Approximately 80% of the 200 million people infected with
schistosomiasis inhabit sub-Saharan Africa, and the annual mortality is estimated to be 280,000.
Praziquantel is the
drug of choice in the treatment of
schistosomiasis and pregnant women may now be treated. It was agreed at the World Health Assembly in 2001 that at least 75% of school-aged children in high burden areas should be treated for
schistosomiasis and soil-transmitted helminth
infections by 2010 to reduce morbidity. A grant from the Bill and Melinda Gates Foundation to the
Schistosomiasis Control Initiative, Imperial College of Science, Technology and Medicine, London has enabled control programmes to be initiated in Uganda, Tanzania, Zambia, Burkina Faso, Niger and Mali. Additional programmes have recently commenced in Zanzibar with a grant from the Health Foundation to The Natural History Museum, London and in Cameroon. Combination treatment for
schistosomiasis, gastrointestinal helminths and
filariasis reduces costs of control programmes. The EC Concerted Action Group on '
Praziquantel: its central role in the
chemotherapy of schistosome
infection' met in Yaoundé Cameroon in 2004 to discuss recent developments in laboratory and field studies. The use of standard operating procedures will enable data on
drug action on schistosomes produced in different laboratories to be compared. With the ever increasing use of
praziquantel there is a possibility of the development of resistance by schistosomes to the
drug, hence the necessity to explore the activities of other compounds.
Artemether, unlike
praziquantel, is effective against immature schistosomes. The effectiveness of
mirazid, an extract of
myrrh, is controversial as data from different laboratories are equivocal. It is suggested that an independent body such as the World Health Organization should determine whether
mirazid should be used in the treatment of
schistosomiasis.