02119nas a2200241 4500000000100000008004100001653001400042653002000056653002300076653001300099653001500112653000900127653001200136653001300148653004100161653001300202100001700215700001600232700001500248245006900263520153100332022001401863 2017 d10aTreatment10aschistosomiasis10apraziquantel (PZQ)10aparadigm10apaediatric10aNTDs10aMothers10amaternal10aFemale genital schistosomiasis (FGS)10aChildren1 aBustinduy AL1 aStothard RJ1 aFriedman J00aPaediatric and maternal schistosomiasis: shifting the paradigms.3 a

Background
In endemic areas, schistosomiasis causes both overt and subclinical disease in young children and their mothers, as well as in returned travellers.
Sources of data
Key recently published literature.
Areas of agreement
An action plan for paediatric schistosomiasis and female genital schistosomiasis (FGS) is needed with expanded access to praziquantel (PZQ) treatment required.
Areas of controversy
Schistosomiasis-related morbidity is underappreciated. Present and future demand for PZQ treatment is bottlenecked, imbalanced and inequitable. Current dosing, treatment algorithms and access plans are suboptimal with treatment stalled during pregnancy.
Growing points
Raised dosing of PZQ (>40 mg/kg) is being explored in young children. Surveillance of female genital schistosomiasis FGS is increasing. Use of PZQ in pregnancy is safe and preventive chemotherapy guidelines are being revised in morbidity- and transmission-control settings.
Areas timely for developing research
Shifting focus of population-level control to individual-case management. Detection and prevention of FGS within general health services and integration of PZQ treatment for women and children in antenatal clinics. Feasibility studies assessing alternative and expanded access to PZQ treatment to at-risk children and mothers and pregnant women.

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