From Mapping to Elimination: A Comprehensive Overview of Rwanda's Schistosomiasis Program

Highlights

• Significant SCH prevalence reductions achieved via data-driven MDA interventions.

• Sensitive POC-CCA diagnostics improved mapping in low-prevalence areas.

• Integrated WASH coordination tackles environmental drivers of SCH transmission.

• Snail control initiatives complement MDA and WASH to strengthen SCH interventions.

• Rwanda's One Health approach fosters cross-sector efforts for SCH elimination.

Abstract

Objectives: Schistosomiasis (SCH) remains a public health challenge in Rwanda despite ongoing interventions. This paper provides an overview of Rwanda's SCH journey, highlighting progress made through mass drug administration (MDA), diagnostic advancements, and strategic partnerships with key stakeholders.

Methods: Since 2014, the point-of-care circulating cathodic antigen (POC-CCA) test has been introduced alongside Kato-Katz (KK), improving mapping accuracy and detecting low-intensity infections. Geographic information systems further identified hotspots. The program expanded MDA coverage, integrated water, sanitation, and hygiene (WASH) interventions, and adopted One Health (OH) approaches to address socio-environmental drivers.

Results: More sensitive diagnostics enabled targeted interventions. Expanded MDA and tailored Social and Behavior Change Communication (SBCC) strengthened SCH control. Key future priorities include piloting interruption of transmission in select areas, enhancing WASH measures, implementing focal snail control, and piloting pediatric praziquantel for treatment of SCH in preschool-aged children (PSAC).

Conclusions: Rwanda's data-driven and integrated strategies, coupled with OH collaboration, exemplify a robust model for eliminating SCH as a public health problem. These efforts, aligned with the WHO 2030 targets, position Rwanda as a leader in SCH elimination and offer a replicable framework for other endemic regions.