02568nas a2200241   4500000000100000008004100001653003900042653002000081653001500101653002400116653002500140653002100165100001400186700001200200700001400212700001600226245011500242856004600357300000700403490000600410520189600416022001402312       2019                            d10aNeglected tropical diseases (NTDs)10aschistosomiasis10acomplexity10ainterdisciplinarity10aSystems epidemiology10aSystems thinking1 aKrauth SJ1 aBalen J1 aGobert GN1 aLamberton P00aA call for systems epidemiology to tackle the complexity of schistosomiasis, its control, and its elimination.  uhttps://www.mdpi.com/2414-6366/4/1/21/htm  a210 v43 a<p>Ever since the first known written report of schistosomiasis in the mid-19th century, researchers have aimed to increase knowledge of the parasites, their hosts, and the mechanisms contributing to infection and disease. This knowledge generation has been paramount for the development of improved intervention strategies. Yet, despite a broad knowledge base of direct risk factors for schistosomiasis, there remains a paucity of information related to more complex, interconnected, and often hidden drivers of transmission that hamper intervention successes and sustainability. Such complex, multidirectional, non-linear, and synergistic interdependencies are best understood by looking at the integrated system as a whole. A research approach able to address this complexity and find previously neglected causal mechanisms for transmission, which include a wide variety of influencing factors, is needed. Systems epidemiology, as a holistic research approach, can integrate knowledge from classical epidemiology, with that of biology, ecology, social sciences, and other disciplines, and link this with informal, tacit knowledge from experts and affected populations. It can help to uncover wider-reaching but difficult-to-identify processes that directly or indirectly influence exposure, infection, transmission, and disease development, as well as how these interrelate and impact one another. Drawing on systems epidemiology to address persisting disease hotspots, failed intervention programmes, and systematically neglected population groups in mass drug administration programmes and research studies, can help overcome barriers in the progress towards schistosomiasis elimination. Generating a comprehensive view of the schistosomiasis system as a whole should thus be a priority research agenda towards the strategic goal of morbidity control and transmission elimination.</p>
  a2414-6366