PROGRESS AND FUTURE INITIATIVES IN SCHISTOSOMIASIS

Schistosomiasis is a chronic worm infection prevalent in Africa, South America, the Middle East, southeast Asia, China, and several islands in the Caribbean. With the advent of praziquantel, we have had for ove r a decade an effective oral curative drug that has formed the basis f or most existing national control programs. Even in countries where ca se finding and treatment programs have been initiated, reinfection is common, pointing out the importance of vaccine development to slow or block transmission. Community-based chemotherapy does appear to have r educed the incidence of severe end organ damage (liver fibrosis or uri nary tract obstruction), but recent studies have pointed out that more subtle morbidity such as retardation in childhood growth or functiona l work capacity in adults still persists following recurrent acute inf ections. As the price of praziquantel falls (patent expires in the nea r future), the need for better diagnostic tests to aid in case finding as well as alternative approaches to control (mass treatment or targe ted mass treatment) become more important topics for future research.