%, only half of that determined by the KK method (26.2%). When compared with the ELISAs and ddPCR assays as a reference, the POC-CCA assay was further shown to be a test with low sensitivity. Nevertheless, the assay exhibited significant positive correlations with egg burden determined by the KK technique and the target gene copy number index values determined by the ddPCR assays within the entire cohort. Conclusions By using in silico image analysis, the POC-CCA cassette test could be converted to a quantitative assay to avoid reader-variability. Because of its low sensitivity, the commercially available POC-CCA assay had limited potential for determining the status of a S. japonicum infection in the target cohort. The assay should be applied with caution in populations where schistosome parasites (especially S. japonicum) are present at low infection intensity. Graphic abstract

Information on areas colonized by snails that transmit Schistosoma mansoni is essential for planning schistosomiasis control measures. Therefore, the purpose of this study was to map the natural breeding sites of Biomphalaria spp. in the municipality of Peri Mirim, Maranhão, Brazil. The snails were manually collected and the breeding sites were geo-referenced (seven in the urban area and five in flooded fields), from November 2017 to March 2018. In the laboratory, the snails were examined for the presence of larval stages of S. mansoni identified by morphology and internal anatomy analysis. While no snails were found in the urban area, sixteen B. glabrata were collected in the flooded fields. No S. mansoni or other trematode infections were detected. Wild rodents, most likely Holochilus sciureus that could act as S. mansoni reservoirs, were also found in the flooded fields. These data indicate possible risk areas for further outbreaks of schistosomiasis transmission in the municipality of Peri Mirim.KEY WORDS: Baixada Maranhense; malacological survey; planorbidae; spatial analysis.

Objective: A cross-sectional study was conducted to determine the human host factors that contribute to the perpetuation of schistosomiasis transmission in endemic communities of Wudil, Kano State, Nigeria. Methods: Information was derived from structured questionnaires supplemented with oral interviews, on perception of the community on the cause of urogenital schistosomiasis, using self-reported macrohaematuria, as the disease proxy, water-use practices, riverside urination and defaecation, and the choice for treatment of schistosome infection. Results: Out of 139 study participants, the perceived causes of gross haematuria by the respondents were Excessive Salt Intake (41.73%); Scorching Sun (20.86%); Unknown (17.27%); Infection (10.07%); Supernatural Force (5.86%) and Water Contact (4.32%). The respondents with self-reported terminal haematuria were 49.64%; riverine water contact 75.54% and riverside contamination 65.41%. Of the 72.46% of the respondents with gross haematuria who attempted for medication only 8.0% visited health facilities, while majority relied on traditional herbalists (39.13%) and roadside medicine stores (20.29%) for treatment. There was a strong association between riverine water contact and terminal haematuria (Odds Ratio: 6.09, 95% CI, 2.825-13.131, P

Schistosomiasis is a widespread helminth disease that poses a heavy social and economic burden on people worldwide. Advanced schistosomiasis often develops into schistosome‐associated liver fibrosis, the pathogenesis of which remains unclear. This study aimed preliminarily to profile immune cells of schistosome‐associated liver fibrosis using single‐cell RNA sequencing. Three patient groups were enrolled, including an Schistosomiasis japonicum (SJ) group (n = 1), a chronic liver failure (CLF) group (n = 3) and a healthy control (HC) group (n = 2), revealing 17 cell clusters out of 20 093 cells. From these limited datasets, it was observed that T cell(1), mononuclear phagocytes‐1 and dendritic cells (DCs) were higher in the SJ group. CAVIN2+ MP(2) was the predominant cell type in the MP subset of the SJ group (53%), and was higher than that in both the CLF (8%) and HC (1%) groups. Kupffer cell marker genes (CD163, MARCO and TIMD4) were enriched in caveolae‐associated protein 2 (CAVIN2)+ MP(2), which was also an important source of TGFB1. The KEGG pathways of CAVIN2 + MP(2) indicated that they were associated with lysosome, endocytosis, phagosome and antigen processing and presentation. The preliminary study showed that granzyme B (GZMB)+ T cell(1) and ankyrin repeat domain‐containing protein 36B+ T cell(3) were the most common T cells in the SJ group (50% and 32%, respectively). The KEGG pathways of GZMB + T cell(1) were mainly related to natural killer cell‐mediated cytotoxicity. The percentage of ring1 and YY1 binding protein (RYBP)+ DC(1) was higher in the SJ group (57%) than in the CLF (16%) and HC (6%) groups. The KEGG pathway of RYBP + DC(1) was related to Fc gamma R‐mediated phagocytosis and antigen processing and presentation. Overall, CAVIN2 + Kupffer cells were the main source of TGFB1, consisting primarily of mononuclear phagocytes in the livers of the SJ group subjects and potentially playing an irreplaceable role in hepatic fibrosis of schistosomiasis., The data in this study provide a reference map of the liver immune landscape of patients with schistosoma‐associated liver fibrosis.

Control and elimination of the parasitic disease schistosomiasis relies on mass administration of praziquantel. Whilst these programmes reduce infection prevalence and intensity, their impact on parasite transmission and evolution is poorly understood. Here we examine the genomic impact of repeated mass drug administration on Schistosoma mansoni populations with documented reduced praziquantel efficacy. We sequenced whole-genomes of 198 S. mansoni larvae from 34 Ugandan children from regions with contrasting praziquantel exposure. Parasites infecting children from Lake Victoria, a transmission hotspot, form a diverse panmictic population. A single round of treatment did not reduce this diversity with no apparent population contraction caused by long-term praziquantel use. We find evidence of positive selection acting on members of gene families previously implicated in praziquantel action, but detect no high frequency functionally impactful variants. As efforts to eliminate schistosomiasis intensify, our study provides a foundation for genomic surveillance of this major human parasite., Schistosomiasis control strategies rely on mass drug administration (MDA) using praziquantel. Here, Berger et al. perform whole-genome sequencing of larvae from infected children across Ugandan regions with differing MDA histories. They find extensive gene flow with limited positive selection suggesting minimal change post MDA.

Schistosomiasis is a chronic and debilitating disease especially in developing countries. S. haematobiumof the urinogenital system is a major human health problem across Africa. Geneticvariability recommended studying variation in disease burden and pathology, and epidemiologicalaspects. The present study investigated genetic diversity and polymorphism human S. S.haematobium isolated by using RAPD-PCR technique on 50/100 urine samples from differentareas in Sohag Governorate.Extracted DNA was used for molecular analysis using RAPD-PCR primers (A01, A02, A12,A13, & Y20). 27 S. haematobium DNA isolates (54%) were amplified by using specific primers.The isolates showed distinct variation in size and number of amplified fragments, indicatinghigh genetic variation among them.

Background: Cryptosporidium species are zoonotic opportunistic coccidian parasites that could causedisseminated life-threatening infection in the immunocompromised host. Unfortunately, few availabledrugs effectively eradicate the infectious oocyst with limited availability in developing countries. AlthoughNitazoxanide (NTZ) is the drug of choice for the treatment of cryptosporidiosis, it has limited efficacyin malnourished and immunocompromised patients. Moreover, platelet-rich plasma (PRP) successfullyameliorated the hepatic granuloma size in patients with parasitic schistosomiasis mansoni.Objective: This study aims to test the potential therapeutic effect of PRP versus the currently used NTZ,and/or using PRP as adjuvant therapy.Material and Methods: Sixty-five immunosuppressed rats were divided into 5 groups: non-infected asnegative control (GI), infected non-treated as the positive control (GII), infected with Cryptosporidiumspp. and treated with either intraperitoneal PRP (GIII), or NTZ (GIV), or a combination of intraperitonealPRP and NTZ (GV). Parameters used for evaluation of the therapeutic efficacy included parasitologicalexamination, histopathological examination of ileocaecal and liver specimens, and quantitative analysisof reduced glutathione (GSH) and malondialdehyde (MDA) for evaluation of oxidative stress markers,glutamic-oxaloacetic transaminase (SGOT), and glutamic pyruvic transaminase (SGPT) for evaluation ofliver functions.Results: Parasitological and histopathological examinations revealed minimal improvement in GIII,marked improvement in GIV, and the best results were recorded in GV. The administration of PRP in GIIIproduced no significant changes in GSH, MDA, SGOT compared to positive control GII. Treatment withNTZ in GIV, and in addition to PRP in GV showed significant difference (P

Human schistosomiasis is a debilitating, life-threatening disease affecting more than 229 million people in as many as 78 countries. There is only one drug of choice effective against all three major species of Schistosoma, praziquantel (PZQ). However, as with many monotherapies, evidence for resistance is emerging in the field and can be selected for in the laboratory. Previously used therapies include oxamniquine (OXA), but shortcomings such as drug resistance and affordability resulted in discontinuation. Employing a genetic, biochemical and molecular approach, a sulfotransferase (SULT-OR) was identified as responsible for OXA drug resistance. By crystallizing SmSULT- OR with OXA, the mode of action of OXA was determined. This information allowed a rational approach to novel drug design. Our team approach with schistosome biologists, medicinal chemists, structural biologists and geneticists has enabled us to develop and test novel drug derivatives of OXA to treat this disease. Using an iterative process for drug development, we have successfully identified derivatives that are effective against all three species of the parasite. One derivative CIDD-0149830 kills 100% of all three human schistosome species within 5 days. The goal is to generate a second therapeutic with a different mode of action that can be used in conjunction with praziquantel to overcome the ever-growing threat of resistance and improve efficacy. The ability and need to design, screen, and develop future, affordable therapeutics to treat human schistosomiasis is critical for successful control program outcomes., Graphical abstract Image 1, Highlights • Identification of gene for oxamniquine drug resistance. • Identify the mode of action of oxamniquine. • Develop an iterative approach to drug discovery. • Identify oxamniquine derivatives that will kill the three major species of Schistosoma.

Currently, praziquantel (PZQ) is the only drug of choice used for treatment of human schistosomes because of its safety and broad-spectrum activity. It is reported that the repeated chemotherapy is complicated by the occurrence of drug resistance to schistosomiasis. So there is an urgent need to develop new drug combinations therapy. The current study aimed to evaluate antischistosomal activity of F. carica leaves extract alone or in combination with PZQ on Schistosoma mansoni infected mice. Mice were experimentally infected with Schistosoma mansoni and orally administrated 6 weeks’ post-infection with Fig leaves extract and/or PZQ. Schistosoma mansoni (S. mansoni)-infected mice were separated into four groups: untreated (I), treated with PZQ in dose of 200 mg/kg bw (II), treated with Fig leaves extract dose of 400 mg/kg bw (III). Group IV was treated with dose of Fig leaves extract-PZQ as in groups II and III, respectively. The effect was detected parasitologically using ova count technique and oogram pattern in intestine and liver. The greatest antischistosomal effect was achieved using orally administered Fig leaves extract—PZQ as indicated by total worm burden, tissue egg count and oogram pattern. Fig leaves extract + PZQ induced the therapeutic efficacy over the PZQ dose alone in intestine and liver as shown by a complete absence of immature worms, a very high reduction in the total numbers of tissue egg load (59.81% vs. 61.43% & 67.96% vs. 73.46%), mature eggs (37.86 ± 1.4 vs. 34.14 ± 1.9) and increasing in the total number of dead eggs (62.14 ± 1.4vs.67.29 ± 1.76). The results suggested the curcumin in combination with PZQ as a strong schistosomicidal regimen against S. mansoni. In addition, F. carica leaves extract is a promising for PZQ potentiating its antischistosomal action in animal model infected with S. mansoni. Therefore, the present work conclude that combined treatment has a synergetic effect and could be more promising in the management of schistosomiasis.

Schistosomiasis is one of the leading chronic parasitic diseases in Ethiopia. We aimed to summarize the prevalence of S. mansoni in human and Biomphalaria snails as well as risk factors in Ethiopia. Literature search was carried out from Scopus, Google Scholar, Science Direct and PubMed which reported Schistosoma mansoni infection in human and Biomphalaria snails in Ethiopia. The overall prevalence was estimated by a random-effect model and heterogeneities among studies were assessed by I2 test. A total of 178,251 participants and 1,097 snails were tested for the presence of S. mansoni in the eligible studies. The pooled prevalence of S. mansoni was 32.5% (95% CI 28.0–37.0) and 15.9% (95% CI − 5.6–37.5) in human and Biomphalaria snails in Ethiopia, respectively. The highest pooled prevalence was 43.2% (95% CI 27.3–59.1) in South Nations and National Peoples region while the lowest pooled prevalence was 25% (95% CI 19.3–30.7) observed in the Afar region. Interestingly, the pooled prevalence of S. mansoni declined from 40.7% (95% CI 33–48.4) to 22.4% (95% CI 18.5–26.3) after the launching of mass drug administration (MDA). The analysis of risk factors showed that swimming habit (OR, 2.78; 95% CI 2.35–3.21) and participation in irrigation (OR, 2.69; 95% CI 1.45–3.73) were independent predictors for S. mansoni infection. This study revealed that about one-third of human and nearly 16% of Biomphalaria snails were infected with S. mansoni in Ethiopia. This review indicated that the prevalence of S. mansoni declined after the implementation of MDA. This study highlights the importance of further integrated approaches for better control of schistosomiasis in Ethiopia.

Schistosome infection is regarded as one of the most important and neglected tropical diseases associated with poor sanitation. Like other living organisms, schistosomes employ multiple biological processes, of which some are regulated by a post-translational modification called Adenosine Diphosphate-ribosylation (ADP-ribosylation), catalyzed by ADP-ribosyltransferases. ADP-ribosylation is the addition of ADP-ribose moieties from Nicotinamide Adenine Dinucleotide (NAD+) to various targets, which include proteins and nucleotides. It is crucial in biological processes such as DNA repair, apoptosis, carbohydrate metabolism and catabolism. In the absence of a vaccine against schistosomiasis, this becomes a promising pathway in the identification of drug targets against various forms of this infection. The tegument of the worm is an encouraging immunogenic target for anti-schistosomal vaccine development. Vaccinology, molecular modeling and target-based drug discovery strategies have been used for years in drug discovery and for vaccine development. In this paper, we outline ADP-ribosylation and other different approaches to drug discovery and vaccine development against schistosomiasis.

Although schistosomiasis containment campaigns have recorded substantial success in most developed countries, sub-Saharan Africa still suffers greatly under the burden of the disease. A basic mathematical model to assess the impact of concomitant immunity in humans and environmental transmission of schistosomiasis disease progression is formulated. Mathematical analysis is carried out to establish the existence of the equilibrium points providing necessary conditions for their local and global stability. Numerical simulations are done to analyze the effects of environmental transmission and processes associated with development of concomitant immunity. Our results suggest that schistosomiasis burden is increased by direct and indirect contribution of individuals with concomitant immunity to the schistosomiasis infection chain, increasing the shedding of miracidia upto the development of cercariae promoting the growth of cercariae, increase in environmental transmission due to cercariae, reducing the clearance rate of cercariae and reducing the development of humans and non-human mammals escape mechanisms from cercariae attack.

Background: Schistosoma mansoni is a trematode helminth responsible for liver fibrosis or cirrhosis. Aim of the work: In the present work natural products Thymoquinone loaded with chitosan nanoparticle (TQ/ChNP)) (TQ/ChNP) were used to determine their therapeutic effect on S. mansoni infection. Materials and methods: A total of 40 healthy Swiss albino mice, 20-25 g in weight, procured from Theodor Bilharz Research Institute (TBRI) Imbaba, Egypt's Schistosome Biological Supply Center (SBSC). Results: The infected mice treated with TQ/ChNP showed a significant decrease in the total worm burden. Treatment with TQ/ChNP had a highly significant effect on mature worm burden, TQ/ChNP in prophylactic and therapeutic doses significantly increased the mean number of dead ova in comparison to control. TQ/ChNP had a high decrease effect on ova count in intestinal tissue and a moderate reduction on ova count in hepatic tissue. Prophylactic dose gave a high reduction effect on ova count in intestinal tissue. As regards the size of hepatic granuloma, TQ/ChNP had the highest significant reduction on mean granuloma diameter with noticeable improvement of hepatic pathology. TQ/ChNP treated group showed observable improvement of liver pathology with mild degeneration and slight-sized fibrocellular. Conclusion: Based on the outcome of this study, TQ/ChNP proved to have potential bioactivity against S. mansoni adult stages and its potentiality in improving hepatic pathology. Efficacy of TQ/ChNP to postpone progression in chronic liver diseases must be considered as preventive medicine in patients with hepatic disorders.

Schistosomiasis is a chronic parasitic disease affecting mostly low income and resourcelimited countries. Despite the distribution of the curative medicine, praziquantel (PZQ), the frequency of re-infection is commonly reported, thus, making a difficulty to discriminate treatment failure after re-infection. Therefore, assessing Schistosoma mansoni re-infection after praziquantel administration is crucial to prove the treatment efficacy and to break the transmission of infection in endemic areas. The evolution of highly sensitive and specific diagnostic markers, reliable to detect the re-infection and to evaluate the treatment efficacy, is required to control schistosomiasis. In this study, the potential role of serpin recombinant antigen of S. mansoni as a biomarker of re-infection and chemotherapeutic efficacy has been assessed. Therefore, 20 mice were experimentally challenged and re-challenged with 50 S. mansoni cercariae and divided into 4 equal groups; the first included infected mice (control positive), the second group was twice infected with S. mansoni and left untreated, the third included mice twice infected then treated with praziquantel following the last challenge, and the forth one remained uninfected and untreated (control negative). The current findings demonstrated that high levels of IgG and IgG1 bound to serpin were detected following the re-infection and rapidly declined post treatment. In summary, S. mansoni recombinant serpin could be used as a promising marker to discriminate S. mansoni re-infection and evaluated the efficacy of treatment. The translation of such a potential tool in endemic areas will provide a significant support for the elimination and control programs against schistosomiasis.

Objectives We measured the production of cytokines, chemokines and antibodies involved in allergic responses and sCD23 levels during Schistosoma mansoni infection. Methods Individuals (n = 164) were selected using the ISAAC questionnaire and parasitological exams. The subjects were divided as follows: those infected individuals with allergy-related symptoms (A-I), those with allergy-related symptoms only (A-NI); those only infected (NA-I); and those non-infected individuals without allergy-related symptoms (NA-NI). We used supernatants from cell culture (mitogenic stimulation) to measure cytokine and chemokine levels using cytometric bead arrays. Serum levels of anti-Ascaris lumbricoides (Asc) and anti-Blomia tropicalis IgE were measured using ImmunoCAP, and sCD23 was measured using ELISA. Results Schistosoma mansoni infection was associated with a lower risk of allergy-related symptoms. In A-I, there were higher levels of TNF-α, IL-10, IL-6, IFN-γ and CXCL8 than in NA-NI group, with TNF-α and IL-6 also at higher levels compared to A-NI group. Levels of IL-6, CXCL8, total and anti-Asc IgE, as well as the numbers of eosinophils, were higher in NA-I than in NA-NI, and the antibodies were also lower in A-NI than in NA-I group. In AI and NA-I, there was less production of CCL2 than in NA-NI. There were no differences in the levels of IL-2, IL-4, IL-17, CCL5, sCD23 and anti-Blomia IgE. Conclusions Patients with allergy-related symptoms and infected (simultaneously) had higher levels of IL-10; due to the infection, there was increased production of IL-6 and CXCL8 and less CCL2. These data may characterize deviation to Th1 or attenuation of the Th2 response in allergy sufferers in areas endemic for schistosomiasis.

Schistosomiasis is an endemic illness found throughout the world, including in Indonesia's Central Sulawesi province. The prevention and control procedures have been in place since 1975, but the prevalence rate has not yet reached 0%. This study used a methodology that combines primary and secondary data collection. The focus of this research is on the importance of leadership in attaining the aims of the schistosomiasis eradication policy, which is concentrated on a single location in Poso, the Bada Valley. This study discovered that policy innovations and personal leadership with a desire to succeed in a career in education and leadership training at the official level in Indonesia through PIM II Education and Training were responsible for the success of the schistosomiasis policy in Bada. The use of close personal and institutional networks is able to drive various formal and non-formal institutional mechanisms to support the achievement of schistosomiasis eradication policies in Poso.

Background: Schistosomiasis remains a major public health problem in Kenya. Environmental factors are critical in creating a medium for growth and spread of schistosomiasis vectors. The study investigated the environmental factors influencing prevention and control of schistosomiasis infection in Mwea West Sub County, Kirinyaga County-Kenya. Methods: A multi stage sampling was used to identify four hundred and sixty-five (465) household. Analytical descriptive cross-sectional design that utilised quantitative data collection method was used. Data was collected using a pretested structured questionnaire and analysed using Chi square tests or Fisher’s exact tests where applicable. Results: Study results indicated a significant association p

Background The World Health Organization previously set goals of controlling morbidity due to schistosomiasis by 2020 and attaining elimination as a public health problem (EPHP) by 2025 (now adjusted to 2030 in the new neglected tropical diseases roadmap). As these milestones are reached, it is important that programs reassess their treatment strategies to either maintain these goals or progress from morbidity control to EPHP and ultimately to interruption of transmission. In this study, we consider different mass drug administration (MDA) strategies to maintain the goals. Methods We used 2 independently developed, individual-based stochastic models of schistosomiasis transmission to assess the optimal treatment strategy of a multiyear program to maintain the morbidity control and the EPHP goals. Results We found that, in moderate-prevalence settings, once the morbidity control and EPHP goals are reached it may be possible to maintain the goals using less frequent MDAs than those that are required to achieve the goals. On the other hand, in some high-transmission settings, if control efforts are reduced after achieving the goals, particularly the morbidity control goal, there is a high chance of recrudescence. Conclusions To reduce the risk of recrudescence after the goals are achieved, programs have to re-evaluate their strategies and decide to either maintain these goals with reduced efforts where feasible or continue with at least the same efforts required to reach the goals.

Schistosomiasis is a widespread human parasitic disease currently affecting over 200 million people, particularly in poor communities. Chemotherapy for schistosomiasis relies exclusively on praziquantel (PZQ). Previous studies have shown that licarin A (LIC-A), a dihydrobenzofuran neolignan, exhibited in vitro antiparasitic activity against Schistosoma mansoni adult worms. This study aimed to investigate the potential of LIC-A, isolated as main metabolite from leaves of Nectandra oppositifolia Nees & Mart. (Lauraceae), as an antischistosomal agent orally active in schistosomiasis animal model. PZQ was used as a reference compound. As result, LIC-A showed, at a single dose of 400 mg/kg, to be able to partially cure infected mice (worm burden reductions of ~50%). Parasite eggs, that are responsible for a variety of pathologies and transmission of schistosomiasis, were also moderately inhibited by LIC-A (egg burden reductions of ~50%-60%). Furthermore, it was observed that LIC-A achieved a slight reduction of hepatomegaly and splenomegaly. Collectively, although LIC-A was partially active when administered orally, these results give support for the antiparasitic potential LIC-A as lead compound for novel antischistosomal agent.

Studies were conducted on assessment of molluscicidal and cercaricidal activities of leaves, fruits and endocarp of Balanite aegyptiaca Del against adult vectors of schistosomiasis (Biomphlaria Pfeifeferi) using standard methods. Preliminary phytochemical screening was conducted, where alkaloids, saponins, flavonoids were found present in leaves, fruits, and endocarp. Molluscicidal and cercaricidal activity test were also conducted. Snail mortalities were compared between each plant part and snail specie as well as LC50 of the plant parts were also recorded. The result obtained revealed that leaves extract was more susceptible to the death of the snail species. Comparing LC50, the leaves extract shows 0.0726 considered as the highest cercaricidal while fruits and endocarp showed highest LC50of 0.0531 and 0.0426 respectively. Keywords: Balanites Aegyptiaca, Molluscicidal, Cercaricidal Activities, Schistosomiasis (Biomphalaria pfeifferi).

According to the Kenya National School-Based Deworming program launched in 2012 and implemented for the first 5 years (2012–2017), the prevalence of soil-transmitted helminths (STH) and schistosomiasis substantially reduced over the mentioned period among the surveyed schools. However, this reduction is heterogeneous. In this study, we aimed to determine the factors associated with the 5-year school-level infection prevalence and relative reduction (RR) in prevalence in Kenya following the implementation of the program. Multiple variables related to treatment, water, sanitation, and hygiene (WASH) and environmental factors were assembled and included in mixed-effects linear regression models to identify key determinants of the school location STH and schistosomiasis prevalence and RR. Reduced prevalence of Ascaris lumbricoides was associated with low (< 1%) baseline prevalence, seven rounds of treatment, high (50–75%) self-reported coverage of household handwashing facility equipped with water and soap, high (20–25°C) land surface temperature, and community population density of 5–10 people per 100 m2. Reduced hookworm prevalence was associated with low (< 1%) baseline prevalence and the presence of a school feeding program. Reduced Trichuris trichiura prevalence was associated with low (< 1%) baseline prevalence. Reduced Schistosoma mansoni prevalence was associated with low (< 1%) baseline prevalence, three treatment rounds, and high (> 75%) reported coverage of a household improved water source. Reduced Schistosoma haematobium was associated with high aridity index. Analysis indicated that a combination of factors, including the number of treatment rounds, multiple related program interventions, community- and school-level WASH, and several environmental factors had a major influence on the school-level infection transmission and reduction.

Objective Schistosomiasis japonica is an important helminthic disease in Asia. Sensitive and accurate diagnostic tools are indispensable for clinical diagnosis, screening infection and monitoring its control. In this study, we developed an immunochromatographic test (Sj-ICT) to detect anti-Schistosoma japonicum immunoglobulin G antibodies in human sera. Methods Somatic extract from adult S. japonicum was used as an antigen. The Sj-ICT was developed and optimized as a point-of-care test. All 214 human serum samples were evaluated for diagnostic usefulness and comparison with an enzyme-linked immunosorbent assay (ELISA). Results The diagnostic sensitivity, specificity, positive and negative predictive values, and accuracy of the Sj-ICT were 90.8%, 87.9%, 86.4%, 91.9% and 89.3%, respectively. For ELISA the values were respectively 91.8%, 87.9%, 86.5%, 92.7% and 89.7%. The concordance between both methods was 86.4 % (Cohen’s kappa value = 0.729). Conclusions The immunochromatographic test kit developed can support clinical diagnosis and large-scale surveys in endemic areas without requiring additional facilities or ancillary supplies.

Background: Bilharzia is a parasitic disease caused by the trematode worms (schistosomes). It is the most important and prevalent of water-borne parasitic disease.Schistosomiasis affects between 200 million and 300 million people in 77 countries throughout the world and is a significant cause of disease in areas of endemic infections especially among children. Aims: The study was aimed to determine the prevalence and intensity of urinary schistosomiasis among people in Goronyo and taloka communities in Sokoto State, Nigeria. Study Design: Investigative study. Place and duration of study: The samples were collected from Goronyo and Taloka communities of Goronyo local government Area of Sokoto State between October and December, 2020. Methodology: 300 water samples were obtained from domestic water sources. 175 of the samples were collected from river, 77 from borehole and 48 from well. Samples were investigated for the presence of parasites using standard parasitological techniques. Samples were subjected to macroscopy, filtration, centrifugation and microscopy. Results: Findings reveals total prevalence of 37%. The prevalence in Taloka was higher (47%) than Goronyo (27%)(P

Background: Schistosomiasis is a chronic granulomatous inflammation affecting many organs and systems of the body including the gastrointestinal tract with frequent involvement of the appendix. It presents with clinical diagnostic challenge without biopsy and histopathologic evaluation. The study aims to documents the histopathologic pattern of the appendiceal schistosomiasis in our environment. Material and Methods: A 15-year (2004 to 2018) review of all appendix specimens received in the department of Histopahology, Aminu Kano University Teaching Hospital. Information on age, sex and duration of disease was retrieved from request cards and patient case notes. Cases with histological evidence of Schistosomiasis were selected for the study. Data presented as frequency distribution tables, charts and photomicrographs. Results: Thirty six (36) cases of histopathologically confirmed Schistosomal appendicitis constituting 3.2% of all appendectomy specimen with male to female ratio of 9:1, and peak incidence in the third decade of life. Majority (83.3%) of cases show granuloma formation with either calcified or viable schistosoma ova or both. Only 6 cases show Minimal inflammatory response and calcified schistosoma ova. The most common presentation was recurrent and acute appendicitis. Conclusion: Appendiceal schistosomiasis constitutes 3.2% of appendiceal lesions in our settings, affecting predominantly young male. High index of suspicions is therefore advocated in all cases of acute recurrent abdominal pains to avoid unnecessary surgical trauma. Keywords: Appendix, Schistosoma ova, Pathology.

This study aimed to describe: 1) soil-transmitted helminthiasis (STH) and schistosomiasis prevalence and intensity in preschool-age children (PSAC) and school-age children (SAC), 2) schistosomiasis seroprevalence in SAC, 3) undernutrition prevalence in SAC, 4) sanitary toilet coverage in households, and 5) association between STH, Schistosoma japonicum exposure, nutritional status, and sanitation. PSAC and SAC in two Haiyan-stricken provinces were examined using Kato–Katz technique and ELISA Antibody test. Anthropometric and hemoglobin measurements were also obtained. The reported sanitary toilet coverage was validated in a survey. The prevalence of any STH in PSAC and SAC was 50.2% and 41.3%, respectively. Moderate-heavy intensity (MHI) STH prevalence in PSAC and SAC was 20.8% and 5.9%, respectively. The prevalence of any STH, MHI STH, ascariasis, MHI ascariasis, and MHI trichuriasis was significantly higher in PSAC. Stunting, underweight, wasting, overweight/obesity, and anemia prevalence was 38.4%, 24.5%, 4.8%, 2.7%, and 34.7% in PSAC, while the prevalence was 34.3%, 21.6%, 8.7%, 3.0%, and 19.2% in SAC, respectively. Anemia and wasting prevalence were significantly higher in PSAC and SAC, respectively. There were five schistosomiasis cases found (0.8% prevalence), while schistosomiasis seroprevalence was 60.1%. Validated and reported sanitary toilet coverage was significantly different in eight out of 13 barangays. Stunting and anemia were associated with STH. STH and anemia prevalence were significantly higher in non-ZOD barangays. High STH burden in PSAC and SAC persists. A more coordinated response addressing STH, undernutrition, and WASH in disaster-stricken areas will require strengthening local health systems and promoting intersectoral collaboration.

Zoonotic pathogens are among the most important causes of ill health all over the world. The presence of these pathogens in free ranging baboons may have significant implications for humans. In Kenya, the encroachment of wildlife habitats has led to increased interaction between humans and wildlife especially non‐human primates. The current study therefore aimed at investigating any possible zoonotic gastrointestinal helminths of olive baboons (Papio anubis) at the human–wildlife interface in two park borders and a ranch in Kenya, namely, Tsavo West National Park, Tana River Primate Reserve and Mutara Ranch, Laikipia, Kenya. One hundred and forty‐seven baboons were used in the study. They were trapped in the wild, sampled for stool marked and then released back to the wild. Gastrointestinal (GIT) helminths identified were Strongyloides, Oesophagostomum, Enterobius spp and Trichuris Trichiura from all the three sites while Schistosoma mansoni was only detected from Tsavo baboons and with very low incidence (2.1%). The prevalence of these parasites varied among the sites but significant difference in prevalence was only noted in Strongyloides and Oesophagostomum (p, Baboons harbor Schistosoma mansoni which is infectious to humans. Humans can be infected through sharing of water resources, eating left overs since their fecal waste contaminate water and food. Control of the schistosomiasis in human population alone will still be a challenge if possible zoonotic sources are not looked at.