Mass drug administration and the global control of schistosomiasis: Successes, limitations and clinical outcomes

David U. Olveda, Donald P. McManus, Allen G.P. Ross

    Research output: Contribution to journalReview articlepeer-review

    28 Citations (Scopus)

    Abstract

    Purpose of review: Preventive chemotherapy is advocated for the global control and elimination of schistosomiasis. Despite the well known short-term benefits of treating patients for schistosomiasis, the impact of mass drug administration (MDA) campaigns to control the disease in the long term remains unresolved.

    Recent findings: Many studies have advocated the success of MDA programs in order to attract donor funds for elimination efforts but such successes are often short-lived given the drug does not alter the life cycle of the organism or prevent reinfection. Within a matter of months to years after halting treatment, the prevalence, intensity of infection and morbidity of disease return to baseline levels. Other mitigating factors contribute to the failings of MDA campaigns namely: poverty, poor drug coverage, poor drug compliance, and, in the case of Asiatic schistosomiasis, zoonotic transmission. Genetic and innate and acquired immunologic mechanisms complicate the epidemiologic picture of schistosomiasis globally, and may contribute indirectly to MDA shortcomings. The possibility of drug resistance is an ever present concern because of the sole reliance on one drug, praziquantel. 

    Summary: Preventive chemotherapy is advocated for the global control and elimination of schistosomiasis. The short term benefits of MDA campaigns are well documented but the long-term benefits are questionable.

    Original languageEnglish
    Pages (from-to)595-608
    Number of pages14
    JournalCurrent Opinion in Infectious Diseases
    Volume29
    Issue number6
    DOIs
    Publication statusPublished - 13 Nov 2016

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