Schistosomiasis mansoni in Burundi: progress in its control since 1985

Area of Science:

• Public Health
• Tropical Medicine
• Parasitology

Background:

• Schistosomiasis control in Burundi has evolved significantly since 1985.
• Initial efforts focused on selective population chemotherapy with limited long-term success due to reinfection.
• The need for sustainable schistosomiasis management strategies became apparent.

Purpose of the Study:

• To describe the evolution of schistosomiasis control programs in Burundi.
• To evaluate the effectiveness of different control strategies over time.
• To identify sustainable approaches for schistosomiasis management.

Main Methods:

• Implementation of selective population chemotherapy (1985-1990).
• Transition to a primary health care (PHC) approach for treatment.
• Introduction of school-based chemotherapy in suburban Bujumbura and extension to endemic areas.
• Assessment of focal snail control, health education, and environmental interventions.

Main Results:

• Selective chemotherapy initially reduced infection prevalence and intensity but improvements were short-lived.
• The PHC approach now treats approximately 10% of schistosomiasis cases annually.
• School-based chemotherapy in Bujumbura lowered pupil infection rates from 23% to 9% (1984-1990).
• Focal snail control yielded disappointing results, shifting focus to other interventions.

Conclusions:

• Sustainable schistosomiasis control requires a shift from unsustainable mass chemotherapy to integrated primary health care.
• Health education and environmental control are crucial for long-term transmission reduction.
• School-based interventions show promise and are being expanded to more endemic regions.