Parasitology

SECTION 2 IMPLEMENTATION OF CONTROL AT NATIONAL LEVELS

The Schistosomiasis Control Initiative (SCI): rationale, development and implementation from 2002–2008

A. FENWICKa1 c1, J. P. WEBSTERa1, E. BOSQUE-OLIVAa1, L. BLAIRa1, F. M. FLEMINGa1, Y. ZHANGa1, A. GARBAa2, J. R. STOTHARDa3, A. F. GABRIELLIa4, A. C. A. CLEMENTSa5a6, N. B. KABATEREINEa7, S. TOUREa8, R. DEMBELEa9, U. NYANDINDIa10, J. MWANSAa11 and A. KOUKOUNARIa1

a1 Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, Imperial College, St. Mary's Campus, Norfolk Place, London W2 1PG, UK

a2 Programme National de Lutte contre la Bilharziose et les Géohelminthes, Ministère de la Santé Publique, 2648 Bd du Zarmaganda, B.P. 13724 Niamey, Niger

a3 Wolfson Wellcome Biomedical Laboratories, Department of Zoology, Natural History Museum, Cromwell Road, London SW7 5BD, UK

a4 Department of Control of Neglected Tropical Diseases, World Health Organization, 20 Avenue Appia, CH-1211 Geneva 27, Switzerland

a5 University of Queensland School of Population Health, Herston Road, Herston, 4006, Queensland, Australia

a6 Australian Centre for International and Tropical Health, Queensland Institute of Medical Research, Herston Road, Herston, 4006, Queensland, Australia

a7 Vector Control Division, Ministry of Health, PO Box 1661, Kampala, Uganda

a8 Programme National de Lutte contre la Schistosomiase et les Vers Intestinaux, Ministère de la Santé, 06 B.P. 9103, Ouagadougou 06, Burkina Faso

a9 Programme National de Lutte contre la Schistosomiase, PNLSH-Quartier du Fleuve, B.P. 228, Bamako, Mali

a10 National Schistosomiasis and Soil-transmitted Helminth Control Programme, National School Health Programme, Ministry of Health and Social Welfare, PO Box 9083, Dar es Salaam, United Republic of Tanzania

a11 University Teaching Hospital, Department of Pathology and Microbiology, Private Bag, RW1X, Lusaka, Zambia

SUMMARY

Schistosomiasis remains one of the most prevalent parasitic diseases in developing countries. After malaria, schistosomiasis is the most important tropical disease in terms of human morbidity with significant economic and public health consequences. Although schistosomiasis has recently attracted increased focus and funding for control, it has been estimated that less than 20% of the funding needed to control the disease in Africa is currently available. In this article the following issues are discussed: the rationale, development and objectives of the Schistosomiasis Control Initiative (SCI)-supported programmes; the management approaches followed to achieve implementation by each country; mapping, monitoring and evaluation activities with quantifiable impact of control programmes; monitoring for any potential drug resistance; and finally exit strategies within each country. The results have demonstrated that morbidity due to schistosomiasis has been reduced by the control programmes. While challenges remain, the case for the control of schistosomiasis has been strengthened by research by SCI teams and the principle that a national programme using ‘preventive chemotherapy’ can be successfully implemented in sub-Saharan Africa, whenever the resources are available. SCI and partners are now actively striving to raise further funds to expand the coverage of integrated control of neglected tropical diseases (NTDs) in sub-Saharan Africa.

(Received February 25 2009)

(Revised May 14 2009)

(Accepted May 26 2009)

(Online publication July 27 2009)

Correspondence:

c1 Corresponding author: Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, Imperial College, St. Mary's Campus, Norfolk Place, London W2 1PG, UK. Tel: +44 (0)20 7594 3418; Fax: +44 (0)20 7262 8140. E-mail: a.fenwick@imperial.ac.uk

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