Belmont CEH2 - Decision support systems to improve schistosomiasis preparedness and control in the era of global changes

With >200 million people infected and >800 million at risk, schistosomiasis is one of the most important among the Neglected Tropical Diseases (NTD). This debilitating disease of poverty is caused by blood flukes of the Schistosoma genus, involving aquatic snails as obligate intermediate hosts. The spatial distribution of schistosomiasis coincides with development of the water management infrastructures - typically dams, irrigation systems and reservoirs for hydropower production - and with the largely ignored, rapidly growing peri-urban areas lacking wastewaters processing facilities. In addition, the host snails and the parasite free-living stages have no thermoregulation ability and, therefore, their reproduction/survival/dispersal in the environment is affected by temperature. As a consequence, projected climate change is expected to alter the distribution/abundance of the snail hosts and, ultimately, schistosomiasis transmission risk for humans. No consideration in urban plans and water-resource development plans is generally given to the health risk for schistosomiasis transmission under climate change projections. The problem is largely ignored and absent in the Environmental Impact Assessment (EIA) of water management infrastructure and severely underestimated in health surveillance plans. This is partially due to a nearly complete lack of tools to bring this information to the table of decision makers in a way that is timely (e.g., in the EIA public-consultation phase), effective (easy to understand), and scientifically robust (based on scientific evidence). By building on the results of a previously awarded Belmont CEH1 grant, which was mainly focused on rural areas only, the present project intends to cast light on the social, climatic & environmental determinants of schistosomiasis over a rural-to-urban gradient, and to develop a family of novel tools to connect knowledge-to-action and a menu of interventions aimed at controlling schistosomiasis transmission risk.