Springer Schistosomiasis: 10 (World Class Parasites, 10)

Human schistosomiasis is a disease with a rich and well-documented past, and every expectation of an unfortunately long future. These infections were known to the ancient Egyptians and their transmission shows little evidence of slowing down, globally. The good news is that field applicable, and increasingly affordable, chemotherapy has been available for almost 25 years. Using chemotherapy and other means of control, some countries have decreased transmission and made excellent headway against morbidity. The bad news is that the public health problems caused by schistosomiasis are still with us, with the estimated number of cases of schistosomiasis, while shifting geographically, remaining approximately 200 million for the last 30 years. In fact, with the development of field usable ultrasound technology and meta-analyses performed on existing data, there is a new appreciation for the extent of non-lethal morbidity associated with these infections. While the percentage of individuals with severe hepatosplenic disease remains below 10%, recent reassessments of morbidity associated with schistosomiasis indicate that the prevelance of symptoms and the cost in diability-adjusted life years is much greater than was previously, commonly appreciated (Van der Werf, M. J. , et al. 2003, Acta Tropica 86:125-139; Charles H. King, personnel communication). Strong impetus for addressing these issues is provided by the World Health Assembly’s recently passed Resolution 54. 19, which calls for efforts to reduce morbidity caused by schistosomiasis and soil-transmitted helminths in school-aged children, largely through chemotherapy campaigns. From the Back Cover The goal of Schistosomiasis is to provide the reader with insights into the active research and programs currently related to schistosomiasis, and to use these insights as a way to project forward into the next 10-15 years of work on this disease, spanning the spectrum from research to public health interventions. A secondary goal of this volume is to initiate conversations among those working across the research-to-control spectrum on schistosomiasis about the future of their field, and by doing so lead to constructive efforts to identify and address the most critical questions and challenges related to schistosomiasis. The book covers four main areas: schistosome phylogenetics, gene expression, and the overall genome, including information on exciting new tools for addressing questions that have long been inaccessible to schistosomologists; the host-schistosome interaction at the larval to adult worm interface and addresses aspects important for vaccine development as well as how differential gene expression as detected by DNA microarrays may be utilized to develop tools for detection and control of infection or pathology; the development of the host immune response to eggs, granuloma formation and factors affecting the development and regulation of immunopathology; and the public health concerns associated with schistosomiasis, including morbidity control, host genetics, treatment and proposals for improved partnerships. The volume concludes with a chapter addressing the schisms that sometimes exist along the spectrum from basic research programs to the implementation of control schemes, and a proposal to make these differences benefit patients and researchers rather than succumb to base temptations to compete for resources to no one’s benefit. Like many of the diseases featured in the World Class Parasites series, the prospects for dramatic advances in schistosomiasis coincide with a seemingly shrinking pool of both human and material resources. The most meaningful progress will occur as the laboratory better understands the needs in the field and the field better understands the capabilities of the laboratory.