Phytochemical Molluscicides and Schistosomiasis: What We Know and What We Still Need to Learn

Worldwide schistosomiasis remains a serious public health problem with approximately 67 million people infected and 200 million at risk of infection from inhabiting or transiting endemically active regions. Africa, South America, the Caribbean, and the Middle East are the main transmission regions of Schistosoma mansoni. The fight against transmission through the use of molluscicides is not recent and has been advocated as the only activity with the possibility of interruption of transmission in small, epidemiologically active outbreaks. Euphorbia milii var. hislopii (syn. splendens) (Des Moulins, 1826) is the most promising for use in official schistosomiasis control programs according to the WHO. In this review, we show that an understanding of some how E. milii latex affects the snail vector and their parasites from a molecular level to field conditions is lacking. On the other hand, this type of treatment could also provide a rationale for the control of schistosomiasis and other parasitosis. Several publications contribute to enforcing the use of E. milii latex in endemic countries as a cheap alternative or complement to mass drug treatment with praziquantel, the only available drug to cure the patients (without preventing re-infection).