Expanded Access to Schistosomiasis Control & Diagnostics

Expanded Access to Schistosomiasis Control & Diagnostics

Mass Drug Administration (MDA) of Schistosomiasis (SCH) and Soil-transmitted Helminthiasis (STH) requires rapid scale-up to achieve the 2020 target. COUNTDOWN has been evaluating how to deliver equitable drug delivery to currently excluded populations, in Cameroon and Ghana. 


The main aim of the project is to develop innovative strategies for expanded access of treatment and improved diagnostic tools for schistosomiasis (SCH) and Soil-Transmitted Helminths (STH) in Cameroon and Ghana.

The specific objectives are:

1. To conduct targeted baseline parasitological and epidemiological surveys to describe infection levels of schistosomiasis and STH, and associated morbidity indicators

2. To assess expanded annual community treatment in reducing prevalence of schistosomiasis and STH

3. To assess community understanding of the current MDA programme and its strengths and weaknesses and economic aspects of whole community treatment.

4. To assess the acceptability and feasibility of introducing an alternative treatment strategy to the current treatment regimen from different perspectives

5. To investigate different levels of access and factors influencing scale-up to PZQ and ALB treatment in areas with limited treatment coverage

The studies will be conducted in communities’ endemic for SCH/STH in Cameroon and Ghana in low and high-transmission settings. Social science research outputs and impact on parasitological and general health indicators will be monitored at baseline and follow-up timepoints.  The data generated by the community screening will be fed back into the ministry of health and help inform mass drug administration, continuous community surveys will then monitor the success of the intervention.


A novel opportunity to scale-up diagnostics was investigated by co-opting samples from the Global Polio Laboratory Network and screening these for STH and schistosomiasis. The Global Polio Laboratory Network (GPLN) comprises 145 laboratories spread throughout the world. Across Africa, there are 16 GPLN laboratories which received around 22,017 samples per year to screen for polio. The polio control programme has been hugely successful and will leave a legacy of expertise in surveillance and disease control. COUNTDOWN partnered with the GPLN to explore cross-disease partnerships and utility of their infrastructure and expertise to survey for NTDs.

The aim of this study was to assess the suitability of samples collected at a GPLN laboratory for their use in the screening of soil transmitted helminths and parasites that cause schistosomiasis. The Ghanaian GPLN laboratory, based at the Noguchi Memorial Institute for Medical Research, Accra, was selected to carry out the assessment. To assess the suitability of the GPLN for screening neglected tropical diseases, COUNTDOWN screened the faecal collection for six pathogens.

COUNTDOWN carried out DNA extraction on the faecal samples and performed a highly sensitive DNA analysis assessment. Using this method, it was possible to screen for multiple worms within the same reaction using a highly sensitive and specific test.

If proven that the faecal collections of the global polio laboratory network are suitable candidates for the detection of parasitic worms, this technique can be used to develop a cost-effective and sustainable means of monitoring intestinal worm and schistosomiasis prevalence’s in resource poor countries.

For further reading please see:

Lucas J. Cunningham , John Odoom , Deborah Pratt, Linda Boatemaa, Nana Asante-Ntim, Keren Attiku, Bismarck Banahene, Mike Osei-Atweneboana, Jaco J. Verweij , David Molyneux, Russell J. Stothard , Emily R. Adams (2018) Expanding molecular diagnostics of helminthiasis: Piloting use of the GPLN platform for surveillance of soil transmitted helminthiasis and schistosomiasis in Ghana PLOS NTDs