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      FioSchisto’s expert perspective on implementing WHO guidelines for schistosomiasis control and transmission elimination in Brazil

      review-article
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      Frontiers in Immunology
      Frontiers Media S.A.
      Schistosoma mansoni, schistosomiasis, neglected tropical diseases, control and elimination, Brazil

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          Abstract

          The World Health Organization (WHO) recognizes schistosomiasis as one of the Neglected Tropical Diseases targeted for global elimination in the 2030 Agenda of the Sustainable Development Goals. In Brazil, schistosomiasis mansoni is considered a public health problem, particularly prevalent among vulnerable populations living in areas with poor environmental and sanitary conditions. In 2022, the WHO published a Guideline encompassing recommendations to assist national programs in endemic countries in achieving morbidity control, eliminating schistosomiasis as a public health problem, and advancing towards interrupting transmission. The perspectives presented here, collectively prepared by members of the Oswaldo Cruz Foundation’s (Fiocruz) Schistosomiasis Translational Program (FioSchisto), along with invited experts, examine the feasibility of the WHO recommendations for the Brazilian settings, providing appropriate recommendations for public health policies applicable to the epidemiological reality of Brazil, and suggests future research to address relevant issues. In Brazil, the provision of safe water and sanitation should be the key action to achieve schistosomiasis elimination goals. The agencies involved in measures implementation should act together with the Primary Care teams for planning, executing, monitoring, and evaluating actions in priority municipalities based on their epidemiological indicators. Host snails control should prioritize judicious ecological interventions at breeding sites. The Information, Education, and Communication (IEC) strategy should be associated with water and sanitation and other control actions, actively involving school community. To identify infected carriers, FioSchisto recommends a two-stage approach of immunological and molecular tests to verify transmission interruption during the intervention and beyond. Praziquantel administration should be done under medical supervision at the Primary Care level. MDA should be considered in exceptional settings, as a measure of initial attack strategy in locations presenting high endemicity, always integrated with water and sanitation, IEC, and snail control. To assist decision-making, as well as the monitoring and evaluation of strategic actions, there is a need for an Information System. FioSchisto considers this systematization essential to make investments in strategic research to support the improvement of schistosomiasis control actions. Efforts toward schistosomiasis elimination in Brazil will succeed with a paradigm shift from the vertical prescriptive framework to a community-centered approach involving intersectoral and interdisciplinary collaboration.

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          Most cited references74

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          Schistosomiasis and water resources development: systematic review, meta-analysis, and estimates of people at risk.

          An estimated 779 million people are at risk of schistosomiasis, of whom 106 million (13.6%) live in irrigation schemes or in close proximity to large dam reservoirs. We identified 58 studies that examined the relation between water resources development projects and schistosomiasis, primarily in African settings. We present a systematic literature review and meta-analysis with the following objectives: (1) to update at-risk populations of schistosomiasis and number of people infected in endemic countries, and (2) to quantify the risk of water resources development and management on schistosomiasis. Using 35 datasets from 24 African studies, our meta-analysis showed pooled random risk ratios of 2.4 and 2.6 for urinary and intestinal schistosomiasis, respectively, among people living adjacent to dam reservoirs. The risk ratio estimate for studies evaluating the effect of irrigation on urinary schistosomiasis was in the range 0.02-7.3 (summary estimate 1.1) and that on intestinal schistosomiasis in the range 0.49-23.0 (summary estimate 4.7). Geographic stratification showed important spatial differences, idiosyncratic to the type of water resources development. We conclude that the development and management of water resources is an important risk factor for schistosomiasis, and hence strategies to mitigate negative effects should become integral parts in the planning, implementation, and operation of future water projects.
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            Identification of small-molecule inhibitors of Zika virus infection and induced neural cell death via a drug repurposing screen.

            In response to the current global health emergency posed by the Zika virus (ZIKV) outbreak and its link to microcephaly and other neurological conditions, we performed a drug repurposing screen of ∼6,000 compounds that included approved drugs, clinical trial drug candidates and pharmacologically active compounds; we identified compounds that either inhibit ZIKV infection or suppress infection-induced caspase-3 activity in different neural cells. A pan-caspase inhibitor, emricasan, inhibited ZIKV-induced increases in caspase-3 activity and protected human cortical neural progenitors in both monolayer and three-dimensional organoid cultures. Ten structurally unrelated inhibitors of cyclin-dependent kinases inhibited ZIKV replication. Niclosamide, a category B anthelmintic drug approved by the US Food and Drug Administration, also inhibited ZIKV replication. Finally, combination treatments using one compound from each category (neuroprotective and antiviral) further increased protection of human neural progenitors and astrocytes from ZIKV-induced cell death. Our results demonstrate the efficacy of this screening strategy and identify lead compounds for anti-ZIKV drug development.
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              A simple device for quantitative stool thick-smear technique in Schistosomiasis mansoni.

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                Journal
                Front Immunol
                Front Immunol
                Front. Immunol.
                Frontiers in Immunology
                Frontiers Media S.A.
                1664-3224
                05 December 2023
                2023
                : 14
                : 1268998
                Affiliations
                [1] 1 Instituto Gonçalo Moniz, Fundação Oswaldo Cruz - FIOCRUZ , Salvador, Brazil
                [2] 2 Instituto René Rachou, Fundação Oswaldo Cruz - FIOCRUZ , Belo Horizonte, Brazil
                [3] 3 Instituto Oswaldo Cruz, Fundação Oswaldo Cruz - FIOCRUZ , Rio de Janeiro, Brazil
                [4] 4 Centro de Ciências da Saúde, Departamento de Medicina Clínica, Universidade Federal de Pernambuco , Recife, Brazil
                [5] 5 Instituto Aggeu Magalhães, Fundação Oswaldo Cruz - FIOCRUZ , Recife, Brazil
                [6] 6 Centro de Ciências da Saúde, Departamento de Análises Clínicas e Toxicológicas, Universidade Federal do Ceará , Fortaleza, Brazil
                [7] 7 Faculdade de Ciências Médicas, Universidade Estatual do Rio de Janeiro , Rio de Janeiro, Brazil
                [8] 8 Seção de Parasitologia, Instituto Evandro Chagas , Ananindeua, Brazil
                [9] 9 Centro de Ciências da Saúde, Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo , Vitória, Brazil
                Author notes

                Edited by: Rafael Toledo, University of Valencia, Spain

                Reviewed by: Moses Adriko, Vector Borne and NTD Control Division, Uganda; Selorme Adukpo, University of Ghana, Ghana

                *Correspondence: Ricardo Riccio Oliveira, ricardo.riccio@ 123456fiocruz.br

                †These authors have contributed equally to this work and share first authorship

                ‡These authors have contributed equally to this work and share last authorship

                Article
                10.3389/fimmu.2023.1268998
                10739458
                38143743
                e24a235a-303a-4d86-9461-27add13cdd35
                Copyright © 2023 Menezes, Montresor, Jangola, de Mattos, Domingues, Júnior, Silva, Barbosa, de Mendonça, Massara, Fonseca, de Oliveira, Gomes, da Silva, Bezerra, Silva, de Siqueira, Silva, Heller, Farias, Beck, Santos, Lima, Mourão, Enk, Fernandez, Katz, Carvalho, Parreiras, Neves, Gava, de Oliveira, Thiengo, Favre, Graeff-Teixeira, Pieri, Caldeira, da Silva-Pereira, Rocha and Oliveira

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 31 July 2023
                : 17 November 2023
                Page count
                Figures: 1, Tables: 2, Equations: 0, References: 75, Pages: 13, Words: 8140
                Funding
                The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.
                Categories
                Immunology
                Review
                Custom metadata
                Parasite Immunology

                Immunology
                schistosoma mansoni,schistosomiasis,neglected tropical diseases,control and elimination,brazil

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