Gates Open Res. 2019 Nov 19;3:1517. doi: 10.12688/gatesopenres.13052.2. eCollection 2019.
Schistosomiasis remains one of the neglected tropical diseases (NTDs) impacting millions of people around the world. The World Health Organization (WHO) recently proposed a goal of elimination as a public health problem (EPHP) for schistosomiasis to be reached by 2030. Current WHO treatment guidelines for achieving EPHP focus on targeting school-aged children. The NTD Modelling Consortium has developed mathematical models to study schistosomiasis transmission dynamics and the impact of control measures. Our modelling insights on have shown that EPHP is likely to be attainable in low to moderate prevalence settings using the current guidelines. However, as prevalence rises within high prevalence settings, EPHP is less likely to be achieved unless both school-aged children and adults are treated (with coverage levels increasing with the adult burden of infection). We highlight the challenges that are faced by treatment programmes, such as non-adherence to treatment and resurgence, which can hinder progress towards achieving and maintaining EPHP. Additionally, even though EPHP may be reached, prevalence can still be high due to persisting infections. Therefore, without interruption of transmission, treatment will likely have to continue to maintain EPHP. Further modelling work is being carried out, including extending our results to . By providing these modelling insights, we aim to inform discussions on the goals and treatment guidelines for schistosomiasis.
血吸虫病仍然是影响全球数百万人的被忽视热带病之一。世界卫生组织(WHO)最近提出了到2030年实现血吸虫病作为公共卫生问题消除(EPHP)的目标。WHO当前实现EPHP的治疗指南侧重于针对学龄儿童。被忽视热带病建模联盟已经开发了数学模型来研究血吸虫病传播动态以及控制措施的影响。我们的建模见解表明,使用当前指南,在低至中等流行率环境中可能实现EPHP。然而,随着高流行率环境中流行率的上升,除非对学龄儿童和成年人都进行治疗(覆盖率随着成年人感染负担的增加而提高),否则不太可能实现EPHP。我们强调了治疗项目面临的挑战,如不坚持治疗和疫情复发,这可能会阻碍实现和维持EPHP的进展。此外,即使可能实现EPHP,但由于持续感染,流行率仍可能很高。因此,在不中断传播的情况下,可能需要持续进行治疗以维持EPHP。正在开展进一步的建模工作,包括将我们的结果扩展到 。通过提供这些建模见解,我们旨在为关于血吸虫病目标和治疗指南的讨论提供信息。