Sylvie Linsuke

Project summary

Schistosomiasis is an infectious disease caused by parasitic worms found in fresh water. Fresh water snails are also infected by this parasite during its life cycle, and humans that come into contact with fresh water that contains these snails are at risk for infection. Seven hundred million people are at risk in 74 countries, and 240 million are already infected. Sub-Saharan Africa is the most affected but in many countries the burden of the disease is not well documented. The guidelines from World Health Organization (WHO) recommend preventive chemotherapy using praziquantel based on the prevalence as the main strategy beside individual case management, vector control and water sanitation and hygiene improvement. The choice of different strategies is based on the prevalence of schistosomiasis in specific foci or district. The preventive chemotherapy strategy is controversial and could be less effective and difficult to achieve in some context. Indeed, WHO reports in 2016 that only 88 million people (42%) received praziquantel among 206.5 million people who required the preventive treatment.  Despite this mass drug administration, the prevalence of schistosomiasis remained high even where the MDA was well administrated like in Senegal. There is a need to well document the epidemiology, the burden, the morbidity to define a better strategy for the management and control of schistosomiasis. In this aim, we will conduct epidemiology studies in Kasansa (Kasai Province), Kinshasa, Kimpese (Bas-Congo). Apart these studies, we assess also the capacity of clinicians and lab technicians to manage the disease from suspicion to diagnostic and treatment. We conducted also qualitative studies to assess perception and perspectives of communities affected by schistosomiasis. We will conduct an epidemiological and molecular study in Kifwa (Bas-Congo) to categorized schistosomiasis strains linked with snails. For this study, lab work is ongoing. Lastly, we will conduct the morbidity study among inhabitants who live in at risk village using both parasitology and ultrasonography including repetitive treatment for the persistent infection after MDA. All of the studies put together can lead to a comprehensive and effective strategy control based on scientific evidence and data from different foci in DRC. Finally, the applied research activities within the present thesis aiming at identifying needs and developing solutions for preventing and controlling schistosomiasis in DRC in a sustainable way, will have an important impact on the Congolese population suffering from schistosomiasis.