Dr Lucas Cunningham gave this presentation at the ISNTD WASH event on 23rd Nov. 2017. He collaborated in a workshop with other partners from SCI and GSA to further elaborate on WASH and its implications for NTDs.

1. Lucas J. Cunningham
Liverpool School of Tropical Medicine
Highlighting WASH at ISNTD Workshop 2017

2. Mass Scale-up Theme 1:
Evidence Synthesis
Mass Scale-up Theme 2:
Applied Social Science
Mass Scale-up Theme 3:
Health Economics
Integrated Complementary Strategy Theme 1:
Macrofilaricides & Vector Control
Integrated Complementary Strategy 2:
Schistosomiasis/STH & Diagnostics
COUNTDOWN activities set across five major themes

3. ICST2 in Ghana
• Expanded access to MDA (with follow-ups) & local
WASH assessment with water contact behaviours
• Three communities peri-urban areas in Weija:
Tomefa, Adakkope-Togokope and Manhaem
• Parasitological (with molecular diagnostics) and
epidemiological surveys conducted by household
• ~750 individuals participating in this in-depth study

4. Multisector actions needed to support
chemotherapy
• No complete coverage (with consecutive challenges)
• Vulnerable groups left out and inequities arise
• PZQ active on adult worms, juveniles tolerant
• Treatment does not always fully clear all worms
• Issue of re-infection due to contaminated environment
• Adverse events can result in treatment rejections

5. WASH and SCH
• SCH is a disease of poor sanitation and water exposure(s)
• Targets both sides of the coin: exposure and contamination
• Potential of long-term behavioural changes
However
• It requires a considerable investment in time and money
• Hard to monitor its direct effects and longer term sustainment
• Does not deal with spread of SCH via movement of people
Tailoring Water, Sanitation, and Hygiene (WASH) Targets for Soil-Transmitted
Helminthiasis and Schistosomiasis Control, Suzy J. Campbell,NanaKwadwo
Biritwum, Geordie Woods, Yael Velleman, Fiona Fleming, and J. Russell Stothard

6. WASH and SCH
• SCH is a disease of poor sanitation and water exposure(s)
• Targets both sides of the coin: exposure and contamination
• Potential of long-term behavioural changes
However
• It requires a considerable investment in time and money
• Hard to monitor its direct effects and longer term sustainment
• Does not deal with spread of SCH via movement of people
Tailoring Water, Sanitation, and Hygiene (WASH) Targets for Soil-Transmitted
Helminthiasis and Schistosomiasis Control, Suzy J. Campbell,NanaKwadwo
Biritwum, Geordie Woods, Yael Velleman, Fiona Fleming, and J. Russell Stothard