Have you ever heard of schistosomiasis? Probably not. Half of the population in Tanzania is affected by this parasitic disease that can lead to severe health problems. KIT epidemiologists Jake Mathewson and Ente Rood are working together with Dr. Humphrey Mazigo, a Professor of Public Health, from the Catholic University of Health and Allied Sciences (CUHAS) to improve the control of this neglected disease in the East African Country. In this blog you will find out why this is a global health problem and what this joint research is all about.  

A worldwide health issue 

More than a decade ago, the World Health Organization (WHO) created the term ‘Neglected Tropical Diseases (NTDs)’ to raise awareness for a group of diseases that mainly affect low-income populations in tropical areas. These diseases are called ‘neglected’ because they are prevalent in the poorest communities with very limited resources and receive little funding for research and control compared to other well-known infectious diseases such as HIV/AIDS and tuberculosis. The fact that NTDs are neglected does not mean they cannot be serious in their symptoms. NTDs can cause severe pain, social stigma, long-term disability, and even lead to death. Infections among children can result in serious medical conditions like malnutrition and stunting, preventing them from attending school.

The parasitic disease of concern in Tanzania 

Luckily, many NTDs are preventable and can often be treated with just a single drug dose. Yet, more than one billion people are affected by NTDs globally, ranging from bacteria and viruses to parasitic worms. One of these diseases caused by parasitic worms is called ‘schistosomiasis’. Say what? Indeed, a very difficult name to pronounce, even for those who have been experts in the field for a long time. Like other NTDs, schistosomiasis is strongly associated with impoverished populations, and is attributed to trapping people into a cycle of poverty. Due to the high number of people that the disease continues to affect, the WHO has prioritized the elimination of schistosomiasis as a public health problem by 2030. Tanzania is, after Nigeria, the country with the second highest burden of schistosomiasis in the world. 

In Sub-Saharan Africa, the most common forms of schistosomiasis infection are intestinal and urogenital schistosomiasis. Urogenital schistosomiasis specifically affects the bladder and reproductive systems, and is often mistreated in females as a sexually transmitted infection. KIT’s partner CUHAS focuses much of their research on urogenital schistosomiasis, and the many stigmatized women in the country affected by the disease. 

Tool development to detect outbreaks and target populations  

Schistosomiasis is recognized as a widespread health issue in East Africa. Current control strategies include targeting large groups of the population through mass drug administration (MDA) campaigns at the district level. However, this has led to over- and under treatment in district areas because the spread of the parasitic disease can vary within the district. To minimize over- and undertreatment, WHO guidelines recommend more targeted MDA treatment campaigns per sub-district. This is exactly what the joint research is focused on. 

Source: Dr Socé Fall: Reflecting on a Year of Triumphs and Challenges at the Helm of the Global NTD Programme

Presently, country programs are missing vital schistosomiasis data for decision making in areas smaller than districts. The WHO NTD roadmap 2021 – 2030 to elimination calls for new and efficient spatial tools to fill this gap. KIT and CUHAS have conducted a study investigating the use of geostatistical models as a potential viable solution. These planning tools can support decision makers with prioritizing sub-district areas for targeted MDA. The research looks at sub-district areas surrounding lakes in the northwest part of the country because it is believed that schistosomiasis is particularly present in the Lake zone. The planning tool that will be developed through this research, will be based on data collected in the lake regions, inputs from interviewed professionals in Tanzania, academic research and past experience of KIT and CUHAS on this topic like the ASCEND project. 

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