Neglected tropical diseases

Schistosomiasis control in Madagascar – Newsletter

18 December 08 | Geneva

More than one million school-aged children have been treated for schistosomiasis in Madagascar between June and October 2008. This compares with just over 110 000 school-aged children treated during the eight-year period 1999–2006. This scale-up was made possible by the donation, free of charge, of 2.5 million praziquantel tablets by Merck KGaA.

In most areas, primary-school teachers are responsible for treating school-aged children; community drug distributors deliver treatment in areas where mass drug administration for lymphatic filariasis is being implemented. Drug distributors are trained by officials of the Ministry of Health, with support from nongovernmental organizations such as RISEAL*, AICU** and the WHO Country Office.

Two forms of schistosomiasis are endemic to Madagascar. The first, intestinal schistosomiasis, is endemic in the southern and eastern parts of the country. Infection is acquired from worms residing in the blood vessels lining the intestine.

The second form, urinary schistosomiasis, is endemic in the northern and western regions of the country. Schistosomiasis affects 95 out of 111 districts, with an estimated prevalence rate of 31%. About 5 million people are thus estimated to be infected, with a further 15 million at risk for the disease. This situation makes schistosomiasis a major health hazard in Madagascar …/…
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“The rapid scale-up is largely due to a collaborative action between the Ministries of Health and Education and their partners, RISEAL, AICU, as well as the WHO Country Office. The private–public partnership between Merck KGaA and WHO arranged the donation of praziquantel, but the actual implementation was made by stakeholders in Madagascar. A little support can go a long way. We expect the scale up to continue with the same enthusiasm and momentum until the children at risk are treated and that deworming of school-aged children becomes routine in the country.”.

Dr Lester Chitsulo, WHO Scientist, Department of Control of Neglected Tropical Diseases

Schistosomiasis is a parasitic disease that leads to chronic ill-health. Infection is acquired from contaminated freshwater containing the larval forms (cercariae) of blood fl ukes, known as schistosomes. The centimetre-long worms mature in the human bladder and intestines, laying eggs that can cause massive damage. Once released by the body into water through faeces and urine, the eggs hatch and their larvae (miracidia) penetrate suitable snail hosts. The cercariae emerge from the snail into water from where they penetrate a human host within seconds, thereby perpetuating the life-cycle.

Schistosomiasis Fact sheet | Schistosmiasis website

*Réseau International Schistosomoses Environnement Amenagements et Lutte (
**Associazione Italiana Carlo Urbani (