The regional impact and control strategies of schistosomiasis in Rwanda, Tanzania, and Uganda: a narrative review

Background: Schistosomiasis remains a major public health problem in East Africa, particularly Rwanda, Tanzania, and Uganda, driven by inadequate sanitation, unsafe water contact, and snail intermediate hosts. Objective: This review summarizes recent epidemiological information and reviews schistosomiasis control efforts in East Africa to highlight the achievements, challenges, and pathways to elimination. Methods: We reviewed 37 recent studies on prevalence, morbidity, and intervention, including mass drug administration (MDA), water sanitation and hygiene (WASH) measures, snail control, and health education. Emphasizing inter-sectoral approaches and One Health. Results: Findings vary across regions, with 15.9% S. haematobium in the Simiyu Region in Tanzania, to declining but persistent S. mansoni in Uganda, while Rwanda has succeeded in lowering the prevalence of schistosomiasis using combined interventions. MDA and WASH have lessened morbidity in school-aged children; however, challenges persist, including low-sensitivity diagnostics, climate-mediated snail expansion, zoonotic aspects, and gender inequalities. Interventions for preschool-aged children and adolescent girls are often excluded, undermining control efforts. Conclusions: Elimination of schistosomiasis requires improved diagnostics, climate-adapted snail control, equitable MDA coverage, and a One Health approach. Achieving WHO’s 2030 targets demand innovation, political commitment, and equitable allocation of resources to address this public burden.