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FioSchisto’s expert perspective on implementing WHO guidelines for schistosomiasis control and transmission elimination in Brazil

Authors :
Camilla Almeida Menezes
Langia Colli Montresor
Soraya Torres Gaze Jangola
Aline Carvalho de Mattos
Ana Lúcia Coutinho Domingues
Arnaldo Maldonado Júnior
Clélia Christina Mello Silva
Constança Simões Barbosa
Cristiane Lafetá Furtado de Mendonça
Cristiano Lara Massara
Cristina Toscano Fonseca
Edward José de Oliveira
Elainne Christine de Souza Gomes
Elizângela Feitosa da Silva
Fernando Schemelzer de Moraes Bezerra
Floriano Paes Silva-Jr
Isadora Cristina de Siqueira
José Roberto Machado e Silva
Leo Heller
Leonardo Paiva Farias
Lilian C. Nobrega Holsbach Beck
Mariana Cristina Silva Santos
Mariana Gomes Lima
Marina de Moraes Mourão
Martin Johannes Enk
Monica Ammon Fernandez
Naftale Katz
Omar dos Santos Carvalho
Patrícia Martins Parreiras
Renata Heisler Neves
Sandra Grossi Gava
Sheilla Andrade de Oliveira
Silvana Carvalho Thiengo
Tereza Cristina Favre
Carlos Graeff-Teixeira
Otávio Sarmento Pieri
Roberta Lima Caldeira
Rosiane A. da Silva-Pereira
Roberto Sena Rocha
Ricardo Riccio Oliveira
Source :
Frontiers in Immunology, Vol 14 (2023)
Publication Year :
2023
Publisher :
Frontiers Media S.A., 2023.

Abstract

The World Health Organization (WHO) recognizes schistosomiasis as one of the Neglected Tropical Diseases targeted for global elimination in the 2030 Agenda of the Sustainable Development Goals. In Brazil, schistosomiasis mansoni is considered a public health problem, particularly prevalent among vulnerable populations living in areas with poor environmental and sanitary conditions. In 2022, the WHO published a Guideline encompassing recommendations to assist national programs in endemic countries in achieving morbidity control, eliminating schistosomiasis as a public health problem, and advancing towards interrupting transmission. The perspectives presented here, collectively prepared by members of the Oswaldo Cruz Foundation’s (Fiocruz) Schistosomiasis Translational Program (FioSchisto), along with invited experts, examine the feasibility of the WHO recommendations for the Brazilian settings, providing appropriate recommendations for public health policies applicable to the epidemiological reality of Brazil, and suggests future research to address relevant issues. In Brazil, the provision of safe water and sanitation should be the key action to achieve schistosomiasis elimination goals. The agencies involved in measures implementation should act together with the Primary Care teams for planning, executing, monitoring, and evaluating actions in priority municipalities based on their epidemiological indicators. Host snails control should prioritize judicious ecological interventions at breeding sites. The Information, Education, and Communication (IEC) strategy should be associated with water and sanitation and other control actions, actively involving school community. To identify infected carriers, FioSchisto recommends a two-stage approach of immunological and molecular tests to verify transmission interruption during the intervention and beyond. Praziquantel administration should be done under medical supervision at the Primary Care level. MDA should be considered in exceptional settings, as a measure of initial attack strategy in locations presenting high endemicity, always integrated with water and sanitation, IEC, and snail control. To assist decision-making, as well as the monitoring and evaluation of strategic actions, there is a need for an Information System. FioSchisto considers this systematization essential to make investments in strategic research to support the improvement of schistosomiasis control actions. Efforts toward schistosomiasis elimination in Brazil will succeed with a paradigm shift from the vertical prescriptive framework to a community-centered approach involving intersectoral and interdisciplinary collaboration.

Details

Language :
English
ISSN :
16643224
Volume :
14
Database :
Directory of Open Access Journals
Journal :
Frontiers in Immunology
Publication Type :
Academic Journal
Accession number :
edsdoj.fe2f516e234147558ec1a98572b6ed7f
Document Type :
article
Full Text :
https://doi.org/10.3389/fimmu.2023.1268998