The global status of schistosomiasis and its control

Schistosomiasis is being successfully controlled in many countries but rema ins a major public health problem, with an estimated 200 million people inf ected, mostly in Africa. Few countries in this region have undertaken succe ssful and sustainable control programmes. The construction of water schemes to meet the power and agricultural requirements for development have lead to increasing transmission, especially of Schistosoma mansoni. Increasing p opulation and movement have contributed to increased transmission and intro duction of schistosomiasis to new areas. Most endemic countries are among t he least developed whose health systems face difficulties to provide basic care at the primary health level. Constraints to control include, the lack of political commitment and infrastructure for public health interventions. Another constraint is that available anti-schistosomal drugs are expensive and the cost of individual treatment is a high proportion of the per capit a drug budgets. There is need for increased support for schistosomiasis con trol in the most severely affected countries. (C) 2000 Elsevier Science B.V . All rights reserved.