Table 3. Risks associated with re-establishing Uganda Schistosoma mansoni life cycle.

Risk	Inherent risk score		Total inherent risk	Controls	Residual risk score		Total risk post control
	Likelihood	Impact			Likelihood	Impact
New isolates of S. mansoni from the Ugandan population might exhibit variable praziquantel susceptibility, or praziquantel resistance	Possible	Critical	15	1)  Test new isolates for praziquantel susceptibility in vitro and in an animal model before use in CHI	Unlikely	Critical	10
New isolates of S. mansoni from the Ugandan population might exhibit unexpected virulence	Possible	Critical	15	1)  Test new isolates for relative virulence in an animal model before use in CHI	Unlikely	Critical	10
Production processes based on GMP principles for single- sex infectious cercariae not established in Uganda	Possible	Critical	15	1)  Development of appropriate animal and snail facilities 2)  Training of Ugandan staff 3)  Monitoring and review by experienced LUMC collaborators 4)  Monitoring and review by Ugandan regulators	Rare	Critical	5

Likelihood was scored as almost certain/common, 5; likely, 4; possible, 3; unlikely, 2; rare, 1. Impact was scored as critical, 5; major, 4; moderate, 3; minor, 2; insignificant 1.