Lucas J. Cunningham Liverpool School of Tropical Medicine Highlighting WASH at ISNTD Workshop 2017 Lucas J. Cunningham Liverpool School of Tropical Medicine

COUNTDOWN activities set across five major themes Mass Scale-up Theme 1: Evidence Synthesis Mass Scale-up Theme 2: Applied Social Science Mass Scale-up Theme 3: Health Economics Integrated Complementary Strategy Theme 1: Macrofilaricides & Vector Control Integrated Complementary Strategy 2: Schistosomiasis/STH & Diagnostics

ICST2 in Ghana Expanded access to MDA (with follow-ups) & local WASH assessment with water contact behaviours Three communities peri-urban areas in Weija: Tomefa, Adakkope-Togokope and Manhaem Parasitological (with molecular diagnostics) and epidemiological surveys conducted by household ~750 individuals participating in this in-depth study

Multisector actions needed to support chemotherapy No complete coverage (with consecutive challenges) Vulnerable groups left out and inequities arise PZQ active on adult worms, juveniles tolerant Treatment does not always fully clear all worms Issue of re-infection due to contaminated environment Adverse events can result in treatment rejections

WASH and SCH SCH is a disease of poor sanitation and water exposure(s) Targets both sides of the coin: exposure and contamination Potential of long-term behavioural changes However It requires a considerable investment in time and money Hard to monitor its direct effects and longer term sustainment Does not deal with spread of SCH via movement of people Tailoring Water, Sanitation, and Hygiene (WASH) Targets for Soil-Transmitted Helminthiasis and Schistosomiasis Control, Suzy J. Campbell, NanaKwadwo Biritwum, Geordie Woods, Yael Velleman, Fiona Fleming, and J. Russell Stothard