A decade after the conclusion of a schistosomiasis control program in
Mali, prevalence of the disease had regressed to pre-intervention levels,
according to a study published May 5 in the open-access journal PLoS
Neglected Tropical Diseases.
The researchers, led by Dr Archie Clements at the University of
Queensland, found that clusters of schistosomiasis infections occurred
generally in
the same, original areas ten years after the end of a donor-funded control
program, conducted between 1982 and 1992.
Schistosomiasis is a parasitic disease caused by several species of fluke
of the genus Schistosoma. Although it has a low mortality rate,
schistosomiasis often is a chronic illness that can damage internal organs
and, in children, impair growth and cognitive development.
Mali is one of the first countries in sub-Saharan Africa to have initiated
a national schistosomiasis control program, which began as a partnership
between the Malian Ministry of Health, the WHO, and the German Technical
Cooperation (GTZ). Lack of government funding curtailed the program's
activities after 1998, until a new program, backed by the Schistosomiasis
Control Initiative, began in 2004.
Clements and his co-authors undertook a comparative study of the spatial
distribution of schistosomiasis in Mali between 1984-1989 and 2004-2006.
They
show that the spatial distribution of schistosomiasis was similar in both
time periods, even in the face of large-scale control program based on
mass
distribution of anti-parasitic drugs.
According to Clements, long-term stability in the spatial distribution of
schistosomiasis means that reviewing historic data can provide a useful,
initial source of evidence for planning targeted contemporary control
program.
"However, if these control program are to have a sustainable impact on the
burden of schistosomiasis they must be delivered over a very long time
period, or supplementary methods need to be implemented, such as
improvement in water sanitation and hygiene," he said.
Co-authors on this manuscript include: Elisa Bosqué-Oliva, Moussa Sacko,
Aly Landouré, Robert Dembélé, Mamadou Traoré, Godefroy Coulibaly, Albis
F. Gabrielli, Alan Fenwick, and Simon Brooker.
Financial Disclosure
The Schistosomiasis Control Initiative was funded by
the Bill and Melinda Gates foundation. Simon Brooker is supported by a
Career Development Fellowship (081673) from the Wellcome Trust. The
funders had no role in study design, data collection and analysis,
decision to
publish, or preparation of the manuscript.
Citation:
"A Comparative Study of the Spatial Distribution of Schistosomiasis in Mali in 1984-1989 and 2004-2006."
Clements ACA, Bosque´-Oliva E, Sacko M, Landoure´ A, Dembe´le´ R, et al. (2009)
PLoS Negl Trop Dis 3(5): e431. doi:10.1371/journal.pntd.0000431
Source
PLoS
Neglected Tropical Diseases