Schistosomiasis in Malawi: a systematic review.

Area of Science:

• * Public Health
• * Infectious Diseases
• * Epidemiology

Background:

• * Schistosomiasis is a significant public health concern in tropical regions, particularly Sub-Saharan Africa, impacting socioeconomic development.
• * A systematic review of schistosomiasis epidemiology and transmission in Malawi since 1985 was lacking.
• * This review aimed to consolidate current knowledge, identify research gaps, and inform future research governance.

Purpose of the Study:

• * To systematically review the epidemiology and transmission of schistosomiasis in Malawi.
• * To identify knowledge gaps in the current understanding of schistosomiasis in the region.
• * To provide recommendations for future research and control strategies.

Main Methods:

• * Computer-aided literature searches were conducted using databases such as Medline, SCOPUS, and Google Scholar.
• * Keywords included "schistosomiasis", "Bilharzia", "Bulinus", and "Biomphalaria" combined with "Malawi".
• * Searches were supplemented by reference list reviews of relevant publications.

Main Results:

• * Eighty-nine documents were reviewed, with most focusing on urinary schistosomiasis and definitive hosts.
• * Urinary schistosomiasis is widespread in Malawi, while intestinal schistosomiasis is concentrated in specific highland and lowland areas.
• * Prevalence rates varied significantly, reaching up to 94.9% for Schistosoma haematobium and 67.0% for Schistosoma mansoni. Key intermediate hosts identified are Bulinus globosus, Bulinus nyassanus, and Biomphalaria pfeifferi.

Conclusions:

• * Schistosomiasis transmission in Malawi is highly focal, exhibiting spatial and temporal variability.
• * Epidemiological data is fragmented, with many areas lacking thorough investigation.
• * Development of functional infection risk assessment systems through systematic surveillance is crucial for effective prevention and control.