WHO GUIDELINE on control and elimination of human schistosomiasis

Human schistosomiasis is a chronic parasitic disease caused by infection with blood flukes (trematode worms) of the genus Schistosoma. The disease is a public health problem in tropical and subtropical regions of Africa, Asia, the Caribbean and South America. Approximately 779 million people are at risk of acquiring the infection (1). Some 236.6 million people required preventive chemotherapy in 2019 (2). Schistosomiasis is a neglected tropical disease (NTD), a diverse group of diseases and conditions that affect predominantly low-income populations worldwide. In response to resolutions adopted by the World Health Assembly and in line with the Organization’s 13th General Programme of Work 2019–2023, WHO supports Member States to expand access to prevention, diagnosis, treatment and care interventions for NTDs as a contribution towards the achievement of universal health coverage by 2030. In 2020, WHO published a new road map to guide action against NTDs during the decade 2021–2030. The road map targets the elimination of schistosomiasis as a public health problem by 2030 and the interruption of schistosome transmission in humans in selected countries by 2030. Attainment of these targets will contribute to progress towards Sustainable Development Goal 3: “ensure healthy lives and promote well-being for all at all ages”. The WHO strategy to control and eliminate human schistosomiasis includes preventive chemotherapy of at-risk groups, access to improved drinking-water, and improved sanitation, hygiene education, environmental management and snail control. This WHO guideline1 was developed in accordance with the WHO handbook for guideline development (2014). A guideline steering group was established to formulate the key questions to be addressed in the guideline using the population, intervention, comparator and outcome (PICO) format and to prioritize outcomes. The PICO questions were reviewed by a guideline development group (GDG) and then used to systematically retrieve, appraise and synthesize the evidence, formulate the recommendations, and plan for dissemination and implementation of the guideline. All policy recommendations were formulated through consensus based on the judgements of the GDG, informed by the evidence and by the expertise and experience of its members; on the one occasion when consensus was not reached, members adopted a voting process. The external review group commented on the final draft of the guideline but could not alter the recommendations made by the GDG.