. Author manuscript; available in PMC: 2018 Feb 1.

Published in final edited form as: Lancet Infect Dis. 2016 Nov 30;17(2):e64–e69. doi: 10.1016/S1473-3099(16)30535-7

Panel 1.

Key steps for strengthening the global strategy for schistosomiasis and STH

Key step	Strength of evidence
Step 1: Update strategy for preventive chemotherapy
• Expanded treatment across broader age groups (i.e., community-wide treatment)	Modelling and cost-effectiveness studies^10,14,18,48 with support from systematic review and meta-analysis of observational studies¹⁷
• Lower prevalence thresholds for treatment, especially for schistosomiasis	Modelling and cost-effectiveness studies¹⁸ with support from observational studies
• Formal guidelines for integration of praziquantel and benzimidazole programming	Cost-effectiveness modelling studies with support from feasibility studies^10,18,31,32
• Validated strategy with trial data	Trials underway
• Rigorous monitoring and evaluation strategies to detect emergence of drug resistance	Statistical models with field validation⁴⁹
Step 2: Incorporate complementary interventions in the global strategy
• Water, sanitation, and hygiene (WASH) programming (e.g. community-led total sanitation)	Systematic review and meta-analysis with mixed findings including mostly observational studies^34-42
• Information, education, and communication (EIC) programmes	Trial data⁴⁰
• Snail control (for Schistosoma spp).	Systematic review and meta-analysis including mostly observational studies; modeling studies^15,43
Step 3: Create distinct guidelines based on epidemiology, programmatic goals, and resource constraints
• Guidelines for a goal of morbidity control versus elimination of transmission	Expert opinion