Re-assessing thermal response of schistosomiasis transmission risk: Evidence for a higher thermal optimum than previously predicted

The geographical range of schistosomiasis is affected by the ecology of schistosome parasites and their obligate host snails, including their response to temperature. Previous models predicted schistosomiasis' thermal optimum at 21.7 degrees C, which is not compatible with the temperature in sub-Saharan Africa (SSA) regions where schistosomiasis is hyperendemic. We performed an extensive literature search for empirical data on the effect of temperature on physiological and epidemiological parameters regulating the free-living stages of S. mansoni and S. haematobium and their obligate host snails, i.e., Biomphalaria spp. and Bulinus spp., respectively. We derived nonlinear thermal responses fitted on these data to parameterize a mechanistic, process-based model of schistosomiasis. We then re-cast the basic reproduction number and the prevalence of schistosome infection as functions of temperature. We found that the thermal optima for transmission of S. mansoni and S. haematobium range between 23.1-27.3 degrees C and 23.6-27.9 degrees C (95% CI) respectively. We also found that the thermal optimum shifts toward higher temperatures as the human water contact rate increases with temperature. Our findings align with an extensive dataset of schistosomiasis prevalence in SSA. The refined nonlinear thermal-response model developed here suggests a more suitable current climate and a greater risk of increased transmission with future warming for more than half of the schistosomiasis suitable regions with mean annual temperature below the thermal optimum.In this research, we explored the complex interplay between temperature and the transmission risk of schistosomiasis, a parasitic disease currently affecting over two hundred million people, predominantly in SSA. We developed a novel mathematical model accounting for the multiple positive and negative ways temperature affects the free-living stages of the parasite and its obligate, non-human host, i.e., specific species of freshwater snails. Our models show that schistosomiasis transmission risk peaks at temperatures 1-6 degrees C higher than previously estimated. This indicates that the impact of climate change on schistosomiasis transmission might be more extensive than previously thought, affecting a wide geographic range where mean annual temperatures are currently below the optimal temperature. Our model projections are consistent with the observed temperatures in locations of SSA where schistosomiasis is endemic and data on infection prevalence in the human population are available. These findings suggest that the current climate is conducive to schistosomiasis transmission, and future warming could escalate the risk further, emphasizing the need for targeted interventions in these regions.