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What is required in terms of mass drug administration to interrupt the transmission of schistosome parasites in regions of endemic infection?

Anderson, RM; Turner, HC; Farrell, SH; Yang, Jie; Truscott, JE


RM Anderson

HC Turner

SH Farrell

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Dr Jie Yang
Lecturer in Applied Mathematics

JE Truscott


Schistosomiasis is endemic in 54 countries, but has one of the lowest coverages by mass drug administration of all helminth diseases. However, with increasing drug availability through donation, the World Health Organisation has set a goal of increasing coverage to 75 % of at-risk children in endemic countries and elimination in some regions. In this paper, we assess the impact on schistosomiasis of the WHO goals in terms of control and elimination.

We use an age-structured deterministic model of schistosome transmission in a human community and the effect of mass drug administration. The model is fitted to baseline data from a longitudinal re-infection study in Kenya and validated against the subsequent re-infection data. We examine the impact on host worm burden of the current treatment trend, extrapolated to meet the WHO goals, and its sensitivity to uncertainty in important parameters. We assess the feasibility of achieving elimination.

Model results show that the current treatment trend, extrapolated to the WHO goals, is able to greatly reduce host worm burdens. If coverage is continued at the same level beyond 2020, elimination is possible for low to moderate transmission settings, where transmission intensity is defined by the basic reproduction number, R0. Low levels of adult coverage have a significant impact on worm burden in all settings. Model validation against the re-infection survey demonstrates that the age-structured model is able to match post-treatment data well in terms of egg output, but that some details of re-infection among school children and young adults are not currently well represented.

Our work suggests that the current WHO treatment goals should be successful in bringing about a major reduction in schistosome infection in treated communities. If continued over a 15 year period, they are likely to result in elimination, at least in areas with lower transmission.


Anderson, R., Turner, H., Farrell, S., Yang, J., & Truscott, J. (2015). What is required in terms of mass drug administration to interrupt the transmission of schistosome parasites in regions of endemic infection?. Parasites and Vectors, 8(1), Article 553.

Journal Article Type Article
Acceptance Date Oct 7, 2015
Online Publication Date Oct 22, 2015
Publication Date 2015-12
Deposit Date May 5, 2022
Publicly Available Date May 27, 2022
Journal Parasites & Vectors
Print ISSN 1756-3305
Publisher BioMed Central
Peer Reviewed Peer Reviewed
Volume 8
Issue 1
Article Number 553
Keywords Schistosomiasis; Treatment coverage; Host population; Praziquantel; Mass drug administration
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© 2015 Anderson et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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