Parasite evolution and impact in action: assessing the importance of hybrid schistosomes in Africa
Science+ meeting organised by Professor J Russell Stothard, Professor Janelisa Musaya, Dr Alexandra Juhasz, and Dr Lucas Cunningham.
This meeting brings together various international groups and experts to discuss the biological, clinical and evolutionary importance of several newly described hybrids of Schistosoma haematobium in sub-Saharan Africa. Embracing a 'OneHealth' perspective, our discussions will focus upon the underlying mechanism that facilitate the emergence and dispersion of hybrids, considering their additional clinical impact in urogenital disease of children and adults.
Participants to the meeting may wish to read the opinion piece published on Philosophical Transactions B on this topic:
Poster session
There will be a poster session on Monday 3 February 2025. If you would like to present a poster, please submit your proposed title, abstract (up to 200 words), author list, and the name of the proposed presenter and institution to the Scientific Programmes team. Submissions received after Wednesday 15 January may not be included in the printed programme.
Attending the meeting
This event is intended for researchers in relevant fields.
- Free to attend
- Both in-person and online attendance available. Advance registration is essential. Please follow the link to register
- Lunch is available on both days of the meeting for an optional £25 per day. There are plenty of places to eat nearby if you would prefer to purchase food offsite. Participants are welcome to bring their own lunch to the meeting
Enquiries: Scientific Programmes team.
Organisers
Schedule
Chair
Professor Janelisa Musaya
Kamuzu University of Health Sciences, Malawi
Professor Janelisa Musaya
Kamuzu University of Health Sciences, Malawi
Janelisa Musaya is a Professor of Immuno-parasitology at the Kamuzu University of Health Sciences (KUHeS) and interim Deputy Director of the Malawi Liverpool Wellcome Research Programme (MLW). With over 19 years of experience in research, teaching, and mentorship, she specialises in neglected tropical diseases (NTDs), focusing on trypanosomiasis and schistosomiasis. Professor Musaya holds a PhD in Immunoparasitology from the University of Malawi, alongside master’s degrees in Epidemiology and Research Ethics. Her ground-breaking research has mapped tsetse fly distribution, identified genetic factors influencing trypanosomiasis outcomes, and uncovered hybrid schistosome species in Malawi. She leads a dynamic international research team, mentoring master’s and PhD students while collaborating with experts from over 15 countries. Passionate about community engagement, she develops innovative, locally relevant approaches to disease control, including improving mass drug administration campaigns. Her dedication to building research capacity and fostering equitable health policies continues to shape the fight against NTDs and improve health outcomes in Malawi
Professor J Russell Stothard
Liverpool School of Tropical Medicine
Professor J Russell Stothard
Liverpool School of Tropical Medicine
Professor Stothard is a medical parasitologist with focus on helminth and protist parasites grouped within the neglected tropical diseases. His specialist expertise is in the evolution, epidemiology and control of schistosomiasis having undertaken many multidisciplinary studies from schistosome characterisation to snail ecology. In so doing, he has advanced our understanding of natural transmission cycles of key species of schistosome and their freshwater intermediate snail hosts. Such knowledge typically underpins scientific guidance to better tailor future disease control strategies and specific intersectoral interventions. His research has been translated into several international policy changes, presenting, co-chairing and chairing several expert committees of the World Health Organisation.
08:55-09:00 |
Welcome by the Royal Society
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09:00-09:30 |
An introduction to the importance of hybrid schistosomes in Africa
In Africa there are two main species of human schistosome, Schistosoma haematobium and Schistosoma mansoni that give rise to urogenital schistosomiasis and intestinal schistosomiasis, respectively. Each schistosome species is a waterborne parasite firmly tied to certain species of freshwater gastropod snails. Infections with schistosomes can start very early in life and, depending on the transmission setting, exposure to these blood flukes is an unavoidable risk of daily life. In addition to these schistosome species, there are several others that infect a variety of wild and/or domesticated mammals. Species of the latter are significant scourges of livestock health and food security yet are not given sufficient veterinary attention. A recently appreciated feature of the reproductive biology of all schistosomes is their capacity for cross-specific interaction, which may, or may not, lead onto the formation of viable hybrids. These saltatory steps in evolution can be between either closely- or distantly-related forms. Heterosis, or hybrid vigour, is a peculiar feature to hybrid schistosomes that may raise their ability to cause disease or expand their range to areas where their parental species cannot. Effective methods used to control such hybrids needs a detailed One Health appraisal. As our understanding of schistosome hybridisation is incomplete, Professor Stothard will give an introductory overview of this scientific meeting’s objectives, a brief outline of critical knowledge gaps with a few considered pointers for subsequent general discussion and deliberation. Professor J Russell StothardLiverpool School of Tropical Medicine Professor J Russell StothardLiverpool School of Tropical Medicine Professor Stothard is a medical parasitologist with focus on helminth and protist parasites grouped within the neglected tropical diseases. His specialist expertise is in the evolution, epidemiology and control of schistosomiasis having undertaken many multidisciplinary studies from schistosome characterisation to snail ecology. In so doing, he has advanced our understanding of natural transmission cycles of key species of schistosome and their freshwater intermediate snail hosts. Such knowledge typically underpins scientific guidance to better tailor future disease control strategies and specific intersectoral interventions. His research has been translated into several international policy changes, presenting, co-chairing and chairing several expert committees of the World Health Organisation. |
09:30-09:45 |
One Health for NTDs: WHO guidance and perspectives from civil society
Neglected Tropical Diseases (NTDs) disproportionately affect marginalised populations, including those with agricultural livelihoods, nomadic lifestyles, and limited access to water, sanitation, or food safety. Achieving the WHO’s 2021–2030 NTD roadmap targets requires a cross-sectoral One Health (OH) approach. This approach, outlined in a WHO companion document co-authored by the NTD NGO Network’s (NNN) OH Cross-Cutting Group, integrates biological, social, and logistical systems to address barriers such as zoonotic transmission, diagnostics, medicine regulation, and reaching underserved communities. Methods: A workshop at the 2023 NNN annual conference in Tanzania gathered ~100 international participants, including non-state and state actors. Using a problem tree framework, small groups identified barriers to systems-based OH approaches for NTDs, explored three African case studies, and proposed solutions. Thematic analysis was conducted on nine problem tree outputs. Results: Approximately 100 participants contributed barriers to better collaboration or integrative approaches to NTDs in four areas:
Participants discussed possible solutions under three major themes:
Dr Gabrielle LaingUnlimit Health Dr Gabrielle LaingUnlimit Health Dr Gabby Laing works as a Senior Policy Adviser in One Health for Unlimit Health (formerly Schistosomiasis Control Initiative Foundation) focusing on how to use One Health approaches to tackle Neglected Tropical Diseases and deliver One Health Systems Strengthening. As Chair of the NTD NGO Network OH group, she co-authored the WHO’s One Health companion document for the NTD roadmap 2021-2030. Gabby has also worked with WHO on the Workforce Development Operational Tool for zoonotic diseases, the World Organisation for Animal Health’s One Health competencies, and FAO’s evaluation of the Global Health Security Agenda. She chairs the Network for Ecohealth and One Health (NEOH), is a trustee of the Soulsby Foundation for One Health leaders, and advises the Lancet One Health Commission. She is a veterinarian and infectious disease epidemiologist by training, completing her studies at the University of Liverpool with research work in Ethiopia. |
09:45-10:15 |
An incomplete historical perspective on the molecular detection of schistosome hybrids
The advancement in molecular methods allowed to study phenomena like hybridisation and introgression at a very detailed level. This resulted in the demonstration of hybridisation between schistosome species in the field, in diverse ecological settings and involving different species combinations. In this talk, Tine Huyse will present some of the first studies on the molecular detection of schistosome hybrids in Africa, and how they evolved over time. Both clinical studies and epidemiological field studies will be presented, with a final reflection on opportunities and challenges. Dr Tine HuyseRoyal Museum for Central Africa, Belgium Dr Tine HuyseRoyal Museum for Central Africa, Belgium Tine Huyse works at the Royal Museum for Central Africa as a senior biologist. She previously worked as a postdoctoral fellow at the University of Leuven, the Tropical Institute of Medicine in Antwerp, and the Natural History Museum in London. She is also the scientific commissioner of the zone Landscapes and Biodiversity in the permanent exhibition of the museum. Her main research interests include the molecular epidemiology of neglected tropical diseases including schistosomiasis and fasciolosis, which affect millions of people and animals worldwide. She studies the anthropogenic and environmental impact on disease transmission and has a special interest in hybridisation between human and animal parasites. A One Health approach is therefore necessary. To this end, she developed new markers and molecular assays with her team to rapidly detect pathogen infections in blood, stool and intermediate snail host samples (xenomonitoring). Next-generation-sequencing technologies on field and museum samples are applied to increase the amount of genomic information in order to reconstruct parasite transmission dynamics. Also the impact of the snail microbiome and parasite co-infections on disease transmission is studied. Finally, in order to tackle complex wicked problems like schistosomiasis, a citizen science approach has been set up, where local community members are involved both in snail monitoring and community-led awareness campaigns. |
10:15-10:30 |
Changing schistosome landscape in the face of MDA: what role for hybrid species
In 2017 we highlighted those profound changes were occurring in the epidemiology and immunology of schistosomiasis as a result of the proliferation of mass drug administration (MDA) programmes using the drug of choice praziquantel. We postulated that these changes could significantly affect the trajectory of chronic pathology, natural immunity, vaccine development strategies, immune disorders, and drug efficacy. Therefore, we recommend careful and comprehensive monitoring and impact assessment of MDA programmes. We subsequently determined the trajectory of praziqunatel (PZQ) efficacy over 4 decades which showed that although there has been no significant reduction in PZQ cure rates (CR) and egg reduction rates (ERR), there considerable variability in CR in contrast with ERR. Several factors including schistosome species drove the variability in CR following treatment with PZQ dose with of 40 mg/kg body weight achieving, indicating the potential importance of hybridisation. In Zimbabwe, we studied areas of persistent infection following 5 rounds of PZQ mass drug administration to determine drivers of persistent infection. In addition to operational and ecological aspects, we have identified host pharmacogenetic variation in PZQ metabolism associated with an unsuccessful PZQ treatment. It is important to now determine parasite-related drivers of persistent infection including hybridisation of schistosome species. Francisca Mutapi
Francisca MutapiProfessor Francisca Mutapi is an award-winning global health expert empowering African scientists and policymakers to tackle infectious diseases and improve epidemic preparedness prioritising local needs and solutions. She holds a Chair in Global Health infection and Immunity at the University of Edinburgh where she is the Deputy Director of the TIBA Partnership and University of Edinburgh’s International Dean for Africa. Her research work on schistosomiasis has led to health improvements for over 50 million African children exposed to schistosomiasis. She has trained and mentored over 100 researchers and health workers in Global Health. She is helping shape global health research and training directly through her own research, as a thought leader and through independent advisory board membership. She sits on various funding, scientific, technical, and strategic advisory boards including the WHO Africa Regional Director’s Advisory Board, the UK Government’s Foreign, Commonwealth & Development Office Science Advisory Group and is the vice chair of the Uniting to Combat Neglected Tropical Diseases board. She chairs the WHO African Region Monitoring COVID-19 Vaccine Effectiveness (AFRO-MoVE) network strategic advisory group. She is a member of the WHO Steering Group working on developing a blueprint for NTD research and development as well as the African Union working group developing a costed roadmap for the AU’s domestic health financing strategic plan. She is a 2021 TED Fellow, Aspen Advanced Global Innovators Fellow as well as a fellow of the Zimbabwe Science Academy, Royal Society of Edinburgh and African Academy of Sciences. |
10:30-11:00 |
Break
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11:00-11:30 |
Reservoir host or not, that is the question…
We have known that distinct Schistosoma species are capable of hybridisation since the 1950s, but it was not until 2009 and the discovery of hybrids between S. haematobium and S. bovis in humans that there were fears of zoonotic urogenital bilharziasis. Then, the interest in these hybrids has grown since their emergence in Europe in 2013. One major question is the zoonotic capacity of these hybrids. The various studies from the laboratory to the field are not consensual. The aim of this presentation will be to review the evidence for and against the zoonotic nature of urogenital bilharziasis. A number of avenues will also be explored to shed light on this issue. Professor Jerome BoissierUniversité de Perpignan, France Professor Jerome BoissierUniversité de Perpignan, France Professor Jerome Boissier is interested in the ecology, evolution and transmission of mesenteric and urogenital schistosomiasis. For more than 10 years, he has been interested in the sexuality of these parasites, successively tackling themes linked to the sex-ratio bias, the pairing system and then sexual determinism. Today, his work focuses more on the field and on factors linked to transmission. On the pathogen side, Professor Boissier is interested in hybridisation phenomenon, particularly in the Haematobium group, through functional biology approaches and field surveys. On the host side, he is interested in the potential role of animals in transmission and the importance of the genetic background of patients in the development of severe forms of the disease. |
11:30-11:45 |
Learnings in schistosomiasis drug discovery
Dr Spangenberg will give an overview of a decade of research on praziquantel, the mainstay drug for schistosomiasis. Starting with some historical considerations of the drug, the status of our understanding will be provided such as its the mode of action, the pharmacodynamic and pharmacodynamic relationship as well as the contribution of the metabolite to the overall clinical activity. Finally, research gaps will be highlighted and as well as the quest for an alternative to praziquantel. Dr Thomas SpangenbergMerck Healthcare KGaA Dr Thomas SpangenbergMerck Healthcare KGaA With Merck since 2015, Thomas is responsible for global health research. He leads drug discovery programmes from drug screening to preclinical candidate nomination including preclinical PK/PD relationship, drug combination and generation of Real-World Evidence for clinical decision making on assets. He also leads open innovation initiatives to catalyse research in infectious diseases. Before joining Merck, Thomas worked in the discovery team of the non-for-profit R&D organisation Medicines for Malaria Venture (Switzerland) and led the open-source Malaria Box and Pathogen Box initiatives designed to catalyse drug discovery research in neglected diseases. Thomas holds a PhD in organic chemistry from the Universities of Strasbourg (France) and Freiburg im Breisgau (Germany). In 2009, he was appointed as a post-doctoral fellow at Harvard University (USA) where he contributed to the total synthesis of the mycolactones and the development towards the point-of-care diagnosis of Buruli ulcer, a neglected necrotising skin disease. He authored and co-authored over 50 peer-reviewed articles and is a co-inventor on several patents. |
11:45-12:15 |
Importance of interactions and hybridisations in schistosomes in Cameroon
Across Africa, human schistosomiasis is caused by four Schistosoma species (S. mansoni, S. haematobium, S. guineensis and S. intercalatum) coexisting alongside with several species associated with animals (eg S. bovis and S. curassoni). Three of these four human schistosome-species occur in Cameroon: S. haematobium and S. mansoni are widely distributed across the country, whereas S. guineensis has a very restricted distribution. Our studies on interactions between these schistosome species have revolutionised general understanding by demonstrating: the existence of a choice of mate in mixed infections, the mating competition between species, the competitive exclusion, the heterosis, and the introgressive hybridisation. The increasing reports of hybrids between human and animal schistosome species in several parts of Africa are very worrisome. These multispecies interactions and hybridisations have significant impacts on schistosome epidemiology, transmission and disease control, with several under-appreciated factors. Our current research on hybrid schistosomes will contribute to elucidate gaps in knowledge of interactions between human and animal schistosome species in Cameroon, especially within the S. haematobium group. Louis-Albert Tchuem Tchuenté will present some of our major findings and provide an overview of our ongoing SHIS-CAM research project on species hybridisation and interactions in schistosomes in Cameroon, within the context of One Health. Louis-Albert Tchuem TchuentéUniversity of Yaoundé I, Cameroon Louis-Albert Tchuem TchuentéUniversity of Yaoundé I, Cameroon Louis-Albert Tchuem Tchuenté is Professor of Parasitology, founding Director of the research Centre for Schistosomiasis & Parasitology, and Coordinator of the National Programme for the Control of Schistosomiasis and Intestinal Helminthiasis. He has extensive expertise in the ecology, epidemiology, biology and control of Neglected Tropical Diseases, with focus on schistosomiasis and soil-transmitted helminthiasis. Through his scientific discoveries, he contributed to a better knowledge of the reproductive biology of schistosomes. His work was a significant step to elucidate the relationships of different schistosome species and to demonstrate the occurrence of mating competitions and their impact on the dynamics of natural transmission of schistosomiasis. He provided strategic direction and built high political commitments for the control of schistosomiasis, with significant achievements. He is a member of committees of several organisations, including the World Health Organisation. He received several awards and distinctions, including the dignity of Commander of the National Order of Valour of Cameroon. |
12:15-12:30 |
Discussion
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Chair
Professor Joanne P Webster FMedSci
Royal Veterinary College, UK
Professor Joanne P Webster FMedSci
Royal Veterinary College, UK
Professor Joanne P Webster FMedSci is Professor of Parasitic Diseases at the Royal Veterinary College and Heads their Pathogen Flow in Ecosystems strategic grouping. Joanne is also Director of the London Centre for Neglected Tropical Disease Research (LCNTDR), Professor of Infectious Diseases at Imperial College London's Faculty of Medicine (hon), and on the Board of Directors for Fauna and Flora International (FFI). From its inauguration in 2002 (until 2014) Joanne served as co-Director of the Schistosomiasis Control Initiative (SCI), which, during this period, provided approximately 300 million anthelminthic preventative chemotherapeutic treatments for children and at-risk adults across sub-Saharan Africa. Joanne sits on a range of World Health Organisation’s, Food and Agriculture Organisation, and beyond, working groups. Her research and disease control activities have been awarded a number of medals and awards including most recently the Royal Society Leeuwenhoek medal and lecture (2023/2024).
Dr Lucas Joseph Cunningham
Liverpool School of Tropical Medicine
Dr Lucas Joseph Cunningham
Liverpool School of Tropical Medicine
Lucas is an early-career medical parasitologist specialising in the design and development of molecular assays to better improve surveillance of pathogens and understanding of transmission cycles. He currently specialises in the study of helminths with a focus on soil transmitted helminths and schistosomiasis. In his role as a PDRA on the Hybridisation in UroGenital Schistosomiasis (HUGS) project he designed a novel, two-tube, high-resolution melt qPCR capable of high-throughput screening of samples for putative hybrids. This assay has been successfully used to detect S. haematobium x S. mattheei hybrids in cattle and humans as well as identifying pure S. haematobium in goats and cattle.
13:30-14:00 |
Hybridisation in urogenital schistosomiasis: a public health challenge in Malawi
Schistosomiasis remains a pressing public health concern in Malawi, compounded by the emergence of hybrid species between Schistosoma. haematobium (human-specific) and Schistosoma matthaei (animal specific). These hybrids, identified in recent studies under the Hybridization in Urogenital Schistosomiasis (HUGS) project, were confirmed in 7% of the communities in Mangochi and Nsanje districts. These hybrids exhibit atypical egg shedding patterns, complicating traditional diagnosis and treatment while raising concerns about potential drug resistance and increased morbidity, particularly among women experiencing Female Genital Schistosomiasis (FGS), highlighting the need for molecular diagnostic tools to accurately identify infections. The zoonotic potential of hybrids broadens the transmission reservoir, incorporating livestock and intensifying risks in communities dependent on shared water sources for domestic and livelihood activities. This heightened human-animal interface complicates control efforts, particularly in endemic areas where water contact is unavoidable. This presentation delves into findings from the HUGS project, addressing the clinical and zoonotic challenges posed by hybrid schistosomes. It advocates for a One Health approach, integrating human and animal health sectors to enhance diagnostic capacity, develop tailored treatment protocols, and promote community awareness (and involvement in preventive and control) initiatives. These strategies are vital for mitigating the public health burden of hybrid schistosomiasis and advancing Malawi’s efforts toward sustainable disease control. Professor Janelisa MusayaKamuzu University of Health Sciences, Malawi Professor Janelisa MusayaKamuzu University of Health Sciences, Malawi Janelisa Musaya is a Professor of Immuno-parasitology at the Kamuzu University of Health Sciences (KUHeS) and interim Deputy Director of the Malawi Liverpool Wellcome Research Programme (MLW). With over 19 years of experience in research, teaching, and mentorship, she specialises in neglected tropical diseases (NTDs), focusing on trypanosomiasis and schistosomiasis. Professor Musaya holds a PhD in Immunoparasitology from the University of Malawi, alongside master’s degrees in Epidemiology and Research Ethics. Her ground-breaking research has mapped tsetse fly distribution, identified genetic factors influencing trypanosomiasis outcomes, and uncovered hybrid schistosome species in Malawi. She leads a dynamic international research team, mentoring master’s and PhD students while collaborating with experts from over 15 countries. Passionate about community engagement, she develops innovative, locally relevant approaches to disease control, including improving mass drug administration campaigns. Her dedication to building research capacity and fostering equitable health policies continues to shape the fight against NTDs and improve health outcomes in Malawi |
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14:00-14:15 |
Schistosome hybrids in stool and urine: the good, the bad and the ugly of point-of-care diagnostics
Schistosoma mattheei is known to cause intestinal disease in cattle, yet it is increasingly implicated in human urogenital disease, particularly in association with Schistosoma haematobium group hybrids. Two exemplar cases of mixed intestinal and urogenital schistosomiasis from Mangochi District, Malawi are presented here, in which we used a newly described high-resolution melting (HRM) real-time PCR assay to identify individual Schistosoma miracidia hatched from paired stool and urine samples. Results show genetic introgressions of Schistosoma mattheei with Schistosoma haematobium and Schistosoma mansoni, respectively, indicating newly emerging genetic diversity. Notably, zoonotic and hybrid species miracidia were predominantly hatched from stool samples, while S. haematobium dominated in urine samples. These results expose current diagnostic gaps and alert to future sampling needs for effective surveillance of zoonotic schistosomiasis. Dr Angus O'FerrallLiverpool School of Tropical Medicine Dr Angus O'FerrallLiverpool School of Tropical Medicine Angus is a PhD researcher at the Liverpool School of Tropical Medicine and a clinician by background. His research is focused on the control of tropical and infectious diseases in One Health contexts, with a particular interest in the transmission of antimicrobial-resistant enteric bacteria and schistosomiasis in freshwater communities. |
14:15-14:45 |
Hybrids in genital tract disease: genital schistosomiasis caused by hybrids in men and women of endemic areas of Southern Malawi in Sub Saharan Africa
Genital schistosomiasis (GS) remains an ignored consequence of urogenital schistosomiasis in the genital system of men and women. However, this is not fully described in infections caused by hybrid schistosomes. Among the research studies conducted on GS, we described a Hybridisation of UroGenital Schistosomiasis (HUGS) longitudinal sub-study on male and female genital schistosomiasis (MGS and FGS) caused by hybrids, conducted in Southern Malawi. Following demographic, health and socio-economic data collection, urine, cervicovaginal fluid, swabs and semen samples were collected and analysed to determine schistosome infection. Samples also underwent molecular analysis to detect human, zoonotic and hybrid schistosomes. Colposcopy and histopathology were also conducted while other associated infections (Human papilloma virus (HPV) and sexually transmitted infections (STIs) were also screened. Dr Sekeleghe KayuniMalawi Liverpool Wellcome Clinical Research Programme, Malawi Dr Sekeleghe KayuniMalawi Liverpool Wellcome Clinical Research Programme, Malawi Seke is a medical doctor and parasitologist from Malawi who holds a Bachelor of Medicine, Bachelor of Surgery from University of Malawi, Diploma in Tropical Medicine and Hygiene from Royal College of Physicians in London, MSc in Tropical Medicine and International Health from University of London, and PhD in Tropical Medicine at University of Liverpool. His expertise is in Tropical Medicine, especially neglected tropical diseases (NTDs). He has conducted several research studies on genital schistosomiasis (GS), a prevalent schistosomiasis complication in men and women in endemic areas; on community interventions for schistosomiasis and geohelminths management; and currently on a NIHR-Wellcome “Hybridization of urogenital schistosomiasis (HUGS) in Malawi”. He also has 20 years’ experience in clinical practice, leadership and management of large facilities in Malawi’s health facilities, treating over 2,000 patients monthly. He’s a Lecturer in Parasitology at Liverpool School of Tropical Medicine and London School of Hygiene and Tropical Medicine. |
14:45-15:00 |
Schistosoma haematobium x S. mansoni hybrids infecting sub-Saharan migrants diagnosed in southern Spain
This study investigates imported schistosomiasis and the introduction of heterospecific hybrids between Schistosoma mansoni and S. haematobium into Spain. Dr Alejandra De Elías EscribanoUniversidad de Valencia, Spain Dr Alejandra De Elías EscribanoUniversidad de Valencia, Spain Dr De Elías-Escribano is a junior postdoctoral researcher at the Molecular Biology Research Unit at the University of Valencia, Spain. She is also a member of the Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC) at the Instituto de Salud Carlos III (ISCIII) and member of the World Health Organisation (WHO) Collaborating Centre on Fascioliasis and Its Snail Vectors. |
15:00-15:30 |
Break
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15:30-16:00 |
Genital schistosomiasis: are we missing something?
Urogenital schistosomiasis is a disease caused mainly by the human parasite, Schistosoma haematobium. The downstream manifestations of the disease, particularly pertaining to the genital track, can be disabling and often go unrecognised, as they are confounded by symptoms commonly related to sexually transmitted diseases. The sexual and reproductive life of the disease sufferers can be affected with an increase in infertility, ectopic pregnancies and abnormal pain and bleeding. An upsurge in advocacy efforts has increased the global interest and recognition of female and male genital schistosomiasis (FGS/MGS) as some of the most neglected genital disorders. Modern diagnostic approaches are refining burden of disease estimates and new questions are emerging on the potential impact of schistosome hybrids and animal species on disease manifestations and respond to treatment. Professor Bustinduy will give an introductory overview of both FGS/MGS and the different diagnostic and treatment strategies available with a special emphasis on gaps in knowledge and potential novel research approaches considering zoonotic species and hybrids. Professor Amaya L BustinduyLondon School of Hygiene & Tropical Medicine Professor Amaya L BustinduyLondon School of Hygiene & Tropical Medicine Professor Bustinduy trained in paediatrics and infectious diseases in the US and started working on helminthic infections, and their impact on child health in Coastal Kenya in 2009. She is foremost a field clinical epidemiologist and has investigated a broad range of disease manifestations in children and young women related to neglected tropical parasitic diseases (NTD), namely schistosomiasis and giardiasis. Other work has included PK/PD driven drug trials (praziquantel) in preschool children in Uganda and PK modelling in pregnant women with schistosomiasis in the Philippines. She is interested in community-based diagnosis of female genital schistosomiasis, validating diagnostic tools at the point-of-care and its integrations with cervical cancer, STIs and HIV diagnosis and access to care. She heads the Schistosomiasis Clinical Research Group at the London School of Hygiene & Tropical Medicine and works as a paediatric infectious diseases’ consultant in the UK NHS. She leads on field related studies in Uganda, Malawi and Zambia. She is a member in several expert committees of the World Health Organisation. |
16:00-16:30 |
The hybrid conundrum!
Inter-species Schistosoma hybrids blur the lines between human and animal African schistosomiasis, creating worrying scenarios of animal reservoirs of human infections and the occurrence of zoonotic species, all of which could severely compromise schistosomiasis control efforts. Molecular and genomic tools have been instrumental in uncovering the different hybrid forms in multiple geographical areas. However, gaps remain in our understanding of the evolutionary history of these hybrid forms, their impact on human and animal health and moreover what further research is needed to fully understand the extent of the permeability of the pre- and post-zygotic barriers that are either maintaining or dissolving species integrity. This presentation will take a step back to look at the African Schistosoma species in terms of their taxonomic status, whilst discussing the opportunities they encounter to enable inter-species mixing / hybridisation, together with the potential outcomes. I will also discuss the biases we observe within the different Schistosoma hybridisation systems now identified in Africa, how best to interpret these so that we better understand what inter-species hybridisation may mean in terms of human schistosomiasis control and elimination in Africa. Dr Bonnie WebsterNatural History Museum, UK Dr Bonnie WebsterNatural History Museum, UK Bonnie Webster is a parasitologist at the Natural History Museum in London, specialising in the study of schistosomiasis, a neglected tropical disease caused by Schistosoma flatworms. Her research combines molecular biology, epidemiology, and parasitology to inform and advance global schistosomiasis control strategies. She works both in the lab and in field settings across endemic regions to improve diagnostic tools and understand parasite transmission dynamics. A significant focus of her work is on integrating genomic and molecular tools, such as qPCR and population genomics, to track genetic changes in Schistosoma populations and identify reservoirs of infection. By studying the biology and evolution of Schistosoma species and their snail hosts, she provides insights critical for improving control programs. Additionally, she collaborates with international partners, contribute to WHO expert committees, and support capacity-building efforts in low-resource settings to drive progress towards eliminating schistosomiasis globally. |
16:30-17:00 |
Panel discussion
Professor Joanne P Webster FMedSciRoyal Veterinary College, UK Professor Joanne P Webster FMedSciRoyal Veterinary College, UK Professor Joanne P Webster FMedSci is Professor of Parasitic Diseases at the Royal Veterinary College and Heads their Pathogen Flow in Ecosystems strategic grouping. Joanne is also Director of the London Centre for Neglected Tropical Disease Research (LCNTDR), Professor of Infectious Diseases at Imperial College London's Faculty of Medicine (hon), and on the Board of Directors for Fauna and Flora International (FFI). From its inauguration in 2002 (until 2014) Joanne served as co-Director of the Schistosomiasis Control Initiative (SCI), which, during this period, provided approximately 300 million anthelminthic preventative chemotherapeutic treatments for children and at-risk adults across sub-Saharan Africa. Joanne sits on a range of World Health Organisation’s, Food and Agriculture Organisation, and beyond, working groups. Her research and disease control activities have been awarded a number of medals and awards including most recently the Royal Society Leeuwenhoek medal and lecture (2023/2024). Dr Lucas Joseph CunninghamLiverpool School of Tropical Medicine Dr Lucas Joseph CunninghamLiverpool School of Tropical Medicine Lucas is an early-career medical parasitologist specialising in the design and development of molecular assays to better improve surveillance of pathogens and understanding of transmission cycles. He currently specialises in the study of helminths with a focus on soil transmitted helminths and schistosomiasis. In his role as a PDRA on the Hybridisation in UroGenital Schistosomiasis (HUGS) project he designed a novel, two-tube, high-resolution melt qPCR capable of high-throughput screening of samples for putative hybrids. This assay has been successfully used to detect S. haematobium x S. mattheei hybrids in cattle and humans as well as identifying pure S. haematobium in goats and cattle. Francisca Mutapi
Francisca MutapiProfessor Francisca Mutapi is an award-winning global health expert empowering African scientists and policymakers to tackle infectious diseases and improve epidemic preparedness prioritising local needs and solutions. She holds a Chair in Global Health infection and Immunity at the University of Edinburgh where she is the Deputy Director of the TIBA Partnership and University of Edinburgh’s International Dean for Africa. Her research work on schistosomiasis has led to health improvements for over 50 million African children exposed to schistosomiasis. She has trained and mentored over 100 researchers and health workers in Global Health. She is helping shape global health research and training directly through her own research, as a thought leader and through independent advisory board membership. She sits on various funding, scientific, technical, and strategic advisory boards including the WHO Africa Regional Director’s Advisory Board, the UK Government’s Foreign, Commonwealth & Development Office Science Advisory Group and is the vice chair of the Uniting to Combat Neglected Tropical Diseases board. She chairs the WHO African Region Monitoring COVID-19 Vaccine Effectiveness (AFRO-MoVE) network strategic advisory group. She is a member of the WHO Steering Group working on developing a blueprint for NTD research and development as well as the African Union working group developing a costed roadmap for the AU’s domestic health financing strategic plan. She is a 2021 TED Fellow, Aspen Advanced Global Innovators Fellow as well as a fellow of the Zimbabwe Science Academy, Royal Society of Edinburgh and African Academy of Sciences. |
Chair
Professor Amaya L Bustinduy
London School of Hygiene & Tropical Medicine
Professor Amaya L Bustinduy
London School of Hygiene & Tropical Medicine
Professor Bustinduy trained in paediatrics and infectious diseases in the US and started working on helminthic infections, and their impact on child health in Coastal Kenya in 2009. She is foremost a field clinical epidemiologist and has investigated a broad range of disease manifestations in children and young women related to neglected tropical parasitic diseases (NTD), namely schistosomiasis and giardiasis. Other work has included PK/PD driven drug trials (praziquantel) in preschool children in Uganda and PK modelling in pregnant women with schistosomiasis in the Philippines. She is interested in community-based diagnosis of female genital schistosomiasis, validating diagnostic tools at the point-of-care and its integrations with cervical cancer, STIs and HIV diagnosis and access to care. She heads the Schistosomiasis Clinical Research Group at the London School of Hygiene & Tropical Medicine and works as a paediatric infectious diseases’ consultant in the UK NHS. She leads on field related studies in Uganda, Malawi and Zambia. She is a member in several expert committees of the World Health Organisation.
Dr Sekeleghe Kayuni
Malawi Liverpool Wellcome Clinical Research Programme, Malawi
Dr Sekeleghe Kayuni
Malawi Liverpool Wellcome Clinical Research Programme, Malawi
Seke is a medical doctor and parasitologist from Malawi who holds a Bachelor of Medicine, Bachelor of Surgery from University of Malawi, Diploma in Tropical Medicine and Hygiene from Royal College of Physicians in London, MSc in Tropical Medicine and International Health from University of London, and PhD in Tropical Medicine at University of Liverpool.
His expertise is in Tropical Medicine, especially neglected tropical diseases (NTDs). He has conducted several research studies on genital schistosomiasis (GS), a prevalent schistosomiasis complication in men and women in endemic areas; on community interventions for schistosomiasis and geohelminths management; and currently on a NIHR-Wellcome “Hybridization of urogenital schistosomiasis (HUGS) in Malawi”.
He also has 20 years’ experience in clinical practice, leadership and management of large facilities in Malawi’s health facilities, treating over 2,000 patients monthly. He’s a Lecturer in Parasitology at Liverpool School of Tropical Medicine and London School of Hygiene and Tropical Medicine.
09:00-09:30 |
Schistosome hybridisation: many questions and a few answers!
How common is hybridisation in schistosome populations? What are the genomic consequences of hybridisation? Does hybridisation result in transfer of important traits between species? How can we characterize hybridisation in natural parasite populations? What are the implications for schistosome control? Professor Tim Anderson's laboratory has analysed genome sequence of Schistosoma bovis and Schistosoma haematobium genomes from multiple countries across Africa providing a genomic perspective on these questions using one species pair of particular interest. Professor Tim AndersonTexas Biomedical Research Institute, USA Professor Tim AndersonTexas Biomedical Research Institute, USA Tim Anderson received his undergraduate training in Zoology from Oxford University and a Masters in Medical Parasitology from the London School of Hygiene and Tropical Medicine, before moving to the Department of Ecology and Evolution at the University of Rochester (New York State) for graduate school. Following postdoctoral work in Oxford and Milan, he moved to the Texas Biomedical Research Institute (Texas Biomed) as the only parasite biologist in 1999. He has previously studied mice on the Orkney Islands, butterfly-ant symbioses in Australia, giant rats in New Guinea, Wolbachia endosymbionts in filarial nematodes, and roundworm transmission in Guatemalan villages, before focusing on the genetics and evolution of malaria and schistosome parasites. His lab aims to bridge the gap between mainstream evolutionary biology and parasitology. They utilise a population/quantitative genetics framework, and both experimental and field based research to ask questions about the evolution, ecology and transmission of parasites. His malaria research focuses on understanding how many times drug resistance has evolved in nature, what genes are involved, the role of copy number variation and SNPs, and the composition of complex parasite infections containing multiple parasite genotypes. His schistosome research pioneers use of laboratory genetic crosses and association mapping for analysis of drug resistance and host specificity, and sequencing of single miracidia larvae for investigating introgression, epidemiology, and population biology. |
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09:30-09:45 |
Hybrid identification with just COX1 and ITS may be misleading
The ribosomal ITS and mitochondrial COX1 markers are widely used to differentiate Schistosoma haematobium from its’ livestock counterparts, S. bovis and S. curassoni. Parasites with heterozygous or discordant markers are often classified as hybrids but this approach has two limitations. First, the evolutionary history of individual genes may not reflect the history of the genome or species. Second, discordant markers cannot, by themselves, be used to determine if hybridisation occurred recently (ex. F1 progeny) or thousands of generations ago. Robust characterisation of hybrid schistosomes is critical, as hybridisation can impact parasite epidemiology and control strategies but alternative explanations for discordance, such as lineage sorting, selection, and drift, must also be considered. In this study, we examined parasites collected from humans, snails, and cattle from across Africa. Each sample was genotyped at ITS, COX1 and single nucleotide variants across the genome. We identified multiple parasites with discordant ITS and COX1 genotypes typically associated with hybridisation. By contrast, autosomal SNVs robustly differentiated S. haematobium from livestock schistosomes and indicate minimal gene flow between groups. These findings highlight discrepancies between single-locus and genome-wide data, pointing to limitations in the standard approaches for documenting hybridising schistosomes. Dr Roy PlattTexas Biomedical Research Institute, USA Dr Roy PlattTexas Biomedical Research Institute, USA Roy “Neal” Platt, PhD, is a computational biologist who uses genome data to study the evolutionary history of species. His current projects focus on pathogen surveillance and population genomics of human pathogens. In particular, he is using population-level datasets to examine historic gene flow between a human schistosome (Schistosoma haematobium) and cattle schistosome (S. bovis) parasites. The results from these studies suggest that parasite traits may be transferred, or introgressed, between human and veterinary species with will have direct implications for human health. Dr Platt earned his PhD from Mississippi State University in 2014 and joined Texas Biomed in 2018. |
09:45-10:15 |
Parasite evolution and impact in action: schistosoma spp. hybridisation in West Africa
Since 2021 we have seen the launch of a new WHO Neglected Tropical Diseases (NTD) Roadmap, together with revised Disease Control and Elimination Guidelines and Targets for schistosomiasis. Across all there is now a clear emphasis on the need to incorporate a One Health approach, recogniSing the critical links between human and animal health and the environment. Whilst animal hosts have been long acknowledged as zoonotic reservoirs across Asia, within Africa or the Americas, in contrast, any zoonotic component of schistosomiasis transmission and its implications for disease control has, until recently, been largely ignored. This is true of both S. mansoni, but also notably, S. haematobium, the latter of which was assumed to be an exclusively human infection – and thus amenable to elimination (so long as no drug resistance evolves) by targeting treatment of humans alone. However, an increasing body of work has revealed widespread viable hybridization between S. haematobium of humans with Schistosoma spp. (notably S. bovis, S. curassoni or S. mattheii) of livestock and wildlife throughout Africa and beyond. The dynamics of which species/species-combination predominates varies focally. Moreover, whilst recent genomic evidence suggests the majority of such hybrids are ancient, there is also evidence of rare ongoing contemporary hybridisation. Here I will present some of our recent research focusing on the transmission dynamics of Schistosoma spp. within Senegal and Niger. Professor Joanne P Webster FMedSciRoyal Veterinary College, UK Professor Joanne P Webster FMedSciRoyal Veterinary College, UK Professor Joanne P Webster FMedSci is Professor of Parasitic Diseases at the Royal Veterinary College and Heads their Pathogen Flow in Ecosystems strategic grouping. Joanne is also Director of the London Centre for Neglected Tropical Disease Research (LCNTDR), Professor of Infectious Diseases at Imperial College London's Faculty of Medicine (hon), and on the Board of Directors for Fauna and Flora International (FFI). From its inauguration in 2002 (until 2014) Joanne served as co-Director of the Schistosomiasis Control Initiative (SCI), which, during this period, provided approximately 300 million anthelminthic preventative chemotherapeutic treatments for children and at-risk adults across sub-Saharan Africa. Joanne sits on a range of World Health Organisation’s, Food and Agriculture Organisation, and beyond, working groups. Her research and disease control activities have been awarded a number of medals and awards including most recently the Royal Society Leeuwenhoek medal and lecture (2023/2024). |
10:15-10:30 |
Discussion
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10:30-11:00 |
Break
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11:00-11:30 |
Prevalence and zoonotic potential of hybrid schistosomes in cattle and goats in Malawi: a case study in Chimbende
Schistosomiasis transmission involving Schistosoma haematobium-mattheei hybrids has emerged in Malawi, presenting notable zoonotic implications. Our previous studies have documented hybrid schistosome infections in cattle and goats, revealing spatial variation and environmental influences on infection rates. In Mangochi District, cattle were found to have a schistosomiasis prevalence of 49.1%, with a small proportion shedding S. haematobium-mattheei hybrids in Chimbende. GPS tracking and praziquantel efficacy studies highlighted the role of Lake Malawi as a focal water source contributing to reinfection among cattle. Similarly, a caprine schistosomiasis survey across three districts found S. mattheei infection rates in goats of up to 25.3% in Mangochi, with evidence of zoonotic transmission from S. haematobium in Chikwawa. Expanding on these findings, we conducted a case study in Chimbende to examine hybrid schistosome prevalence in 15 sleeping kraals from cattle small holders. Although our case example investigated 80 cattle at Chimbende in much greater detail it did not re-encounter hybrid infections. This highlights the more ephemeral dynamics of hybrids most likely within younger animals. However, the presence of zoonotic and hybrid schistosomes in Malawi emphasises the need for integrated control efforts that address both animal and human transmission pathways. Future management should incorporate targeted praziquantel treatment, ongoing snail host surveillance, and One Health strategies to mitigate zoonotic spillover and support sustainable schistosomiasis control in Malawi. Dr Alexandra JuhaszLiverpool School of Tropical Medicine, UK Dr Alexandra JuhaszLiverpool School of Tropical Medicine, UK Dr Alexandra Juhasz is a Post-Doctoral Research Associate with a background in Veterinary Medicine and extensive expertise in parasitology. She completed her degree at the University of Szent István in Budapest and pursued a PhD at the University of Veterinary Medicine, where she studied the morphology, epidemiology, and molecular evolution of Schistosoma blood flukes. Through her work, she developed a strong interest in molecular genetics, collaborating with Kingston University on projects involving disease vector identification and the phylogenetics of Radix auricularia, an intermediate host of Schistosoma turkestanicum. At LSTM, Dr Juhasz contributes to the HUGS study, exploring hybridisation between human and animal schistosomes to inform WHO guidelines on schistosomiasis control. Her research has revealed Schistosoma mattheei as a common parasite in Malawian cattle, often hybridising with human schistosomes. A recognised educator, she has ten years of teaching experience and has been awarded a Higher Education Academy Fellowship. She actively supervises student research projects and mentors students in publishing peer-reviewed articles. |
11:30-12:00 |
Modelling insights: zoonotic spillover and hybridisation of Haematobium group schistosome transmission dynamics at the human-animal interface
Zoonotic spillover together with hybridisation of parasites are major emerging public and veterinary health concerns at the interface of infectious disease biology, evolution, and control. Combining model-based approaches and analyses of parasitological, molecular, and epidemiological data from northern Senegal, a region with a high prevalence of schistosome hybrids, we aimed to unravel the transmission dynamics of this complex multi-host, multi-parasite system. Using Bayesian methods and by estimating the basic reproduction number (R0), we evaluate the frequency of zoonotic spillover of Schistosoma bovis from livestock and the potential for onward transmission of hybrid S bovis × S haematobium offspring within human populations. We estimate R0 of hybrid schistosomes to be greater than the critical threshold of one (1.76; 95% CI 1.59 to 1.99), demonstrating the potential for hybridisation to facilitate spread and establishment of schistosomiasis beyond its original geographical boundaries. We estimate R0 for S bovis to be greater than one in cattle (1.43; 95% CI 1.24 to 1.85) but not in other ruminants, confirming cattle as the primary zoonotic reservoir. Through longitudinal simulations, we also show that where S bovis and S haematobium are coendemic (in livestock and humans respectively), the relative importance of zoonotic transmission is predicted to increase as the disease in humans nears elimination. Finally, we consider how quantitative approaches may provide new insights into the morbidity impact of an increasing prevalence of hybrid schistosome. Dr Anna BorlaseUniversity of Oxford, UK Dr Anna BorlaseUniversity of Oxford, UK Dr Borlase is an infectious disease modeller and epidemiologist with a veterinary background, currently based at the University of Oxford. Dr Borlase worked on hybrid schistosomes in Senegal, West Africa as a PhD student, supervised by Professor Joanne Webster (Royal Veterinary College) and Dr James Rudge (London School of Hygiene and Tropical Medicine), a project that combined field work, statistics and mathematical modelling. Dr Borlase moved to Oxford in 2019 to work with Professor Deirdre Hollingsworth and the NTD Modelling Consortium, where she primarily focused on trachoma, an infectious cause of blindness. She then commenced a Royal Society Dorothy Hodgkin Fellowship in 2023, in which she aims to evaluate the complex relationships between community infection dynamics, individual history of infection (for example number, duration, and intensity of infections experienced) and morbidity for NTDs, including schistosomiasis and trachoma. Having originally trained and practiced as a veterinarian, she is very interested in zoonotic diseases, in particular multi-host systems, partitioning of host contribution to transmission, and One Health approaches. |
Chair
Professor J Russell Stothard
Liverpool School of Tropical Medicine
Professor J Russell Stothard
Liverpool School of Tropical Medicine
Professor Stothard is a medical parasitologist with focus on helminth and protist parasites grouped within the neglected tropical diseases. His specialist expertise is in the evolution, epidemiology and control of schistosomiasis having undertaken many multidisciplinary studies from schistosome characterisation to snail ecology. In so doing, he has advanced our understanding of natural transmission cycles of key species of schistosome and their freshwater intermediate snail hosts. Such knowledge typically underpins scientific guidance to better tailor future disease control strategies and specific intersectoral interventions. His research has been translated into several international policy changes, presenting, co-chairing and chairing several expert committees of the World Health Organisation.
Dr Alexandra Juhasz
Liverpool School of Tropical Medicine, UK
Dr Alexandra Juhasz
Liverpool School of Tropical Medicine, UK
Dr Alexandra Juhasz is a Post-Doctoral Research Associate with a background in Veterinary Medicine and extensive expertise in parasitology. She completed her degree at the University of Szent István in Budapest and pursued a PhD at the University of Veterinary Medicine, where she studied the morphology, epidemiology, and molecular evolution of Schistosoma blood flukes. Through her work, she developed a strong interest in molecular genetics, collaborating with Kingston University on projects involving disease vector identification and the phylogenetics of Radix auricularia, an intermediate host of Schistosoma turkestanicum.
At LSTM, Dr Juhasz contributes to the HUGS study, exploring hybridisation between human and animal schistosomes to inform WHO guidelines on schistosomiasis control. Her research has revealed Schistosoma mattheei as a common parasite in Malawian cattle, often hybridising with human schistosomes. A recognised educator, she has ten years of teaching experience and has been awarded a Higher Education Academy Fellowship. She actively supervises student research projects and mentors students in publishing peer-reviewed articles.
13:00-13:30 |
Epidemiology of schistosoma haematobium hybrids: probing host age, sex, and household location in Southern Malawi
Schistosomiasis is best known as an anthroponotic disease most commonly caused by S. mansoni and S. haematobium, with the latter two responsible for the majority of global cases, over 90% of which occur in sub-Saharan Africa. Less recognised are zoonotic species of Schistosoma, particularly the sister species of S. haematobium, which infect domesticated Bovidae. However, due to the close phylogenetic relationship between anthroponotic and zoonotic species, of the S. haematobium group, hybridisation readily occurs. Despite the growing number of schistosomiasis cases that implicate these zoonotic species in humans, our understanding of their prevalence in local communities and transmission patterns is incomplete. This gap in our understanding spurred the Hybridisation in UroGenital Schistosomiasis (HUGS) study in Southern Malawi's Mangochi and Nsanje districts. Over three years, this study investigated the prevalence and risk factors associated with zoonotic and hybrid schistosome infections in humans through annual urine screening using microscopy and novel, high-throughput, HRM qPCR assays capable of putative identification of zoonotic and hybrid schistosomes. Approximately 1,000 participants from each district were enrolled annually, yielding over 6,000 samples. Among these, 208 samples tested positive for zoonotic S. mattheei, with 37 cases in Nsanje and 171 in Mangochi. One putative mixed infection involving S. bovis and S. haematobium was also identified.This research highlights zoonotic schistosomiasis's significant, yet underappreciated, role in human infection. Here, we present further analysis of these findings at the household level, exploring associations with sex and age demographics in the studied communities. Dr Lucas Joseph CunninghamLiverpool School of Tropical Medicine Dr Lucas Joseph CunninghamLiverpool School of Tropical Medicine Lucas is an early-career medical parasitologist specialising in the design and development of molecular assays to better improve surveillance of pathogens and understanding of transmission cycles. He currently specialises in the study of helminths with a focus on soil transmitted helminths and schistosomiasis. In his role as a PDRA on the Hybridisation in UroGenital Schistosomiasis (HUGS) project he designed a novel, two-tube, high-resolution melt qPCR capable of high-throughput screening of samples for putative hybrids. This assay has been successfully used to detect S. haematobium x S. mattheei hybrids in cattle and humans as well as identifying pure S. haematobium in goats and cattle. |
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13:30-13:45 |
Molecular insights into Schistosoma haematobium hybridisation in Southern Malawi
Urogenital schistosomiasis, historically associated with Schistosoma haematobium, remains an endemic burden in Southern Malawian communities despite control efforts. In 2019, molecular analyses identified hybrid schistosome eggs between human-infective S. haematobium and livestock-infective S. bovis and S. mattheei, marking the first documented hybrids in Malawi. This discovery raised concerns regarding altered virulence, expanded host ranges, and potential drug resistance. The HUGS-MLW team launched a 4-year initiative integrating molecular and epidemiological tools to map hybrid prevalence and inform control strategies. This study, nested within the initiative, assessed S. haematobium hybrid prevalence in two endemic Malawian districts, Nsanje and Mangochi, during 2023. Urine samples (n=981) and miracidia (n=1,310) were analysed using real-time polymerase chain reaction, high-resolution melt analysis to unravel hybrid mitochondrial-nuclear profiles. Results revealed putative S. haematobium-mattheei hybrids in <9% of infections, S. haematobium-bovis hybrids in <2.6%, and intestinal schistosomiasis co-infections in <13.7%. These findings confirm an established hybrid zone in Malawi and provide novel insights into the transmission dynamics of S. haematobium hybrids. They underscore the need for enhanced clinical surveillance, especially regarding female and male genital disease manifestations, and renewed investment in bi-annual community-wide praziquantel treatment. Abigail Cawley
Abigail CawleyAbigail Cawley is an aspiring global health researcher with a background in parasitology and molecular epidemiology, based in Liverpool. During her bachelor’s at the University of Liverpool, she investigated the transmission capacity of tsetse flies, sleeping sickness vectors. This sparked her interest in neglected parasitic diseases and first introduced her to the global reach of the Liverpool School of Tropical Medicine (LSTM). In September 2023, Cawley joined the HUGS-MLW team and completed her Master of Research on the molecular epidemiology of hybrid schistosomes. Her fieldwork in Malawi was transformative, enhancing her research skills and deepening her understanding and appreciation of unique challenges in addressing neglected tropical diseases. At LSTM, she connected with an inspiring community of passionate researchers whose work motivates her to explore these diseases further. Now, Cawley is actively pursuing a PhD in parasitology to advance my professional development, tackle complex research questions, and contribute to global health solutions. |
13:45-14:00 |
Female genital schistosomiasis (FGS) in clinical practice: retrospective case-notes analysis of FGS cases with confirmed S. haematobium at the Hospital for Tropical Diseases from 1998-2018, with a pragmatic diagnosis and management pathway
Background: Female genital schistosomiasis (FGS), the genital manifestation of S. haematobium infection in women, results in a variety of gynaecological symptoms and longer-term complications. With increasing migration and tropical travel, FGS will be encountered more frequently in non-endemic settings. Despite this, clinical guidelines for and evaluation of FGS diagnosis and management in non-endemic settings are lacking. Methods: A retrospective case-notes review was undertaken of patients presenting to the Hospital for Tropical Diseases from 1998-2018 with S. haematobium ova detected in terminal urine, or on biopsy. Various descriptive and outcome variables were collected. Specific FGS variables included documented gynaecological symptoms and follow up with sexual health and gynaecology specialists. Results from this study were used to develop a clinical pathway to aid diagnosis and management of FGS. Results: Overall, 186 patients were included, 62 were women (33.3%). Four women reported gynaecological symptoms (4/62, 6.5%). One symptomatic woman was referred for gynaecology follow up (1/4, 25%), and two were lost to follow up (2/4, 50%). Importantly, gynaecological symptoms were not discussed with most women, despite proven S. haematobium. Conclusions: Given three-quarters of women with S. haematobium infection are estimated to have FGS, there is a gap in diagnosis in this non-endemic setting. To address this, we developed a clinical pathway to improve diagnosis and management of women at risk of FGS. This includes specific enquiry about gynaecological symptoms, followed by multi-specialty comprehensive assessment for FGS and its differentials. By formalising a pathway, we aim to improve FGS care in this non-endemic setting. Dr Hannah RaffertyHospital for Tropical Diseases, UK Dr Hannah RaffertyHospital for Tropical Diseases, UK Dr Hannah Rafferty is a clinician specialising in Infectious Diseases and Microbiology in London. During a clinical placement in Cape Maclear on the shore of Lake Malawi, Hannah managed numerous cases of schistosomiasis and developed a specialist interest in this disease. This interest was fostered whilst studying for a Tropical Medicine masters at LSHTM, during which she completed an award-winning project linking female genital schistosomiasis and cervical dysplasia. Her work on female genital schistosomiasis continued in the clinic, with a retrospective clinical audit investigating the diagnosis and management of female genital schistosomiasis over a 21-year period at the Hospital for Tropical Diseases in London. This work has led to the creation of the first female genital schistosomiasis-specific guideline for a non-endemic setting. |
14:00-14:30 |
Elimination of schistosomiasis as public health problem in Africa: progress and challenges
Schistosomiasis remains a significant global public health problem. The control of schistosomiasis is based on integrated approaches combining large-scale treatment of at-risk population groups, access to safe water, improved sanitation, hygiene education and behavior change, and snail control and environmental management. Following the 2012 World Health Assembly resolution 65.21 and the London Declaration on Neglected Tropical Diseases (NTD) and the first NTD roadmap, endemic countries implemented large-scale programmes to control and eliminate the disease. The second World Health Organisation Roadmap for NTDs 2021-2030 went further, setting the goal of global elimination of schistosomiasis as a public health problem and elimination of transmission in selected countries. Schistosomiasis is endemic in 78 countries and territories, with 254 million people needing treatment by 2023 in 50 countries with moderate to high transmission. The African Region has the highest burden, with 91% of people requiring preventive chemotherapy for schistosomiasis living in this region. Between 2006 and 2023, 952 million treatments were provided through mass campaigns in Africa. This has resulted in a 60% reduction in the prevalence of schistosomiasis over the last 10 years. Progress towards elimination requires country ownership and implementation of programmes in line with guidelines for targeted treatment and provision of a comprehensive package of interventions, including impact assessment and a strong surveillance system, including snail control and case tracking. However, there are many challenges on the road to elimination, such as integration into the health system, dwindling financial resources, and the need to develop new interventions. Amadou Garba DjirmayWorld Health Organisation, Switzerland Amadou Garba DjirmayWorld Health Organisation, Switzerland Amadou Garba Djirmay is currently the Schistosomiasis Focal Point at the World Health Organisation in Geneva, Switzerland. Before moving to WHO headquarters, he worked at the WHO Regional Office for Africa to strengthen the region's neglected tropical disease control programmes. His work involves providing technical support to endemic countries and developing global guidelines for the control and elimination of schistosomiasis. His research focuses on schistosomiasis epidemiology, morbidity, preventive chemotherapy and treatment strategies, anthelmintic efficacy monitoring, and One Health. |
14:30-15:00 |
Break
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15:00-15:45 |
Open short talk prize
Professor Sir Roy Anderson FMedSci FRSImperial College London, UK Professor Sir Roy Anderson FMedSci FRSImperial College London, UK Sir Roy is currently Professor of Infectious Disease Epidemiology in the School of Public Health, Faculty of Medicine, Imperial College London and Director of the London Centre for Neglected Tropical Disease Research. His past posts include, the Chief Scientist at The UK Ministry of Defence, and Rector of Imperial College London. He is the author of over 650 scientific articles and has an h index of 125 in google scholar. Among many past commitments, he served as a Trustee of the Natural History Museum London, and as a non-executive director of GlaxoSmithKline for ten years. He is currently Chair of Oriole Global Health Ltd, a Vice President of Fauna and Flora International, Trustee of the London Institute of Mathematical Sciences and of the Banga charity. Sir Roy was elected Fellow of the Royal Society in 1986, a Founding Fellow of the Academy of Medical Sciences in 1998, and a Foreign Associate Member of both the National Academy of Medicine at the US National Academy of Sciences in 1999 and of the French Academy of Sciences in 2010. He was knighted in the 2006 Queen's Birthday Honours. Professor J Russell StothardLiverpool School of Tropical Medicine Professor J Russell StothardLiverpool School of Tropical Medicine Professor Stothard is a medical parasitologist with focus on helminth and protist parasites grouped within the neglected tropical diseases. His specialist expertise is in the evolution, epidemiology and control of schistosomiasis having undertaken many multidisciplinary studies from schistosome characterisation to snail ecology. In so doing, he has advanced our understanding of natural transmission cycles of key species of schistosome and their freshwater intermediate snail hosts. Such knowledge typically underpins scientific guidance to better tailor future disease control strategies and specific intersectoral interventions. His research has been translated into several international policy changes, presenting, co-chairing and chairing several expert committees of the World Health Organisation. Professor Janelisa MusayaKamuzu University of Health Sciences, Malawi Professor Janelisa MusayaKamuzu University of Health Sciences, Malawi Janelisa Musaya is a Professor of Immuno-parasitology at the Kamuzu University of Health Sciences (KUHeS) and interim Deputy Director of the Malawi Liverpool Wellcome Research Programme (MLW). With over 19 years of experience in research, teaching, and mentorship, she specialises in neglected tropical diseases (NTDs), focusing on trypanosomiasis and schistosomiasis. Professor Musaya holds a PhD in Immunoparasitology from the University of Malawi, alongside master’s degrees in Epidemiology and Research Ethics. Her ground-breaking research has mapped tsetse fly distribution, identified genetic factors influencing trypanosomiasis outcomes, and uncovered hybrid schistosome species in Malawi. She leads a dynamic international research team, mentoring master’s and PhD students while collaborating with experts from over 15 countries. Passionate about community engagement, she develops innovative, locally relevant approaches to disease control, including improving mass drug administration campaigns. Her dedication to building research capacity and fostering equitable health policies continues to shape the fight against NTDs and improve health outcomes in Malawi |
15:45-16:00 |
Closing remarks
Professor J Russell StothardLiverpool School of Tropical Medicine Professor J Russell StothardLiverpool School of Tropical Medicine Professor Stothard is a medical parasitologist with focus on helminth and protist parasites grouped within the neglected tropical diseases. His specialist expertise is in the evolution, epidemiology and control of schistosomiasis having undertaken many multidisciplinary studies from schistosome characterisation to snail ecology. In so doing, he has advanced our understanding of natural transmission cycles of key species of schistosome and their freshwater intermediate snail hosts. Such knowledge typically underpins scientific guidance to better tailor future disease control strategies and specific intersectoral interventions. His research has been translated into several international policy changes, presenting, co-chairing and chairing several expert committees of the World Health Organisation. |