Guideline

WHO guideline on control and elimination of human schistosomiasis.

Year of Publication

2022

Issuing Institution

WHO

Links

Recommendations

6 included recommendations

In endemic communities with Schistosoma spp. prevalence of 10% or higher, WHO recommends annual preventive chemotherapy with praziquantel in a single dose for ≥ 75% up to 100% of pregnant women after the first trimester, and non-pregnant adolescent girls and women of reproductive age, including postpartum and/or lactating women, to control schistosomiasis morbidity and move towards eliminating the disease as a public health problem.

Status

Maintained

Recommended in favor

Strong

Certainty of evidence

Moderate

In endemic communities with Schistosoma spp. prevalence of less than 10%, WHO suggests one of two approaches based on the programmes’ objectives and resources: (i) where there has been a programme of regular preventive chemotherapy, continuing preventive chemotherapy at the same or a reduced frequency towards interruption of transmission; and (ii) where there has not been a programme of regular preventive chemotherapy, a clinical approach of test-and-treat, instead of preventive chemotherapy targeting a population.

Status

Maintained

Recommended in favor

Conditional

Certainty of evidence

Very low

In endemic communities with prevalence of Schistosoma spp. infection ≥ 10% that demonstrate lack of an appropriate response to annual preventive chemotherapy, despite adequate treatment coverage (≥ 75%), WHO suggests consideration of biannual (twice yearly) instead of annual preventive chemotherapy.

Status

New

Recommended in favor

Conditional

Certainty of evidence

Very low

WHO recommends that health facilities provide access to treatment with praziquantel to control morbidity due to schistosomiasis in all infected individuals regardless of age, including infected pregnant excluding the first trimester, lactating women and pre-SAC aged < 2 years. The decision to administer treatment in children under 2 years of age should be based on testing and clinical judgement.

Status

New

Recommended in favor

Strong

Certainty of evidence

Moderate

WHO recommends WASH interventions, environmental interventions (water engineering and focal snail control with molluscicides) and behavioural change interventions as essential measures to help reduce transmission of Schistosoma spp. in endemic areas.

Status

New

Recommended in favor

Strong

Certainty of evidence

Low

In communities approaching the interruption of transmission (defined as having no autochthonous human cases reported for 5 consecutive years), WHO suggests a verification framework that consists of: 1. Testing for Schistosoma infection in humans with a diagnostic that has high sensitivity and specificity. This may require the use of a two-step diagnostic process starting with a high sensitivity test confirmed with a second, high specificity test. 2. Testing for Schistosoma infection in snails with a diagnostic that has high sensitivity and specificity. This may require the use of a two-step diagnostic process starting with a high sensitivity test confirmed with a second, high specificity test. 3. Testing for Schistosoma infection in non-human mammalian hosts, as applicable, with a diagnostic that has high sensitivity and specificity. This may require the use of a two-step diagnostic process starting with a high sensitivity test confirmed with a second, high specificity test.

Status

New

Recommended in favor

Conditional

Certainty of evidence

Low