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Researchers at Oxford Population Health and the Uganda Ministry of Health have presented new evidence assessing the effectiveness of the current indicators used by the World Health Organization (WHO) to identify likely cases or communities affected by periportal fibrosis (PPF) as a result of schistosomiasis. The study is published in The Lancet Microbe.

Schistosomiasis is a tropical disease caused by a parasitic flatworm that is transmitted to humans through contact with freshwater sources such as lakes and slow-moving rivers. It is estimated to affect around 250 million people every year and more than 700 million people live in endemic areas where infections are common.

PPF is a late-stage complication of schistosomiasis where chronic and repeated infection causes damage to the vessels that supply blood to the liver and eventually in its most severe form to the liver tissue itself. There are currently no routine treatment or case management strategies for individuals with PPF. The only treatment available is for the infection, but does not reverse liver fibrosis.

Praziquantel is given to all people at risk of infection irrespective of their current disease status as part of a mass drug administration (MDA) programme. It is often assumed that early-in-life and frequent praziquantel administration will prevent irreversible diseases that occur as a result of a schistosome infection, such as PPF.

As a result of this assumption, current WHO guidelines rely on prevalence and intensity of infection as substitute indicators for understanding how to control and eliminate schistosomiasis-related disease. However, it is possible for PPF to outlast an initial schistosome infection and it is not currently known whether or not a past history of other diseases or coinfections can affect the risk of PPF, which is thought to be specific to schistosomiasis.

 

Read the full story on the Nuffield Department of Population Health (NDPH) website.