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This paper was published in PNAS.

“Significance: Reinfection after treatment is a problem that plagues efforts to control parasites with complex transmission pathways, such as schistosomiasis, which affects at least 220 million people worldwide and requires an obligate snail intermediate host. Our study highlights a potential ecological solution to this global health problem: We show that a species of river prawn indigenous to the west coast of Africa, Macrobrachium vollenhovenii, could offer a low-cost, sustainable form of snail control that, when used in synergy with existing drug distribution campaigns, could reduce or locally eliminate the parasite. Biological conservation does not always benefit human health, but our results show that where it does, it could provide a win-win outcome for humans and nature.

Abstract: Eliminating human parasitic disease often requires interrupting complex transmission pathways. Even when drugs to treat people are available, disease control can be difficult if the parasite can persist in nonhuman hosts. Here, we show that restoration of a natural predator of a parasite’s intermediate hosts may enhance drug-based schistosomiasis control. Our study site was the Senegal River Basin, where villagers suffered a massive outbreak and persistent epidemic after the 1986 completion of the Diama Dam. The dam blocked the annual migration of native river prawns (Macrobrachium vollenhoveni) that are voracious predators of the snail intermediate hosts for schistosomiasis. We tested schistosomiasis control by reintroduced river prawns in a before-after-control-impact field experiment that tracked parasitism in snails and people at two matched villages after prawns were stocked at one village’s river access point. The abundance of infected snails was 80% lower at that village, presumably because prawn predation reduced the abundance and average life span of latently infected snails. As expected from a reduction in infected snails, human schistosomiasis prevalence was 18 ± 5% lower and egg burden was 50 ± 8% lower at the prawn-stocking village compared with the control village. In a mathematical model of the system, stocking prawns, coupled with infrequent mass drug treatment, eliminates schistosomiasis from high-transmission sites. We conclude that restoring river prawns could be a novel contribution to controlling, or eliminating, schistosomiasis…”

Access the paper at PNAS.