Strategy

Control and preventive chemotherapy

The strategy for schistosomiasis control aims to reduce morbidity through regular treatment with praziquantel, which is the only available drug. Praziquantel has been used successfully over the past 20 years to control schistosomiasis in Brazil, Burkina Faso, Cambodia, China, Egypt, Mauritius, Morocco, Oman and Saudi Arabia. Treatment at least three times during childhood is likely to prevent disease in adulthood.

The recent consensus on neglected tropical diseases has highlighted that some of these diseases can be controlled in a coordinated approach with treatment on a large scale with safe and effective drugs, and at regular intervals. Such treatment is done without individual diagnosis, once the endemic area is defined, the overlap of diseases determined, and the algorithm for treatment agreed.

• Neglected tropical Diseases (NTD)

Recommended intervention strategy and aim

Targeted distribution of praziquantel is the norm. Intervention frequency is determined by the prevalence of infection or haematuria (for S. haematobium only) among school-age children. The aim is morbidity control: periodic treatment of at-risk populations will cure subtle morbidity and prevent infected individuals from developing severe, late-stage morbidity due to schistosomiasis. In children, lesions may be reversed following specific treatment.

Praziquantel is safe in pregnancy, and it is recommended that women, and adolescent girls of child-bearing age, should not be excluded from public health interventions

Eligible population

Ineligible population

There is no documented information on the safety of praziquantel for children under 4 years of age (or under 94 cm in height). These children should therefore be excluded from large-scale preventive chemotherapy interventions but can be treated on an individual basis by medical personnel.

Access to drugs

Praziquantel is the recommended treatment for schistosomiasis at 40 mg/kg body weight. The cost of a single 600-mg tablets is about US$ 0.08 and an average treatment is estimated to be between US$ 0.20–0.30.

Praziquantel is now available free of charge to a few high-disease burden least developed countries (LDC), through a donation from Merck KGaA to the World Health Organization. The donation of praziquantel is based on a successful review of the national plan for schistosomiasis control and a commitment of resources for implementation.

To be considered for this donation programme, please download and complete the form.