Schistosomiasis in children: a major public health problem

Schistosomiasis is one of the most prevalent parasitic diseases worldwide, and a very important one in terms of public health burden and economic impact. At present, the group of preschool-age children is left untreated in public health programs due to lack of confirmatory clinical data and a missing appropriate child-friendly formulation of the drug praziquantel. 

Schistosomiasis (also known as bilharzia) is one of the most prevalent parasitic diseases. It is a poverty-related disease that leads to chronic illness. The threat posed by schistosomiasis is substantial: the WHO estimates that at least 200 million people worldwide required treatment in 2016, of which more than 90% live in Africa.1 Schistosomiasis affects a large proportion of children under 14 years of age, including at least 25 million preschool-age children. In these very young children, prevalence of infection may exceed 60%.2

Schistosomiasis is acquired when people come into contact with fresh water infested with the larval forms (cercariae) of parasitic blood flukes, known as schistosomes. The microscopic adult worms live in the veins draining the urinary tract and intestines. Most of the eggs they lay are trapped in the tissues and the body’s reaction to them can cause massive damage. Left untreated, schistosomiasis can lead to anemia, stunted growth, reduced learning ability and chronic inflammation of the organs, which can be fatal in the most serious cases.

As efforts focus on morbidity control and elimination, there is a pressing need to treat preschool-age children. No suitable drug formulation is made available for this high-risk group, which accounts for about 10% of the more than 200 million people already infected. The age group of preschool-age children is strategically important: they play a role in local disease transmission and an active infection acquired at an early age might aggravate the clinical significance of schistosomiasis in later-life.

The existing drug of choice for the treatment of schistosomiasis is praziquantel, which was developed in the 1970s. A WHO-recommended global strategy to control schistosomiasis already exists; preventive chemotherapy involves yearly administration of praziquantel to entire populations at risk. Tablets (usually 600 mg) are given as single oral doses, but the prophylactic treatment is suitable only for adults and school-aged children. Younger children usually cannot swallow the existing tablets because of their large size and bitter taste. More importantly, although clinical data for the treatment of very young children are promising, an appropriate treatment with praziquantel for these children using the optimal dosing and that permits enhanced patient compliance does not exist.

The Pediatric Praziquantel Consortium has developed a praziquantel formulation that is more suitable for younger children, including infants and toddlers. The formulation is a small, orally dispersible tablet with an acceptable taste, and should also withstand the challenges presented by a tropical climate.

Learn more about our pediatric formulation technology, our development & registration program and our access program, or visit our timeline to find out where we stand.

1WHO Schistomiasis Fact Sheet (accessed 20 July 2017)
2WHO Report of a meeting to review the results of studies on the treatment of schistosomiasis in preschool-age children