BugBitten Uganda Schistosomiasis Symposium – sharing innovative research into schistosomiasis.

The Uganda Schistosomiasis Multidisciplinary Research Centre (U-SMRC) hosted the first Uganda Schistosomiasis Symposium in Entebbe Uganda and online. The theme of this first symposium was Schistosomiasis research and controlled human infection studies for helminth vaccine development in Africa. Kat Gulyas attended the symposium online and reports on the exciting research presented and outreach activties that took place.

Kat Gulyas 4 Mar 2023

Scanning electron micrograph of a pair of Schistosoma mansoni. Source: Wikipedia. Credit: Davies Laboratory Uniformed Services University Bethesda, MD.

The Uganda Schistosomiasis Symposium, brought together researchers working on schistosomiasis over 4 days, to share exciting science, provide cutting-edge training and to raise the profile of schistosomiasis controlled human infection studies in Uganda for vaccine development.

Day 1 of this three-day symposium on schistosomiasis focused on epidemiology, social science & control and biology of the worm itself. 

• Dr Edridah Tukahebwa introduced the work of the Uganda Schistosomiasis Multidisciplinary Research Center, part of the Tropical Medicine Research Centers Network (TMRC), focused on building expertise and understanding of the underlying biological determinants of severe schistosomiasis morbidity.
  

  Uganda Schistosomiasis Multidisciplenary Research Center – Schistosomiasis lifecycle and Key Research Aims. Figure by Dr Edridah Tukahebwa

• Dr Alfred Mubangizi, Vector Control Division of the Ministry of Health of Uganda, described the current situation regarding schistosomiasis in Uganda, with 93 out of 146 districts endemic for schistosomiasis, all districts endemic for intestinal schistosomiasis & 4 districts endemic for urogenital schistosomiasis. Dr Mubangizi outlined the MoH’s Neglected Tropical Diseases control & elimination Master plan, with it’s 4 strategic pillars: 

  • Accelerating programmatic action.
  • Intensify cross-cutting approaches.
  • Operating models & culture to facilitate country ownership.
  • Strengthen resource mobilization, coordination & communication.

• Dr Goylette Chami, from the Big Data Institute, University of Oxford, presented SchistoTrack a large-scale, multidisciplinary study, using a community-based, prospective human participant cohort. The project aims to identify and evaluate the determinants of schistosomiasis-related morbidities, combining multiple methodologies from epidemiology and parasitology to network science, applied statistics, and machine learning.
• Maxson Anyolitho, a Joint PhD Doctoral Student at Mbarara University of Science & Technology-Uganda & University of Antwerp-Belgium, presented his research using a community-based qualitative study to look at health-seeking behaviour regarding schistosomiasis treatment in the absence of a regular mass drug administration program among endemic communities along Lake Albert, Uganda.
• Awardee of a Royal Society of Tropical Medicine and Hygiene Early Careers Grant, Mujumbusi Lazaaro, PhD student and ethnographer at the University of Glasgow, shared their work on developing a contextualized health education program to reduce persistent schistosomiasis transmission in rural fishing communities including community radio, murals & videos. 

The next set of presentations included:

• Dr Andrew Edielu’s (MRC/UVRI and LSHTM Uganda Research Unit) talk on the Praziquantel In Pre-schoolers (PIP) trial looking at the optimal dose of praziquantel to reduce morbidity in children under the age of four who have schistosomiasis.
• A look at schistosome genomics by Dr Matt Berriman (University of Glasgow) reporting on mapping the schistosome genome, genome-wide functional insights & using genomics to study parasite populations; and
• Prof Afzal Siddiqui (Texas Tech University Health Sciences Center) shared where we are with a schistosomiasis vaccine development and presented the work developing SchistoShield®, now in phase 1 trials, highlighting that in 2016 Science Magazine ranked developing a schistosomiasis vaccine in the top 10 vaccine priorities.

Day 2 was equally full of exciting and innovative presentations with a focus on Controlled human infection (CHI) studies for helminths and the morbidity caused by schistosomiasis. 

• Prof Maria Yazdanbakhsh (Leiden University Medical Center, LUMC) introduced the CHI models, and their purpose in facilitating vaccine development for schistosomiasis and soil-transmitted helminths and Dr Selidji Todadbe Agnandji (Centre de Recherches Médicales de Lambaréné) and Friederike Sonnet (LUMC) presented updates from the CHI hookworm project in Gabon. 
• Drs Alain Dessein and Simon Mpoya, French Institute of Health and Medical Research, reported on a 6 year study assessing schistosome-induced liver pathology in fishing communities around Lake Albert.
• Dr Hannah Rafferty shared findings from the BILHIV (Bilharzia and HIV) cross-sectional study, on the association between cervical dysplasia (a pre-curser for cervical cancer) & Female Genital Schistosomiasis by visual inspection with acetic acid in Zambia.
• Dr Mario Jiz (Research Institute for Tropical Medicine, Manila) presented the One Health approach to eliminate schistosomiasis in the Philippines, where over 10% of the overall population are potentially exposed to Schistosoma japonicum. Dr Jiz described interventions including using Mass Drug Administration, transmission control through WASH, health education & zoonotic host management in a variety of animals, from cats, dogs and pigs, to water buffalos that carry 90-97% of community-exposed incidents.

At the end of Day 2 secondary school students from Entebbe had the opportunity to tour the laboratories at the Uganda Virus Research Institute and watched a demonstration of different life stages of the schistosoma life cycle lead by Prossy Kabuubi (MRC/UVRI and LSHTM Uganda Research Unit) and Dr Fiona Allan (University of St Andrews and Natural History Museum, London). 

Day 3 looked at the intermediate hosts, covering Snails 101 and the importance of medical malacology, as well as further updates from the CHI studies.  

• Professor Russell Stothard started the day by raising the question: What is the difference between Malacology & Medical Malacology? Prof Stothard gave an important overview of marvellous molluscs, highlighting how understanding their genomics, reproduction, morphology (e.g. the importance of shell chirality) is crucial to understand the biology, epidemiology and elimination of schistosomiasis. Medical malacology is a fascinating discipline! 

• We learnt about an innovative project using citizen science to help map transmission sites for schistosomiasis, presented by Julius Tumusiime , The ATRAP project harnesses citizen scientists and digital platform KoboToolBox to map and monitor snails at water-contact sites around Lake Albert, highlighting the important role of citizen science in schistosomiasis and snail data collection, and behaviour change advocacy.
• Next we heard from project lead Dr Moses Egese (MRC/UVRI and LSHTM Uganda Research Unit) who presented and discussed the Controlled Human Schistosoma mansoni Study sharing insights on their work establishing a single sex mansoni CHI model, community engagement, local infrastructure, technical capacity & protocol development. 
• Presenting on the effects of helminths & urbanisation on metabolic outcomes, Dr Bridgious Walusimbi shared their research on schistosomiasis, the gut microbiome & cardiovascular risk factors in rural & urban populations in Uganda.

Throughout the symposium early-career researchers presented posters on their research in progress, on the final day awards were given to the best posters with PhD student Emmanuella Pesh awarded Best Poster Presentation for her poster on setting up a laboratory production process for single-sex schistosomes to accelerate vaccine development for schistosomiasis.  

For those lucky people attending the symposium in-person Day 3 closed with a sample collection visit at Kigungu fishing village, a great hands-on experiences, led by Ronald Kiyemba and Moses Ssewankambo and there was a special Day 4 which included a workshop on preparing miracidia from stool samples for parasite genetics, practical session and the steering committee meeting focussing on logistical plans for the Uganda Schistosomiasis Multidisciplinary Research Centre. 

This was the first Uganda Schistosomiasis Symposium, filled to the brim with exciting, innovative and vital research, training, discussions and outreach activities to encourage STEM literacy and careers in the next generation. Can’t wait for the next symposium!