Schistosomiasis in Lambaréné and the surrounding areas Understanding disease epidemiology to pave the way to improved control

The main objective of the present thesis was to outline the current situation of schistosomiasis in Lambaréné and surrounding areas (Gabon) endemic to urogenital schistosomiasis, with the idea to provide data that could help to optimise the design and implementation of a local control program that is tailored to need.
To cover the issue, we conducted observational studies. We determined for the first time the prevalence of the disease in Lambaréné, and have investigated and reported the knowledge, attitudes, and practices of- the local population regarding urogenital schistosomiasis. Similarly, we have reported the results of pilot malacology surveys in which Bulinus truncatus appears to be the potential intermediate host for schistosomiasis in the area. We have investigated the morbidity of the disease in our community, including changes observed in full blood count parameters among children infected with schistosomiasis. We also investigated the efficacy of praziquantel for the treatment of schistosomiasis which we found satisfactory. Assessing the effect of schistosomiasis on malaria, we found that Trichuris trichiura and hookworm infections increase the risk to be infected with Plasmodium parasite, while schistosomiasis affects the risk and the susceptibility of malaria even. We conclude our work with a narrative review on schistosomiasis research and control activities in Gabon during the two past decades.
With the present work, we estimate having considerably contributed to improving the knowledge of the epidemiological situation of schistosomiasis in our area of interest, and by extension in Gabon. However, considerable work still has to be conducted, particularly on the transmission of the disease and on the issue of genital schistosomiasis, among others.