02500nas a2200265   4500000000100000008004100001653003900042653002000081653002200101653004100123653001500164100001100179700001500190700001500205700001300220700001400233700001400247700001100261700001500272245014000287300001400427490000700441520177200448022001402220       2018                            d10aNeglected tropical diseases (NTDs)10aschistosomiasis10aMorbidity control10aWorld Health Organization guidelines10a2020 goals1 aToor J1 aAlsallaq R1 aTruscott J1 aTurner H1 aWerkman M1 aGurarie D1 aKing C1 aAnderson R00aAre we on our way to achieving the 2020 goals for schistosomiasis morbidity control using current World Health Organization guidelines?  aS245-S2520 v663 a<p><strong>Background: </strong>Schistosomiasis remains an endemic parasitic disease affecting millions of people around the world. The World Health Organization (WHO) has set goals of controlling morbidity to be reached by 2020, along with elimination as a public health problem in certain regions by 2025. Mathematical models of parasite transmission and treatment impact have been developed to assist in controlling the morbidity caused by schistosomiasis. These models can inform and guide implementation policy for mass drug administration programs, and help design monitoring and evaluation activities.</p>

<p><strong>Methods: </strong>We use these models to predict whether the guidelines set by the WHO are on track for achieving their 2020 goal for the control of morbidity, specifically for Schistosoma mansoni. We examine whether programmatic adaptations; namely increases in treatment coverage and/or expansion to adult inclusion in treatment, will improve the likelihood of reaching the WHO goals.</p>

<p><strong>Results: </strong>We find that in low-prevalence settings, the goals are likely to be attainable under current WHO guidelines, but in moderate to high-prevalence settings, the goals are less likely to be achieved unless treatment coverage is increased and expanded to at least 85% for school-aged children and 40% for adults.</p>

<p><strong>Conclusions: </strong>To improve the likelihood of reaching the WHO goals, programmatic adaptations are required, particularly for moderate- to high-prevalence settings. Furthermore, improvements in adherence to treatment, potential development of candidate vaccines, and enhanced snail control and WASH (water, sanitation, and hygiene) measures will all assist in achieving the goals.</p>
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