FioSchisto's expert perspective on implementing WHO guidelines for schistosomiasis control and transmission elimination in Brazil.

The World Health Organization (WHO) recognizes schistosomiasis as one of the Neglected Tropical Diseases targeted for global elimination in the 2030 Agenda of the Sustainable Development Goals. In Brazil, schistosomiasis mansoni is considered a public health problem, particularly prevalent among vulnerable populations living in areas with poor environmental and sanitary conditions. In 2022, the WHO published a Guideline encompassing recommendations to assist national programs in endemic countries in achieving morbidity control, eliminating schistosomiasis as a public health problem, and advancing towards interrupting transmission. The perspectives presented here, collectively prepared by members of the Oswaldo Cruz Foundation's (Fiocruz) Schistosomiasis Translational Program (FioSchisto), along with invited experts, examine the feasibility of the WHO recommendations for the Brazilian settings, providing appropriate recommendations for public health policies applicable to the epidemiological reality of Brazil, and suggests future research to address relevant issues. In Brazil, the provision of safe water and sanitation should be the key action to achieve schistosomiasis elimination goals. The agencies involved in measures implementation should act together with the Primary Care teams for planning, executing, monitoring, and evaluating actions in priority municipalities based on their epidemiological indicators. Host snails control should prioritize judicious ecological interventions at breeding sites. The Information, Education, and Communication (IEC) strategy should be associated with water and sanitation and other control actions, actively involving school community. To identify infected carriers, FioSchisto recommends a two-stage approach of immunological and molecular tests to verify transmission interruption during the intervention and beyond. Praziquantel administration should be done under medical supervision at the Primary Care level. MDA should be considered in exceptional settings, as a measure of initial attack strategy in locations presenting high endemicity, always integrated with water and sanitation, IEC, and snail control. To assist decision-making, as well as the monitoring and evaluation of strategic actions, there is a need for an Information System. FioSchisto considers this systematization essential to make investments in strategic research to support the improvement of schistosomiasis control actions. Efforts toward schistosomiasis elimination in Brazil will succeed with a paradigm shift from the vertical prescriptive framework to a community-centered approach involving intersectoral and interdisciplinary collaboration.

A Mobilização do cálcio em biomphalaria glabrata exposta a diferentes quantidades de carbonato de cálcio / Calcium mobilization in biomphalaria glabrata exposed to different quantities of calcium carbonate

O cálcio é essencial na vida dos moluscos, pois está relacionado com a formação da concha e com vários processos metabólicos fundamentais para manter a sua homeostase. O objetivo deste trabalho foi verificar a mobilização do cálcio na hemolinfa e na concha de Biomphalaria glabrata exposta a diferentes soluções de carbonato de cálcio. Para este estudo, foram utilizados caramujos com 60 dias de vida, distribuídos em cinco grupos, quatro expostos a diferentes soluções (20, 40, 60 e 80mg/L) de carbonato de cálcio e um controle. O tempo total de exposição foi de 45 dias. Quinzenalmente, os caramujos eram sacrificados por meio de punção cardíaca para extração da hemolinfa. A concentração de cálcio na hemolinfa foi determinada usando-se kits de diagnóstico (Doles Reagentes) e o conteúdo de cálcio nas conchas, pelo método de volumetria de complexação modificada. Os resultados demonstraram que houve aumento de cálcio na hemolinfa e diminuição de cálcio na concha aos 15 dias de exposição a 20mg/L de carbonato de cálcio. Nos demais grupos expostos, verificou-se que a concentração de cálcio na hemolinfa é inversamente proporcional à quantidade de cálcio na concha. Concluiu-se que, em moluscos expostos a diferentes quantidades de cálcio, ocorre uma mobilização frequente do cálcio na hemolinfa e na concha de acordo com a quantidade de cálcio disponível.

Calcium is essential to mollusk’s life, because is associated with shell formation and metabolic processes that are essential to maintain their homeostasis. The aim of this work was to verify the mobilization of calcium in the haemolymph and shell of Biomphalaria glabrata (strain BH) exposed to different calcium carbonateconcentrations. Sixty days old snails were used for this study, distributed in five groups: four groups exposed to different concentrations (20, 40, 60, 80 mg/L) of calcium carbonate and one control group. The exposition time was forty-five days. Fortnightly, the snails were sacrificed by cardiac puncture for haemolymph extraction. The concentration of calcium was determined in the haemolymph, using diagnosis kits (Doles Reagentes®) and for the calcium content in the shell,a modified volumetric method of complexing was employed. The results showed an increase of the calcium content in haemolymph and a decrease in shell of snails exposed to 15 days of 20mg/L of calcium carbonate. In the other exposed groups, the calcium concentration in the haemolymph was inversely proportional to the amountof calcium in the shell. We conclude that in snails exposed to different amounts ofcalcium, mobilization in the hemolymph and in the shell occurs according to theamount of calcium available.