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Modeling the Effect of Chronic Schistosomiasis on Childhood Development and the Potential for Catch-Up Growth with Different Drug Treatment Strategies Promoted for Control of Endemic Schistosomiasis

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  • Department of Mathematics, Department of Pediatrics, and Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio
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In areas endemic for schistosomiasis having limited healthcare, targeted drug treatment of school-age children is recommended for control of Schistosoma-associated morbidity. However, optimal timing, number, and frequency of treatments are not established. Because longitudinal studies of long-term impact of treatment are few, for current policy considerations we performed quantitative simulation (based on calibrated modeling of Schistosoma-associated disease formation) to project the impact of different school-age treatment regimens. Using published efficacy data from targeted programs, combined with age-specific risk for growth retardation and reinfection, we examined the likely impact of different strategies for morbidity prevention. Results suggest the need for early, repeated treatment through primary school years to optimally prevent the disabling sequelae of stunting and undernutrition. Dynamics of infection/reinfection during childhood and adolescence, combined with early treatment effects against reversible infection-associated morbidities, create a need for aggressive retreatment of preadolescents to achieve optimal suppression of morbidity where drug-based control is used.

Author Notes

*Address correspondence to Charles H. King, Center for Global Health and Diseases, Wolstein Research Building 4126, 2103 Cornell Road, Cleveland, OH 44106-7286. E-mail: chk@cwru.edu

Financial support: This work was supported by National Institutes of Health Research grant R01TW008067 funded by the Ecology of Infectious Diseases Program of the Fogarty International Center. Funding support was also provided to ALB through an NIH T32 Ruth L. Kirschstein-National Service Research Award-Training Grant.

Authors' addresses: David Gurarie and Xiaoxia Wang, Department of Mathematics, Yost Hall, Case Western Reserve University, Cleveland, OH, E-mails: dxg5@cwru.edu and xxw@cwru.edu. Amaya L. Bustinduy, Division of Infectious Diseases, Department of Pediatrics, Rainbow Babies and Children's Hospital, Cleveland, OH, E-mail: axb342@case.edu. Charles H. King, Center for Global Health and Diseases, Wolstein Research Building, Cleveland, OH, E-mail: chk@cwru.edu.

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