Situation analysis of urogenital bilharzia in West Africa (2010-2021) and control strategies and prospects: systematic review and meta-analysis

Schistosomes are parasitic diseases caused by flatworms (schistosomes or bilharzia), transmitted in the urine or in the faeces, and involving intermediate hosts (freshwater molluscs). Their recrudescence in endemic areas is no longer in question and remains a crucial public health problem in the world in general and in West Africa in particular. In order to eradicate bilharzia, many control strategies and policies have been implemented on both sides. The objective of this systematic literature review is to synthesize the existing evidence on control strategies implemented by West African countries. To achieve this, data were collected from PubMed, Direct Science, Web of Sciences, Google Scholar, PloS and Banque de Données de Santé Publique (BDSP), using appropriate keywords. Academic articles and theses written in French or English that evaluated the analysis of a bilharzia situation in West Africa were selected. Sixteen scientific papers were selected for the study, ten of which were used for a meta-analysis. The systematic review revealed that bilharzia is still an endemic disease in West Africa. Clearly, it continues to wreak havoc on the population, especially among school children. Rural areas are the most affected by the disease. Strategies to control bilharzia are based on preventive and curative treatment of the infection with chemotherapy and vector control of soil molluscs (host and vector of bilharzia eggs). Praziquantel is the main known antibilharzian. Also, the species most frequently found in analyses are S. haematobium and S. mansonii. This review has allowed to evaluate the control strategies carried out and to deduce the strengths and weaknesses, in order to define the perspectives for the efficiency of the anti-bilharzia control for the eradication of bilharzia in the endemic zones of West Africa.