Hybridisation in urogenital schistosomiasis (HUGS): A multidisciplinary longitudinal population study revealing the transmission biology, epidemiological impact and clinical importance of Schistosoma haematobium-hybrids in Malawi

Our discovery of Schistosoma haematobium hybrids co-infecting Malawian children exposes critical knowledge gaps in WHO’s preventive chemotherapy (PC) strategy for schistosomiasis. Our HUGS (hybridisation in urogenital schistosomiasis) study will generate robust evidence that best informs medical, veterinary and environmental sectors in schistosomiasis control and interruption of schistosome transmission. This 4-year multidisciplinary investigation will develop new molecular assays that quantify multihost transmission dynamics and zoonotic spill-overs. We will reveal which pre- or post-zygotic drivers facilitate saltatory hybrid evolution. HUGS is set out in four objectives [% allocation] that: Obj-1 [25%]: Test if the proportion of hybrid co-infection is (non)uniform across two representative communities where S. haematobium-mattheei or S. haematobium-bovis occur, inclusive of household GPS mapping and identification of associated risk factors by questionnaire; Obj-2 [45%]: Verify, in a 2-year longitudinal population follow-up study with annual PC, if the above proportions and spatial patterns of hybrid co-infection hold or alter in the two communities; Obj-3 [15%]: Ascertain if there is any increased host morbidity (e.g. anaemia or urogenital disease) in hybrid co-infection(s) as measured by point-of-contact assays and portable ultrasonography; Obj-4 [15%]: Reveal hybrid environmental transmission by malacological inspections, livestock tracking and abattoir surveillance, with advanced molecular typing of collected schistosome material.