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).

1. Environmental Surveillance for Schistosomiasis
Russell Stothard
Liverpool School of Tropical Medicine

2. • Key role of DNA diagnostics
• Interfacing medical malacology

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. An environmental framework - transmission biology (contamination v. exposure)
• Conceptual framework
• Applied significance?

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. Sampling framework – challenge of ‘integrated’ specimen collection
egg-patent = ~9%
Rt-PCR = ~15%
Church

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
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