New tools for the schistosomiasis elimination toolbox Barriers and opportunities for the development of a topical cercarial anti-penetrant

By Philip Downs, Natasha Massoudi, Anna Powers Dick Guggenheim, Achille Max Kabore, Ginger Rothrock, Bruce Blough

Schistosomiasis is a neglected tropical disease (NTD) affecting about 260 million people worldwide. Elimination of schistosomiasis remains a challenge because of high reinfection rates and limitations of current treatment guidelines and disease control interventions. Despite over 70 years of research on schistosome cercariae anti-penetrants, a personal protective product (PPP) remains elusive for the prevention of schistosomiasis. In this paper we explore perceptions of topical PPPs to identify potential opportunities and barriers in the development, promotion, and use as a tool to control and prevent schistosomiasis. Results from key informant interviews suggest that despite recognized benefits of a cercarial anti-penetrant, translation of research into a practical PPP for endemic areas is hindered by two critical issues: (1) minimal available evidence to demonstrate effective and practical use of topically applied products in community-based settings and (2) limitations of current business models to sustain product availability among high-risk groups in low-income settings. Additionally, introduction of a PPP would require an intensive behavioral change communication strategy to reinforce and enable routine use of the product. The potential additive impact of a PPP on reducing point of source infections, in combination with a comprehensive elimination strategy that includes preventive drug treatment, snail control, and improved water and sanitation, may still present an effective strategy to reduce moderate to high intensity of infection among high-risk groups, but requires additional translational research and business model development.


Downs, P., Massoudi, N., Dick Guggenheim, A. P., Kabore, A. M., Rothrock, G., & Blough, B. (2017). New tools for the schistosomiasis elimination toolbox: Barriers and opportunities for the development of a topical cercarial anti-penetrant. (RTI Press Publication No. RR-0029-1703). Research Triangle Park, NC: RTI Press.

© 2019 RTI International. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.


Philip DownsPhilip W. Downs, DrPh, MPH, is a senior manager of health policy on neglected tropical diseases in RTI International’s Global Health division. He served as study coordinator for this study.

Natasha MassoudiNatasha Massoudi, MPH, an independent consultant, conducted the literature review and interviewed key informants.

Anna Powers Dick GuggenheimAnna Dick, MPH, is a project operations manager with the division of International Education and advises on public/private partnerships.

Achille Max KaboreAchille Kabore, MD, also a senior manager of RTI’s Global Health division, is a schistosomiasis control expert and technical advisor on neglected tropical diseases.

Ginger RothrockGinger D. Rothrock, PhD, is the director of the Advanced Materials and Systems Integration group at RTI. She is responsible for business development and technical leadership in the areas of advanced materials and manufacturing for commercial sectors.

Bruce BloughBruce Blough, PhD, is a senior researcher in RTI’s Discovery Science Technology division and served as a study advisor.

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