Model-based insights into multi-host transmission and control of schistosomiasis.

摘要: Schistosomiasis is a tropical disease of great antiquity that remains endemic in 76 countries, affecting 200 to 300 million people the developing world. Current control schistosomiasis heavily dependent on chemotherapy, primarily through praziquantel, safe and highly effective drug introduced early 1980s. In recent decades, large-scale school- or community-based treatment strategies have been successful suppressing average infection intensity many parts world, dramatically reducing schistosomiasis-associated morbidities such as hepatosplenomegaly, hepatic fibrosis, bladder kidney inflammation for urinary [1,2]. We expect see similar pattern low-income particularly sub-Saharan Africa, praziquantel made increasingly available [3]. However, increasing evidence shows chemotherapy-based alone are unlikely be sustainable strategy prevention schistosome infections all areas [2,4,5]. This has two important implications. First, although advanced stages can effectively controlled use, there light chronic due continuing transmission contribute significantly growth retardation, anemia, exercise intolerance, poor school performance, lower work capacity [6]. Second, does not change environmental conditions foster parasite communities [2,4]. some environments, cessation even few years result re-occurrence high levels infection, back pretreatment extreme cases [7,8]. Hence, pressing need return more comprehensive beyond treatment. Linked Research Article This Perspective discusses following new study published PLoS Medicine: Riley S, Carabin H, Belisle P, Joseph L, Tallo V, et al. (2008) Multi-host dynamics Schistosoma japonicum Samar Province, Philippines. Med 5(1): e18. doi:10.1371/journal.pmed.0050018 Obtaining data from thousands humans mammalian hosts Philippines, Steven Riley colleagues find acquisition, rather than snails, drives prevalence. In absence viable vaccines against schistosome, reason reconsider earlier approaches targeting cycle augment strategy. However, (e.g., mollusciciding, improved sanitation, provision water) require greater financial resources chemotherapy. To make best use limited resources, key identify target efforts at locally vulnerable cycle. Although complete life was described almost century ago, characterizing local regional vulnerabilities parasite-snail-host interaction still challenging task because its complex dependence agricultural other ecological factors. true japonicum, which, contrast species number nonhuman hosts. The contribution these zoonotic carriers seldom well characterized [9]. Medicine, present an analysis using mathematical model complemented with statistical unravel this particular aspect region Philippines [10].