ICOSA (Integrated Control of Schistosomiasis in Sub Saharan Africa) is a Department for Foreign and International Development (DFID) funded project to support integrated control of schistosomiasis and STH in eight countries in sub-Saharan Africa. The project was awarded to SCI, Imperial College, London in October 2010 and with our partners at the Centre for Neglected Tropical Diseases Liverpool (CNTD Liverpool), our experienced, multi-disciplinary teams work to support country managers in planning, implementing and monitoring of nationally-owned country programmes embedded within Ministries of Health and Education. ICOSA aims to ensure all countries have a successful, sustainable control programme for schistosomiasis and STH within five years, scaling up annually. Our selection of countries was based on our knowledge of existing control efforts and on the scale of need, government commitment to act, capacity to deliver and governance. The 8 countries are in three groups:
Group One: Cote D’Ivoire, Liberia and Malawi - countries which have no or minimal active control programme.
Group Two: Tanzania, Zambia and Mozambique -countries which have delivered effective treatment for NTDs to some degree. They need support to scale up towards national coverage.
Group Three: Uganda and Niger - countries which have been successfully delivering chemotherapy through mass drug administration (MDA) for several years. These countries now need to move towards a more targeted approach, and to develop an exit strategy.
Although preventive chemotherapy is currently the mainstay of control for several NTDs, and ICOSA is funding chemotherapy against schistosomiasis and STH, SCI and CNTD Liverpool are encouraged to include wider public health interventions such as health education, sanitation and safe water supply, vital for the comprehensive control or elimination of NTDs. Through ICOSA we will develop linkages in each country to encourage synergy with water and sanitation projects to maximise the public health benefit.
Experience has taught us that advocacy and sensitization at all levels, particularly of religious, political, education and civic leaders, ensures both financial and political support of the programmes.
The Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) was established in December 2008 to answer strategic questions about schistosomiasis control and elimination. SCORE is funded by the Bill and Melinda Gates Foundation through a five-year grant to the University of Georgia Research Foundation (UGARF).
SCORE's focus is on the two major disease-causing schistosomes in Africa, South America, and the Middle East -Schistosoma mansoni and S. haematobium.
SCORE's goal is to find answers that will help current and future schistosomiasis control program managers to do the job better. This includes learning what approaches to controlling and eliminating schistosomiasis work best and developing and evaluating new tools for program managers to use. SCORE's vision is that this work will inform efforts to gain control of schistosomiasis in high-prevalence areas, sustain control and move towards elimination in areas of moderate prevalence, and ultimately eliminate schistosomiasis. SCORE does this by funding investigators from around the world to conduct the needed research and evaluation activities. Professor Joanne P Webster, Dr Amadou Garba, and Dr Anna E Phillips from SCI are carrying out SCORE projects in Mozambique and Niger.
SCORE projects include both field and laboratory-based efforts. These include projects on:
- Gaining control of schistosomiasis. This involves evaluation of alternative approaches to mass drug administration (MDA) in communities with high prevalence rates of schistosomiasis. Studies related to subtle morbidity, snail infections and schistosome population genetics will be layered onto interventions in some areas where gaining control is being studied.
- Sustaining control of schistosomiasis. This involves evaluation of alternative approaches to MDA in areas of moderate prevalence.
- Elimination of schistosomiasis. This project has as its goals eliminating schistosomiasis in a defined geographic area and providing data and insights into effective strategies for moving large areas from having a low prevalence of infection to eliminating schistosomiasis. In addition to demonstrating that infections in humans are reduced and/or eliminated, data will be collected on snail infections and schistosome population genetics.
- Field evaluations of the point-of-contact (POC) circulating cathodic antigen (CCA) urine assay for use as a screening tool for S. mansoni infection in humans.
- Research and evaluation on human diagnostic tests for schistosomiasis.
- Development of tools for studies of schistosome population genetics.
Click here to view the SCORE brochure