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Environmental Surveillance for Schistosomiasis

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This presentation by Prof. Russell Stothard, COUNTDOWN's Director was given at the WHO NTD Summit on Friday, 21st April 2017. This session on Schistosomiasis was organised by the Global Alliance for Schistosomiasis (GSA).

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Environmental Surveillance for Schistosomiasis

  1. 1. Environmental Surveillance for Schistosomiasis Russell Stothard Liverpool School of Tropical Medicine
  2. 2. • Key role of DNA diagnostics • Interfacing medical malacology
  3. 3. DNA diagnostic platforms – real-time PCR assays with species-probes • Modern platform for simultaneous detection of pathogens/parasites (semi-automated) • Assay results in less than 12 hrs, analysis of freshly-collected or ethanol-archive samples Specimens Stool & urine water & snails (H) (NH) Prevalence & Intensity in PEOPLE AND(OR) SNAILS
  4. 4. An environmental framework - transmission biology (contamination v. exposure) • Conceptual framework • Applied significance?
  5. 5. Transmission biology – contamination versus exposure High contamination Low exposure Low contamination High exposure Egg/antigen detection Increase MDA (x2?) Reduce water contact Antigen/antibody assays Increase WASH Selective PZQ treatment (PSAC?) MDA & snail control PLUS what? OR
  6. 6. Sampling framework – challenge of ‘integrated’ specimen collection egg-patent = ~9% Rt-PCR = ~15% Church
  7. 7. Towards WHO 2020 Target: Surveillance and Beyond • Integrate DNA diagnostic platforms BUT this will require increased resourcing • Need to maintain medical malacology within ‘end-game’ surveillance • Integrate malacology themes into WASH-related interventions & evaluations • Develop geographical surveillance systems responsive to focality/seasonality @DFID_UK @DFID_NTDs

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