Routine focal mollusciciding after chemotherapy to control Schistosoma mansoni in Cul de Sac valley, St. Lucia

ABSTRACT

Concluding results of a ten year schistosomiasis control programme in Cul de Sac valley, St. Lucia, are described. After an area wide mollusciciding campaign (1970-1975), and a surveillance/treatment programme supplemented with selective population chemotherapy in 1975 and 1976, prevelence rates of Schistosoma mansoni were reduced to low levels. To prevent a resurgence of transmission a cost effective routine focal mollusciciding programme, suitable for public health implementation was evaluated from 1977 to 1981. Streams and main collector drains in banana fields, considered to be potential S. mansoni transmission sites, were treated every four weeks with Bayluscide 6076 emulsifiable concentrate (Clonitralide). Snail populations were effectively controlled in the treated areas but large numbers were present where no treatment was given. Only 0.06 percent of sentinel snails became infected. Prevalence of infection in the human population remained low (over-all 5 percent) and intensity of infection at a level not normally associated with schistosomal disease. Since control started ten years earlier the level of potential contamination has fallen by 92 percent in high transmisssion areas. The four year programme cost US$12,909, of which 54 percent was for molluscicide, 27 percent for labour and 19 percent for transport, equipment and sundries. The average annual cost per head of population was US$0.46