Expanding preventive chemotherapy to all in need

A total of 78 countries are endemic for schistosome infections, of which populations in 52 countries require preventive chemotherapy. In 2018, an estimated 229.2 million people required treatment, of which school-aged children represented more than half (54.3%) of that total.

Africa, the most affected region, houses 90% of people requiring preventive treatment.

The WHO-recommended strategy to control schistosomiasis involves large-scale treatment of affected populations through periodic treatment with praziquantel.

In order to sustain the achievements made in controlling morbidity from schistosomiasis, and in striving towards elimination, it is essential that 100% geographical coverage with preventive chemotherapy is achieved and maintained, and that all age groups requiring treatment are reached.

Managing the treatment of preschool-aged children will be greatly enhanced when the paediatric formulation of praziquantel, currently under clinical development, will be introduced. This will also close a major gap in reaching this age group as  future  inclusion of pre-school-aged children in preventive chemotherapy programmes will enable a comprehensive coverage of all children. To promote increased awareness of the disease, WHO developed an illustrated booklet for school children which has been widely distributed in multiple languages in many countries. Women, and in particular pregnant and lactating women are also at risk in endemic areas and should be included in treatment.

WHO is working to scale up treatment in all countries requiring preventive chemotherapy and aims to achieve the target of 100% geographical coverage or at least 75% national coverage. WHO supports country with technical guidance, establishment of control programmes, donation of praziquantel from Merck for the treatment of school age children.

WHO is working to ensure that adequate supply of praziquantel and resources are available to all countries for the implementation of schistosomiasis control and elimination activities.  WHO is working to increase quality-assured praziquantel through its prequalification process. (Insert table of Prequalified NTD Medicines or provide link to PQ site) and country health workers capacity to deliver the interventions (link to training courses on preventive chemotherapy of neglected tropical diseases / schistosomiasis).

The Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN); a special WHO project in partnership with donors is  mandated  to achieve full scale implementation of preventive chemotherapy in WHO’s AFRO region and in some EMRO countries.