RESIST - Resistance Evaluation and Surveillance Initiative for Schistosomiasis Treatment (RESIST)

Zanzibar has an impressive track record implementing mass drug administration (MDA) with praziquantel (PZQ) against Schistosoma haematobium infections since the 1980s, achieving elimination of schistosomiasis as a public health problem in most areas, with a possibility of interruption of transmission. However, a few hotspots with high prevalence of infection (5-10%) remain. This project is set in Pemba (Zanzibar, Tanzania), where we hypothesise that MDA-driven selection of drug-resistant parasite strains is contributing to persistent transmission in hotspots. Recent revolutionary advances in understanding the molecular basis of PZQ action means that for the first time we are able to screen natural Schistosoma populations for genetic signatures that may infer reduced PZQ efficacy, or even resistance. With a combination of parasitological fieldwork, genomic analyses, and mathematical modelling, this proposal aims to deliver new insights into how MDA has shaped genetic diversity of S. haematobium over space and time in Pemba, how this has potentially affected drug efficacy and contributed to the persistence of hotspots, and how emerging resistance can best be monitored and mitigated. Thus, this project will lay the foundations for population-based research into drug resistance in Schistosoma species and will have important implications for novel drugs in the pipeline.

Involved Regions: Africa
Involved Countries: Tanzania, United Republic of, Netherlands (the), Switzerland, United Kingdom of Great Britain and Northern Ireland (the)

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