Schistosomiasis Interventions in Africa: Assessment and Systematic Review

Background: Schistosomiasis is a neglected tropical disease with high endemicity across Africa. As a waterborne parasitic disease, the population at highest risk includes school-age children, although adults are also affected. The rationale for this review is to assess the effectiveness of the various schistosomiasis control interventions implemented across Africa. Methods: A targeted systematic search for studies published from January 2000 to August 2023 in African Journals Online, ScienceDirect, PubMed, World Health Organization Database, Cochrane Library and Web of Science databases was conducted. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was followed in the screening of the studies conducted from 2000 to 2023. Results: A total of 165 articles (out of an initial number of 9791) that met the inclusion criteria were reviewed in this study under the broad subthemes: pharmacological and nonpharmacological interventions. Praziquantel is the most widely implemented control measure for both preventive and curative purposes across the 35 countries surveyed in this study. Praziquantel either was the sole control strategy (18/35; 51.4%) or was used in conjunction with one or more other interventions (5/35; 14.3%). Studies conducted in 14 countries did not specify the type of schistosomiasis interventions used. Research on schistosomiasis in Africa and its control measures is primarily funded and supported by the WHO and other international research initiatives (49.1%), national governments (17.6%) and private researchers (33.3%). Ineffective coordination at the local, national, regional or continental levels; inconsistent and donor-driven mass drug administration and lack of an effective approach that integrates pharmacological and nonpharmacological control strategies are major bottlenecks hindering the elimination of schistosomiasis across Africa. Conclusion: There is a paucity of data on a systematic approach by the national governments of Africa that effectively integrates pharmacological and nonpharmacological control strategies to meet the 2030 elimination roadmap targets.