02050nas a2200277 4500000000100000008004100001653001400042653002000056653001700076653003500093653001400128653003100142653003900173653002200212653001700234653001400251100001500265700001600280700001300296245007100309856009800380300001300478490000700491520126000498022001401758 2018 d10aTreatment10aschistosomiasis10aRisk Factors10aPreschool-aged children (PSAC)10aPathology10aPaediatric schistosomiasis10aNeglected tropical diseases (NTDs)10aImmune mechanisms10aEpidemiology10adiagnosis1 aOsakunor D1 aWoolhouse M1 aMutapi F00aPaediatric schistosomiasis: What we know and what we need to know. uhttp://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0006144&type=printable ae00061440 v123 a

Schistosomiasis affects over 200 million people worldwide, most of whom are children. Research and control strategies directed at preschool-aged children (PSAC), i.e., ≤5 years old, have lagged behind those in older children and adults. With the recent WHO revision of the schistosomiasis treatment guidelines to include PSAC, and the recognition of gaps in our current knowledge on the disease and its treatment in this age group, there is now a concerted effort to address these shortcomings. Global and national schistosome control strategies are yet to include PSAC in treatment schedules. Maximum impact of schistosome treatment programmes will be realised through effective treatment of PSAC. In this review, we (i) discuss the current knowledge on the dynamics and consequences of paediatric schistosomiasis and (ii) identify knowledge and policy gaps relevant to these areas and to the successful control of schistosome infection and disease in this age group. Herein, we highlight risk factors, immune mechanisms, pathology, and optimal timing for screening, diagnosis, and treatment of paediatric schistosomiasis. We also discuss the tools required for treating schistosomiasis in PSAC and strategies for accessing them for treatment.

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