Discussion

Zoonotic intestinal helminthiasis affects more than 949 million people globally, collectively contributing to an estimated 9.68 million disability adjusted life years (DALYs) lost per annum. Endemicity is focused in rural and poor urban areas of low-and-middle-income countries, where access to sanitation, hygiene, health care and education on parasite transmission is lacking. Zoonotic intestinal helminths include the Schistosoma spp. (Schistosoma japonicum), soil transmitted helminths, foodborne trematodes, and Taenia spp. Each having varying degrees of lifecycle complexity, but all utilising animal reservoirs as well as human definitive hosts to maintain transmission, complicating control strategies. The mainstay of control for helminth infections is mass drug administration with a handful of anthelmintic chemotherapies (praziquantel, and benzimidazoles). Despite great efforts involving pharmaceutical companies and non-governmental organisations to distribute these treatments freely in endemic regions to relieve morbidity, it is believed a more multidisciplinary approach to control, a One Health approach, will be required to successfully eradicate helminthiasis completely. This project will focus on endemicity in southeast Asia, applying a multidisciplinary approach to investigate the prevalence of zoonotic intestinal helminthiasis in the Philippines. Sampling from animals, humans and the environment will be integrated with parasitological, molecular diagnostic, and genomics and mathematical modelling approaches to investigate helminth transmission dynamics. The end focus, to predict whether a One Health approach involving integrated human/animal control and surveillance programmes can provide more effective management options than solely human-focused control.