**1. Introduction**

*Schistosomiasis* is among the Neglected Tropical Diseases (NTDs), and the main challenge is the control of the disease [1]. *Schistosomiasis* transmission has been reported from 78 countries with over 65% in Africa with estimated 800 million people at risk of the disease [2, 3]. Literature affirmed that *Schistosomiasis* is the third-highest burden among parasitic NTDs, 2019 estimation of the World Health Organization peg the infection at over 140 million people and at least 236.6 million people required preventive treatment and it remains among the major global health threats [4–6]. Consequently, *schistosomiasis* is still highly endemic in several countries especially in Sub-Saharan Africa [5–9].

Scientifically, *schistosomiasis* could be a mild, acute, and chronic parasitic disease caused by blood flukes (trematode worms) of the genus *Schistosoma* [2, 6].



*Dancing in a Cycle: Global Health Agenda and* Schistosomiasis *Control in Africa DOI: http://dx.doi.org/10.5772/intechopen.103164*

#### **Table 1.**

*Status of* Schistosomiasis *in 54 African countries showing the estimated number of people and school-age children that required preventive chemotherapy (PC) in the year 2020.*

Africa shares not less than 90% of the global burden of *schistosomiasis* disease necessitating her need for preventive chemotherapy (see **Table 1**) in about 51 endemic countries with moderate-to-high transmission [6]. There are five different types of species causing *schistosomiasis* infection: *Schistosoma haematobium* affecting the urinary tract; *Schistosoma mansoni*, *Schistosoma japonicum*, *Schistosoma intercalatum*, and *Schistosoma mekongi* affecting the intestine. *S*. *haematobium* and *S. mansoni* infections are common in Africa [9, 10].

In Sub-Saharan Africa (SSA), *S. mansoni* (intestinal *schistosomiasis*) and *S. haematobium* (urogenital *schistosomiasis*) (**Table 2**), transmitted through feces and urine, has been identified as the main species causing human *schistosomiasis* [11]. Research shows that *S. mansoni* is widely distributed across the tropics and subtropics especially in the vast poverty-stricken but environmentally and climatically friendly sub-Saharan Africa [12, 13]. Some reported that S. *haematobium* is the most prevalent parasite in Nigeria, with an estimated population of 30 million people annually [8, 14]. Also, *S*. *haematobium* is affirmed to be more endemic because of the agricultural activities such as fishing, subsistence farming, and washing among others that forces the rural people to interact with freshwater [15, 16].

Subsequently, the population experiences *schistosomiasis* symptoms like anemia, fever, genital lesions, stunting, and sometimes irreversible organ damage [17].


#### **Table 2.**

*Parasite species and geographical distribution of schistosomiasis.*

This was the rationale behind the preventive chemotherapy (PC) and the recommendation of *Praziquantel* by WHO as a notable strategy to control schistosomiasis by targeting the school-aged children (SAC) from aged 5–15 years because they were most infected and can be reached successfully through schools [5]. "The PC strategy is indicated by prevalence (estimated by initial parasitological assessment) at implementation unit level, usually, district, the prevalence of infection less than 10% requires triennial PC, 10% to 49% biennial treatment, and 50% or greater annual treatment" [5].

Although some countries recorded success of morbidity control, the narrative is different in most African countries. If some countries were able to eliminate *schistosomiasis*, some scholars have asked the question why not Africa [18]. Could it be argued that the COVID-19 Pandemic hinders the WHO set goals for the control and elimination of *schistosomiasis* in 2020? Or could we measure the progress so far and project that the WHO will achieve the goal of elimination of *Schistosomiasis* as a public health problem in all endemic countries by 2025 or 2030? Complete interruption of transmission is a target in selected regions by 2025 [19–23]. Although strategic plans exist on how the WHO guidance on how *schistosomiasis* can be controlled and scale up to elimination [18, 20], but is yet uncertain if such goals can be achieved with the little time left [23]. The current review traced the historical analysis of *schistosomiasis*, exposed the neglected nature of the disease as a possible reason for persistent transmission, ex-rayed the burden and the challenge of elimination, explained the use of preventive chemotherapy and the proposition for African traditional medication, finally concluded with the global health agenda and *schistosomiasis* control campaign in Africa.
