Abstract：
Zanzibar is among the few places in sub-Saharan Africa where interruption of Schistosoma transmission seems an achievable goal. Our systematic review identifies and discusses milestones in schistosomiasis research, control and elimination efforts in Zanzibar over the past 100 years. The search in online databases, libraries, and the World Health Organization Archives revealed 153 records published between May 1928 and August 2022. The content of records was summarised to highlight the pivotal work leading towards urogenital schistosomiasis elimination and remaining research gaps. The greatest achievement following 100 years of schistosomiasis interventions and research is undoubtedly the improved health of Zanzibaris, exemplified by the reduction in Schistosoma haematobium prevalence from>50% historically down to<5% in 2020, and the absence of severe morbidities. Experiences from Zanzibar have contributed to global schistosomiasis guidelines, whilst also revealing challenges that impede progression towards elimination. Challenges include: transmission heterogeneity requiring micro-targeting of interventions, post-treatment recrudescence of infections in transmission hotspots, biological complexity of intermediate host snails, emergence of livestock Schistosoma species complicating surveillance whilst creating the risk for interspecies hybridisation, insufficient diagnostics performance for light intensity infections and female genital schistosomiasis, and a lack of acceptable sanitary alternatives to freshwater bodies. Our analysis of the past revealed that much can be achieved in the future with practical implementation of integrated interventions, alongside operational research. With continuing national and international commitments, interruption of S. haematobium transmission across both islands is within reach by 2030, signposting the future demise of urogenital schistosomiasis across other parts of sub-Saharan Africa.
摘要：
桑给巴尔是撒哈拉以南非洲为数不多的中断血吸虫传播的地方之一，这似乎是可以实现的目标。我们的系统评价确定并讨论了血吸虫病研究中的里程碑，在过去的100年中，桑给巴尔的控制和消除努力。在线数据库中的搜索，图书馆,世界卫生组织档案公布了1928年5月至2022年8月之间的153条记录。总结了记录的内容，以突出导致消除泌尿生殖道血吸虫病的关键工作和仍然存在的研究空白。经过100年的血吸虫病干预和研究，最大的成就无疑是改善了桑给巴尔人的健康状况，例如，血吸虫患病率从历史上的>50％下降到2020年的<5％，并且没有严重的发病率。桑给巴尔的经验为全球血吸虫病指南做出了贡献，同时也揭示了阻碍淘汰进程的挑战。挑战包括：传播异质性需要干预措施的微观目标，传播热点感染的治疗后复发，中间寄主蜗牛的生物复杂性，牲畜血吸虫物种的出现使监测复杂化，同时产生种间杂交的风险，对光强感染和女性生殖器血吸虫病的诊断性能不足，缺乏可接受的淡水尸体卫生替代品。我们对过去的分析表明，通过实际实施综合干预措施，未来可以取得很大成就。除了运营研究。有了持续的国家和国际承诺，到2030年，在这两个岛屿上中断血吸虫传播是可以实现的，这标志着撒哈拉以南非洲其他地区泌尿生殖道血吸虫病的未来消亡。
