Mathematical models of transmission dynamics and control of schistosomiasis.

Mathematical models are potentially valuable aids to a quantitative understanding of schistosome epidemiology and to the design of control programs. A basic theoretical framework is described that is developed to incorporate the impact of acquired immunity, heterogeneous transmission rates, and the effects of control measures. Models that assume that acquired immunity acts to moderate the rate of human infection make predictions consistent with age-intensity data from different human populations. Models incorporating heterogeneous water contact behavior can be applied to suitable field data and used to predict the potential efficacy of targeted chemotherapy or focal molluscicide application. More complex and detailed models can be used in simulation studies to assist with the design of field trials and in the interpretation of data from these trials. These applications of mathematical models suggest several areas requiring further theoretical development and also indicate areas in which adequate field data are still lacking.