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Heterogeneities in schistosome transmission dynamics and control

Published online by Cambridge University Press:  01 November 1998

M. E. J. WOOLHOUSE ,
J.-F. ETARD ,
K. DIETZ ,
P. D. NDHLOVU  and
S. K. CHANDIWANA
M. E. J. WOOLHOUSE
Affiliation:
Centre for Tropical Veterinary Medicine, University of Edinburgh, Easter Bush, Roslin, Midlothian EH25 9RG
J.-F. ETARD
Affiliation:
L'Institut Francais de Researche Scientifique pour le Developpement en Cooperation (ORSTOM), BP1386, Dakar, Senegal
K. DIETZ
Affiliation:
Institut für Medizinische Biometrie, Westbahnhofstrasse 55, D72070 Tübingen, Germany
P. D. NDHLOVU
Affiliation:
Blair Research Laboratory, PO Box CY573, Causeway, Harare, Zimbabwe
S. K. CHANDIWANA
Affiliation:
Blair Research Laboratory, PO Box CY573, Causeway, Harare, Zimbabwe
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Abstract

We review the theoretical framework for exploring the impact of individual and spatial heterogeneities in patterns of exposure and contamination and on the basic reproduction number, R0, for human schistosomes. Analysis of water contact data for 5 communities in Zimbabwe and Mali suggests that the impact is substantial, increasing R0 by factors of up to 6·5, mostly due to highly overdispersed distributions of contact rates among individuals. Several practical conclusions emerge: concentration of contacts at a single site should be avoided; the impact of control targeted at certain sites cannot be predicted without knowledge of how individuals' contacts are distributed among sites; control programmes targeted at individuals or sites contributing most to transmission can be very efficient but, conversely, will be ineffective if any of these individuals or sites are missed.

Keywords

basic reproduction numberexposureheterogeneityschistosomiasiswater contact
Type
Research Article
Information
Parasitology , Volume 117 , Issue 5 , November 1998 , pp. 475 - 482
Copyright
1998 Cambridge University Press

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