Diagnosis and management of schistosomiasis

Schistosomiasis, or bilharzia, is a common intravascular infection caused by parasitic Schistosoma trematode worms. 1 2 A systematic review and meta-analysis published in 2006 estimated that more than 200 million people are infected across Africa, Asia, and South America, and close to 800 million are at risk of infection. 3 Meta-analyses have estimated that the current disease burden may exceed 70 million disability adjusted life years. 4 5 The disease is also associated with anaemia, chronic pain, diarrhoea, exercise intolerance, and undernutrition, and female urogenital schistosomiasis may be a risk factor for HIV infection. 4 w1 5 Figure histosome transmission requires contamination of water by faeces or urine containing eggs, a specific freshwater snail as intermediate host, and human contact with water inhabited by the intermediate host snail. 1 2 Schistosomiasis transmission is highly dependent on environmental conditions, particularly those affecting the snail host. Climate change will alter aquatic environments and subsequently the transmission and distribution of waterborne diseases. 6w2