BACKGROUND:
Schistosomiasis is highly endemic in the African continent despite decades of mass drug administration (MDA). Biomedical strategies such as praziquantel distribution, have shown limited long-term impact without community participation. However, engaging the community is difficult. This Systematic Review aims to review evidence on strategies that improve community participation in schistosomiasis control, and to identify key lessons for the success of future programmes.

METHODS:
In line with the PRISMA guidelines, a systematic literature search was conducted across five databases, using terms related to schistosomiasis and the community. Inclusion criteria comprised peer-reviewed randomised control trials, non-randomised trials, observational studies, and qualitative research conducted in African countries from 2000-2023. Titles and abstracts were screened, full texts reviewed, and the CASP checklist applied to assess study quality. 32 studies were included.

RESULTS:
Seven themes emerged as successful in engaging the community in schistosomiasis control programs. The most effective theme was health education with interactive games, especially when done in culturally appropriate locations such as madrassas. Engaging respected community leaders encouraged community wide participation. Those with specific occupations such as fishermen or farmers often missed MDA due to occupational demands. Programs which offered realistic alternatives for culturally established risky practices such as open defecation were more successful than simple education. Sustainability was maintained through minimising dependence on political will and unpaid work.

CONCLUSIONS:
Community participation is a significant factor schistosomiasis control in Africa. Effective programmes integrate community-led education, leadership engagement, and sustainable infrastructure support, which have been the most successful in ensuring participation and long-term success.