Progress towards control and elimination of neglected tropical diseases targeted by preventive chemotherapy in São Tomé e Príncipe

Abstract

The São Tomé e Príncipe government is committed to achieving neglected tropical disease (NTD) control and elimination as a public health problem by 2025. In 2014, the Ministry of Health led a national survey to determine the prevalence of soil-transmitted helminths (STHs) and schistosomiasis across the country. Following this survey, a preventive chemotherapy (PC) campaign with mebendazole and praziquantel reached 31 501 school-age children in 2015. A follow-up 2017 survey to determine the impact of the intervention showed success in controlling schistosomiasis, as no infections were found, but limited impact on STHs, with prevalence similar to pretreatment levels. The survey also investigated the prevalence of a third NTD, lymphatic filariasis (LF), which was found to be endemic in the country. Since then the Ministry of Health has developed the Strategic Plan for the Fight Against Neglected Tropical Diseases 2019–2025 and identified gaps to be addressed. This narrative review systematises the existing literature reporting on the epidemiology of NTDs for which there are PC programs in São Tomé e Príncipe. PubMed was searched for relevant papers that measured the prevalence of LF, schistosomiasis and STHs. Additionally, data provided by the Ministry of Health surveys were analysed. Finally, we discuss current NTD control, including the impact of the coronavirus disease 2019 pandemic and identify priorities for program strengthening and operational research.

Intestinal parasitic infections and adverse outcomes for pregnant women and their newborns in Sao Tome & Principe: a hospital-based cross-sectional study

“…In this article, S. intercalatum terminology will be kept since the original reports and diagnosis registered in each woman´s ANC pregnancy card are for S. intercalatum. However, Schistosoma guineensis seems to re ect the current molecular terminology for this parasite species in STP as recently published [30], without any differences in the clinical manifestations or transmission previously documented.…”

“…Women living in low-to middle-income countries (LMICs) are known to have a higher risk of acquiring an IPI during their pregnancy and consequently to suffer eventual complications from these NTDs [2,53]. The authors have previously found an overall prevalence of IPI among pregnant women of 58.2% (95% CI: 52.9-63,3), which is not surprising since STP is known to be an endemic country for four NTDs, namely, STHs, schistosomiasis, lymphatic lariasis (LF) and leprosy [30]. Thus, this study was conducted to clarify the adverse outcomes among these IPI-infected pregnant women and their offspring.…”

“…According to our research, S. intercalatum is still a reality among pregnant women in STP; thus, women-of-reproductive age and pregnant women after the rst trimester should be considered for inclusion, as recommended by the WHO, in the country´s preventive chemotherapy (PC) programmes to achieve the goal of eliminating schistosomiasis in the country [18]. Currently, national PC with praziquantel for schistosomiasis control only targets school children, missing out on other at-risk populations [30,43]. In STP, the elimination programme for LF has a mass drug PC administration using a triple drug combination of ivermectin, diethylcarbamazine and albendazole [30].…”

“…Amebiasis is reported to be more severe in pregnant women than in nonpregnant women, linked to the reduced production of IgA during pregnancy, which may lead to subchronic in ammation and placental dysfunction resulting in preeclampsia, preterm delivery, and foetal growth restriction [24,25]. None of the drugs used in STP for NTD PC have e cacy in treating E. histolytica infections [25,30]. Thus, routine ANC screening for IPIs through coproparasitological exams should be kept, and pregnant women should be treated according to the WHO´s recommendations and follow-up [25,43].…”

“…Soil-transmitted helminths (STHs) and schistosomiasis are NTDs endemic in Sao Tome & Principe (STP), a two island SSA country in the Gulf of Guinea [29,30]. Currently, the STP government is committed to achieving NTD control and elimination as a public health problem by 2025 and has developed a Strategic Plan for the Fight Against NTDs 2019-2025 [30,31]. However, IPIs in STP have only been studied among toddlers [32,33], pre-school, and school children [34][35][36][37], missing out pregnant women and their unborn baby.…”