A multi-disciplinary approach to optimize, evaluate uptake, and mathematically predict the impact of POC-CCA and CAA diagnostic tests for targeted treatment of zoonotic hybrid and livestock schistosomiasis in sub-Saharan Africa.
PI: Professor Joanne P. Webster (RVC)
Co-Is: Dr Elsa Leger (RVC), Dr Martin Walker (RVC), Dr James Rudge (LSHTM)
RAs1&2: To be appointed
Schistosomiasis is a neglected tropical disease of profound medical importance. Over 240 million people are infected, 90% of these are amongst the poorest of sub-Saharan Africa (SSA). Although generally ignored, schistosomiasis is also a disease of substantial veterinary importance, causing widespread morbidity and mortality. Furthermore, recent environmental changes are exacerbating opportunities for the mixing and subsequent viable hybridization between human and animal schistosome species in many parts of Africa, in particular West Africa (ZELS project). In addition to the economic impact of livestock schistosomiasis, novel zoonotic hybrid schistosomes are having a substantial impact on the epidemiology, evolution and clinical outcomes of disease, with further challenges and constraints for effective control. One challenge to this previously unforeseen need is to, in line with current human-focused national disease control programmes, promote appropriate schistosomiasis diagnosis and treatment to livestock under specific conditions of need, whilst minimizing drug emergence risk.
A novel point-of-care (POC) lateral flow cassette assay that diagnoses human intestinal (S. mansoni) schistosomiasis infection, through detection of parasite circulating cathodic antigen (CCA) in patient urine, is now commercially available (POC-CCA) and is currently gaining favour as the diagnostic tool of choice for rapid mapping of human schistosomiasis. There are few, if any comparable rapid diagnostic tools available for animal schistosomiasis. Here we aim to, in collaboration with industrial (RMD, South Africa) and diagnostic development partners (University of Leiden: https://www.lumc.nl/org/parasitologie/medewerkers/GovertvanDam), evaluate and optimise the POC-CCA diagnostic test for potential rapid detection of zoonotic hybrid and animal schistosomiasis (S. bovis, S. curassoni with S. haematobium and hybrids therein) amongst domestic livestock in SSA. This will be combined with differential predictive mathematical simulations to design the most effective and sustainable treatment strategies for livestock, together with an evaluation as to whether key stakeholders in endemic countries would be amenable to such livestock diagnosis and targeted ant-schistosomiasis treatment practices and policies. Working within a One Health framework, this research therefore ultimately aims to improve human and animal health.
Collaborators and Funders
This research is funded by Research England under Connecting Capability Fund project CCF-17-7779 – The Bloomsbury SET: Connecting capability to combat the threat from infectious disease and antimicrobial resistance.