Schistosomiasis in African infants and preschool children: let them now be treated!

Abstract

The occurrence of schistosomiasis within African infants and preschool children has been much better documented in recent years, revealing an important burden of disease previously overlooked. Despite mounting evidence showing that treatment with praziquantel is safe, beneficial, and could be delivered within ongoing public health interventions, young children still do not have satisfactory access to this drug, and a significant treatment gap exists. Progress towards resolution of this unfortunate health inequity is highlighted, including the development of an appropriate paediatric praziquantel formulation, and present blocks are identified on securing this issue within the international health agenda.

Urinary schistosomiasis among preschool children in Malengachanzi, Nkhotakota District, Malawi: Prevalence and risk factors

“…1,2 3 Estimates show that 200 million people worldwide are at risk of infection, 4 while 120 million people already display symptoms of the disease. 5 It has been estimated that more than 97% of all schistosomiasis cases occur in Africa, 6,7 and high prevalence estimates and infection intensities are found in school-aged children, adolescents, and adults. 1,8,9 In order for schistosomes to complete their lifecycles, they require aquatic intermediate snail hosts.…”

“…In Malawi, schistosomiasis in infants and preschool children has been documented in recent years, revealing an important demographic that was previously overlooked in the public health context of schistosomiasis. 6,7,11 For instance, lack of a suitable paediatric praziquantel formulation has excluded preschool children from mass drug administration efforts. Preschool children have been overlooked despite emerging evidence from other countries and other parts of Malawi that preschoolers carry significant levels of schistosomiasis infection and are at risk of infection just like their older school-aged counterparts.…”

Schistosomiasis Sustained Control Program in Ethnic Groups Around Ninefescha (Eastern Senegal)

“…4 Preschoolaged children (PSAC) had been excluded from mass treatment programs for control of schistosomiasis because of the limited documentation on the safety of praziquantel in this age group and lack of an appropriate formulation. 5 However, during an informal meeting in Geneva, Switzerland, the WHO presented new evidence to consider these children as a high-risk group in endemic areas and to encourage changes in praziquantel formal licensing or off-label use in treatment of PSAC. 6 However, these new recommendations have to be accepted at the national level.…”

Anemia Among Children Exposed to Polyparasitism in Coastal Kenya

“…14 With more sensitive testing, there is greater evidence that Schistosoma infection begins in very early childhood. [15][16][17] While children under 5 years are not yet included in WHO preventive chemotherapy protocols, 18 anti-schistosomal treatment with praziquantel for preschool children could be easily synergized with the ongoing STH early childhood strategies for the prevention of anemia. 18 The aim of this study was to use more in-depth laboratory testing to identify the most likely mechanisms for anemia among children in a resource-limited area endemic for multiple chronic parasitic infections, with the goal of informing local and regional choices for management of early childhood anemias.…”