[Accepted Manuscript] A call to strengthen the global strategy against schistosomiasis and soil-transmitted helminthiasis: the time is now.

In 2001, the World Health Assembly (WHA) passed the landmark WHA 54.19 resolution for global scale-up of mass administration of anthelmintic drugs for morbidity control of schistosomiasis and soil-transmitted helminthiasis, which affect more than 1·5 billion of the world's poorest people. Since then, more than a decade of research and experience has yielded crucial knowledge on the control and elimination of these helminthiases. However, the global strategy has remained largely unchanged since the original 2001 WHA resolution and associated WHO guidelines on preventive chemotherapy. In this Personal View, we highlight recent advances that, taken together, support a call to revise the global strategy and guidelines for preventive chemotherapy and complementary interventions against schistosomiasis and soil-transmitted helminthiasis. These advances include the development of guidance that is specific to goals of morbidity control and elimination of transmission. We quantify the result of forgoing this opportunity by computing the yearly disease burden, mortality, and lost economic productivity associated with maintaining the status quo. Without change, we estimate that the population of sub-Saharan Africa will probably lose 2·3 million disability-adjusted life-years and US$3·5 billion of economic productivity every year, which is comparable to recent acute epidemics, including the 2014 Ebola and 2015 Zika epidemics. We propose that the time is now to strengthen the global strategy to address the substantial disease burden of schistosomiasis and soil-transmitted helminthiasis

Multiple Praziquantel Treatments of Schistosoma mansoni Egg-Negative, CCA-Positive Schoolchildren in a Very Low Endemic Setting in Egypt Do Not Consistently Alter CCA Results

Forty-four Schistosoma mansoni egg-negative/circulating cathodic antigen (CCA) low-positive (trace or 1+) children in three districts of very low prevalence in Egypt were given three sequential praziquantel (PZQ) treatments. Stool and urine specimens were collected 3 months following the initial treatment, and 3 weeks following the second and following the third PZQ treatments, which were conducted 5 weeks apart. Stool specimens were examined by Kato–Katz (four slides/stool sample) and all S. mansoni egg-negative stools were further tested by the “miracidia hatching test” (MHT). Urine samples were examined by the point-of-care CCA assay (POC-CCA). Over the study period, all stool samples from study subjects remained S. mansoni egg negative and MHT negative. Of the POC-CCA test results, in the first day of the study 3 months following the initial treatment, 29.5% were negative, 61.4% CCA trace positives, and 9.1% CCA 1+ positives. Following each PZQ treatment, the test results fluctuated between 1+, trace, and negative, but did not consistently decrease. The proportions of POC-CCA–positive results obtained in the first day (70.5%) as compared with the last day of the study (72.7%) in all of the three districts were very similar. We conclude that CCA trace and 1+ readings, in Kato–Katz S. mansoni egg-negative children in this area with very low levels of intestinal schistosomiasis, are not consistently altered or rendered consistently negative following repeated PZQ treatments and are therefore likely to represent false-positive readings. This finding is of critical importance for countries such as Egypt as they approach elimination.Host-parasite interactio

Effects of iron-rich intermetallics and grain structure on semisolid tensile properties of Al-Cu 206 cast alloys near solidus temperature

The effects of iron-rich intermetallics and grain size on the semisolid tensile properties of Al-Cu 206 cast alloys near the solidus were evaluated in relation to the mush microstructure. Analyses of the stress–displacement curves showed that the damage expanded faster in the mush structure dominated by plate-like β-Fe compared to the mush structure dominated by Chinese script-like α-Fe. While there was no evidence of void formation on the β-Fe intermetallics, they blocked the interdendritic liquid channels and thus hindered liquid flow and feeding during semisolid deformation. In contrast, the interdendritic liquid flows more freely within the mush structure containing α-Fe. The tensile properties of the alloy containing α-Fe are generally higher than those containing β-Fe over the crucial liquid fraction range of ~0.6 to 2.8 pct, indicating that the latter alloy may be more susceptible to stress-related casting defects such as hot tearing. A comparison of the semisolid tensile properties of the alloy containing α-Fe with different grain sizes showed that the maximum stress and elongation of the alloy with finer grains were moderately higher for the liquid fractions of ~2.2 to 3.6 pct. The application of semisolid tensile properties for the evaluation of the hot tearing susceptibility of experimental alloys is discussed