DOCSLIB.ORG

Personal View a Call to Strengthen the Global Strategy Against Schistosomiasis and Soil-Transmitted Helminthiasis

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Personal View a Call to Strengthen the Global Strategy Against Schistosomiasis and Soil-Transmitted Helminthiasis Personal View A call to strengthen the global strategy against schistosomiasis and soil-transmitted helminthiasis: the time is now Nathan C Lo, David G Addiss, Peter J Hotez, Charles H King, J Russell Stothard, Darin S Evans, Daniel G Colley, William Lin, Jean T Coulibaly, Amaya L Bustinduy, Giovanna Raso, Eran Bendavid, Isaac I Bogoch, Alan Fenwick, Lorenzo Savioli, David Molyneux, Jürg Utzinger, Jason R Andrews Lancet Infect Dis 2016 In 2001, the World Health Assembly (WHA) passed the landmark WHA 54.19 resolution for global scale-up of mass Published Online administration of anthelmintic drugs for morbidity control of schistosomiasis and soil-transmitted helminthiasis, which November 29, 2016 affect more than 1·5 billion of the world’s poorest people. Since then, more than a decade of research and experience has http://dx.doi.org/10.1016/ S1473-3099(16)30535-7 yielded crucial knowledge on the control and elimination of these helminthiases. However, the global strategy has Division of Infectious Diseases remained largely unchanged since the original 2001 WHA resolution and associated WHO guidelines on preventive and Geographic Medicine chemotherapy. In this Personal View, we highlight recent advances that, taken together, support a call to revise the global (N C Lo BS, J R Andrews MD), strategy and guidelines for preventive chemotherapy and complementary interventions against schistosomiasis and soil- and Division of Epidemiology, transmitted helminthiasis. These advances include the development of guidance that is specific to goals of morbidity Stanford University School of Medicine, Stanford, CA, USA control and elimination of transmission. We quantify the result of forgoing this opportunity by computing the yearly (N C Lo); Children Without disease burden, mortality, and lost economic productivity associated with maintaining the status quo. Without change, Worms, Task Force for Global we estimate that the population of sub-Saharan Africa will probably lose 2·3 million disability-adjusted life-years and Health, Decatur, GA, USA US$3·5 billion of economic productivity every year, which is comparable to recent acute epidemics, including the (D G Addiss MD); Sabin Vaccine Institute and Texas Children’s 2014 Ebola and 2015 Zika epidemics. We propose that the time is now to strengthen the global strategy to address the Hospital Center for Vaccine substantial disease burden of schistosomiasis and soil-transmitted helminthiasis. Development, National School of Tropical Medicine at Baylor Introduction people using praziquantel (against schistosomiasis) and College of Medicine, Houston, TX, USA (Prof P J Hotez MD); More than 15 years ago, the World Health Assembly 565 million people using albendazole or mebendazole Department of Biology, Baylor (WHA) passed the landmark WHA 54.19 resolution to (against soil-transmitted helminthiasis) throughout Africa, University, Waco, TX, USA address the 1·5 billion people affected by schistosomiasis Asia, Latin America, and the Middle East.5,6 During this (Prof P J Hotez); James A Baker and soil-transmitted helminthiasis (including ascariasis, period, the number of infections and global disease burden III Institute for Public Policy, Rice University, Houston, TX, 1,2 1,2,7 hookworm disease, and trichuriasis). WHO sub- estimates have been correspondingly reduced. This USA (Prof P J Hotez); Center for sequently created a Department of Neglected Tropical strategy of morbidity control has defined a goal of Global Health and Diseases, Diseases (NTDs), and produced guidelines that set a new eliminating helminths as a public health problem. For soil- Case Western Reserve framework for a public health approach against many transmitted helminthiasis, this goal is defined as less than University, Cleveland, OH, USA (Prof C H King MD); NTDs, including schistosomiasis and soil-transmitted 1% prevalence of moderate-to-heavy intensity infection in Department of Parasitology, helminthiasis, through a strategy of preventive chemo- at-risk populations, as determined by egg counts on Liverpool School of Tropical therapy (via mass drug admin istration).3 This strategy microscopic examination; for schistosomiasis, the goal has Medicine, Liverpool, UK involves large-scale, periodic (eg, yearly) empirical been expressed as less than 1% prevalence of heavy- (Prof J R Stothard PhD, Prof D Molyneux DSc); treatment of entire populations and typically focuses on intensity infections based on egg counts in stools or urine. United States Agency for groups assumed to have the greatest disease morbidity, Although this commendable morbidity control International Development, such as school-aged children (aged 5–15 years) for strategy has certainly led to success, mainly by averting Global Health, Washington, DC, USA (D S Evans DPH); schistosomiasis and preschool and school-aged children long-term sequelae in school-aged children, the Center for Tropical and 3,4 8,9 (aged 1–15 years) for soil-transmitted helminthiasis. reinfection rate has been high in most settings. Emerging Global Diseases and These helminthiases are characterised by mostly chronic, Unfortunately, even countries that have successfully the Department of often insidious helminth-specific sequelae ranging from implemented the recommended preventive chemo- Microbiology, University of Georgia, Athens, GA, USA mild to severe morbidities. These sequelae include therapy strategy for schistosomiasis and soil-transmitted (Prof D G Colley PhD); Global anaemia, chronic abdominal pain, and malnutrition, and helminthiasis—ie, WHO recommends repeated Public Health, Johnson & also more rare and serious complications including treatment of school-aged children with at least Johnson, New Brunswick, NJ, bladder cancer, hepato splenomegaly, and death for 75% coverage—have met challenges in achieving USA (W Lin PhD); Unité de Formation et de Recherche schistosomiasis, and small bowel obstruction and rectal optimal morbidity control or the more ambitious goal of Biosciences, Université Félix 8,10,11 prolapse for soil-transmitted helminthiasis. transmission elimination. This finding is consistent Houphouët-Boigny, Abidjan, Today, under the auspices of the WHO Department of with estimates by the Global Burden of Disease (GBD) Côte d’Ivoire NTDs—catalysed by the 2012 London Declaration for study12 and others5 that have documented how progress (J T Coulibaly PhD); Centre Suisse de Recherches NTDs, and with large-scale support from governments, has lagged behind for schistosomiasis and soil- Scientifiques en Côte d’Ivoire, pharmaceutical companies, and non-governmental transmitted helminthiasis relative to many other NTDs. Abidjan, Côte d’Ivoire organisations (NGOs)—preventive chemotherapy pro- To address this challenge, in light of the past decade (J T Coulibaly); Swiss Tropical grammes have achieved impressive gains. In 2015 alone, of data and experience from the field, we re-visit and Public Health Institute, Basel, Switzerland these programmes delivered treatment to 65 million the global strategy for preventive chemotherapy and www.thelancet.com/infection Published online November 29, 2016 http://dx.doi.org/10.1016/S1473-3099(16)30535-7 1 Personal View studies.16 Furthermore, expanded community-wide Strength of evidence treatment can be highly cost-effective because of this Step 1: Update strategy for preventive chemotherapy averted morbidity, even if transmission is not Expanded treatment across broader age groups Modelling and cost-effectiveness studies,10,13–15 with eliminated.10,14 To achieve community-wide coverage, (ie, community-wide treatment) support from systematic review and meta-analysis of settings could use distribution networks from other observational studies16 community-based health platforms for feasibility and 14 Lower prevalence thresholds for treatment, Modelling and cost-effectiveness studies, with cost-efficiency, including integration with vaccination especially for schistosomiasis support from observational studies programmes, Demographic and Health Surveys (DHS), Formal guidelines for integration of praziquantel Cost-effectiveness modelling studies, with support and benzimidazole programming from feasibility studies10,14,17,18 or through continued use of lymphatic filariasis or onchocerciasis drug distributors who have delivered Validated strategy with trial data Trials underway community-wide anthelmintics (eg, ivermectin and 19 Rigorous monitoring and evaluation strategies to Statistical models with field validation 33,34 detect emergence of drug resistance albendazole) at scale. Guidelines currently provide prevalence thresholds, Step 2: Incorporate complementary interventions in the global strategy above which a preventive chemotherapy strategy is Water, sanitation, and hygiene programming Systematic review and meta-analysis with mixed (eg, community-led total sanitation) findings, including mostly observational studies20–28 recommended, but these guidelines might be too restrictive to achieve optimal averted disability and cost- Information, education, and communication Trial data26 14 programmes effectiveness even under a goal of morbidity control. Snail control (for Schistosoma spp) Systematic review and meta-analysis, including These prevalence thresholds are based on expert opinion mostly observational studies; modelling studies29,30 and a historically more limited drug supply, and have 3,4 Step 3: Create distinct guidelines based on epidemiology, programmatic goals, and resource constraints remained largely unchanged for more than a decade.
Load more

Recommended publications
  • CDC Overseas Parasite Guidelines
    Guidelines for Overseas Presumptive Treatment of Strongyloidiasis, Schistosomiasis, and Soil-Transmitted Helminth Infections for Refugees Resettling to the United States U.S. Department of Health and Human Services Centers for Disease Control and Prevention National Center for Emerging and Zoonotic Infectious Diseases Division of Global Migration and Quarantine February 6, 2019 Accessible version: https://www.cdc.gov/immigrantrefugeehealth/guidelines/overseas/intestinal- parasites-overseas.html 1 Guidelines for Overseas Presumptive Treatment of Strongyloidiasis, Schistosomiasis, and Soil-Transmitted Helminth Infections for Refugees Resettling to the United States UPDATES--the following are content updates from the previous version of the overseas guidance, which was posted in 2008 • Latin American and Caribbean refugees are now included, in addition to Asian, Middle Eastern, and African refugees. • Recommendations for management of Strongyloides in refugees from Loa loa endemic areas emphasize a screen-and-treat approach and de-emphasize a presumptive high-dose albendazole approach. • Presumptive use of albendazole during any trimester of pregnancy is no longer recommended. • Links to a new table for the Treatment Schedules for Presumptive Parasitic Infections for U.S.-Bound Refugees, administered by IOM. Contents • Summary of Recommendations • Background • Recommendations for overseas presumptive treatment of intestinal parasites o Refugees originating from the Middle East, Asia, North Africa, Latin America, and the Caribbean o Refugees
    [Show full text]
  • Rapid Screening for Schistosoma Mansoni in Western Coã Te D'ivoire Using a Simple School Questionnaire J
    Rapid screening for Schistosoma mansoni in western Coà te d'Ivoire using a simple school questionnaire J. Utzinger,1 E.K. N'Goran,2 Y.A. Ossey,3 M. Booth,4 M. TraoreÂ,5 K.L. Lohourignon,6 A. Allangba,7 L.A. Ahiba,8 M. Tanner,9 &C.Lengeler10 The distribution of schistosomiasis is focal, so if the resources available for control are to be used most effectively, they need to be directed towards the individuals and/or communities at highest risk of morbidity from schistosomiasis. Rapid and inexpensive ways of doing this are needed, such as simple school questionnaires. The present study used such questionnaires in an area of western Coà te d'Ivoire where Schistosoma mansoni is endemic; correctly completed questionnaires were returned from 121 out of 134 schools (90.3%), with 12 227 children interviewed individually. The presence of S. mansoni was verified by microscopic examination in 60 randomly selected schools, where 5047 schoolchildren provided two consecutive stool samples for Kato±Katz thick smears. For all samples it was found that 54.4% of individuals were infected with S. mansoni. Moreover, individuals infected with S. mansoni reported ``bloody diarrhoea'', ``blood in stools'' and ``schistosomiasis'' significantly more often than uninfected children. At the school level, Spearman rank correlation analysis showed that the prevalence of S. mansoni significantly correlated with the prevalence of reported bloody diarrhoea (P = 0.002), reported blood in stools (P = 0.014) and reported schistosomiasis (P = 0.011). Reported bloody diarrhoea and reported blood in stools had the best diagnostic performance (sensitivity: 88.2%, specificity: 57.7%, positive predictive value: 73.2%, negative predictive value: 78.9%).
    [Show full text]
  • Visceral and Cutaneous Larva Migrans PAUL C
    Visceral and Cutaneous Larva Migrans PAUL C. BEAVER, Ph.D. AMONG ANIMALS in general there is a In the development of our concepts of larva II. wide variety of parasitic infections in migrans there have been four major steps. The which larval stages migrate through and some¬ first, of course, was the discovery by Kirby- times later reside in the tissues of the host with¬ Smith and his associates some 30 years ago of out developing into fully mature adults. When nematode larvae in the skin of patients with such parasites are found in human hosts, the creeping eruption in Jacksonville, Fla. (6). infection may be referred to as larva migrans This was followed immediately by experi¬ although definition of this term is becoming mental proof by numerous workers that the increasingly difficult. The organisms impli¬ larvae of A. braziliense readily penetrate the cated in infections of this type include certain human skin and produce severe, typical creep¬ species of arthropods, flatworms, and nema¬ ing eruption. todes, but more especially the nematodes. From a practical point of view these demon¬ As generally used, the term larva migrans strations were perhaps too conclusive in that refers particularly to the migration of dog and they encouraged the impression that A. brazil¬ cat hookworm larvae in the human skin (cu¬ iense was the only cause of creeping eruption, taneous larva migrans or creeping eruption) and detracted from equally conclusive demon¬ and the migration of dog and cat ascarids in strations that other species of nematode larvae the viscera (visceral larva migrans). In a still have the ability to produce similarly the pro¬ more restricted sense, the terms cutaneous larva gressive linear lesions characteristic of creep¬ migrans and visceral larva migrans are some¬ ing eruption.
    [Show full text]
  • Performance of Two Serodiagnostic Tests for Loiasis in A
    Performance of two serodiagnostic tests for loiasis in a Non-Endemic area Federico Gobbi, Dora Buonfrate, Michel Boussinesq, Cédric Chesnais, Sébastien Pion, Ronaldo Silva, Lucia Moro, Paola Rodari, Francesca Tamarozzi, Marco Biamonte, et al. To cite this version: Federico Gobbi, Dora Buonfrate, Michel Boussinesq, Cédric Chesnais, Sébastien Pion, et al.. Perfor- mance of two serodiagnostic tests for loiasis in a Non-Endemic area. PLoS Neglected Tropical Dis- eases, Public Library of Science, 2020, 14 (5), pp.e0008187. 10.1371/journal.pntd.0008187. inserm- 02911633 HAL Id: inserm-02911633 https://www.hal.inserm.fr/inserm-02911633 Submitted on 4 Aug 2020 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. PLOS NEGLECTED TROPICAL DISEASES RESEARCH ARTICLE Performance of two serodiagnostic tests for loiasis in a Non-Endemic area 1 1 2 2 Federico GobbiID *, Dora Buonfrate , Michel Boussinesq , Cedric B. Chesnais , 2 1 1 1 3 Sebastien D. Pion , Ronaldo Silva , Lucia Moro , Paola RodariID , Francesca Tamarozzi , Marco Biamonte4, Zeno Bisoffi1,5 1 IRCCS Sacro
    [Show full text]
  • Schistosomiasis Front
    Urbani School Health Kit TEACHER'S RESOURCE BOOK No Schistosomiasis For Me A Campaign on Preventing and Controlling Worm Infections for Health Promoting Schools World Health Urbani Organization School Health Kit Western Pacific Region Reprinted with support from: Urbani School Health Kit TEACHER'S RESOURCE BOOK No Schistosomiasis For Me A Campaign on the Prevention and Control of Schistosomiasis for Health Promoting Schools World Health Urbani Organization School Health Kit Western Pacific Region Urbani School Health Kit TEACHER'S RESOURCE BOOK page 1 What is schistosomiasis? What should children know about Schistosomiasis (or snail fever) is a disease common among residents (such as farmers, fisherfolk and their families) of communities where schistosomiasis? there they are exposed to infected bodies of water (such as irrigation systems, rice paddies, swamps). It is caused by worms (blood fluke) called Schistosoma japonicum that live in the intestines (particularly in the hepatic portal vein of the blood vessels) of infected persons. People get these worms by being exposed to waters where a type of tiny snail is present. The cercaria (or larva) that emerged from tiny snails can penetrate the skin submerged in the water. Once inside the body, the cercariae losses its tail and become schistosomula (the immature form of the parasite) that follows blood circulation, migrate to the blood vessels of the intestines and liver and cause illness. Schistosoma Japonicum The schistosomiasis worm has three distinct stages of development (see picture) during a lifetime, namely: (1) egg, (2) larva, and (3) worm. Egg: Persons who are infected with schistosomiasis will pass out worm Egg Larva Worm eggs through their feces.
    [Show full text]
  • Progress Toward Global Eradication of Dracunculiasis — January 2012–June 2013
    Morbidity and Mortality Weekly Report Weekly / Vol. 62 / No. 42 October 25, 2013 Progress Toward Global Eradication of Dracunculiasis — January 2012–June 2013 Dracunculiasis (Guinea worm disease) is caused by water from bore-hole or hand-dug wells (6). Containment of Dracunculus medinensis, a parasitic worm. Approximately transmission,* achieved through 1) voluntary isolation of each 1 year after infection from contaminated drinking water, the patient to prevent contamination of drinking water sources, worm emerges through the skin of the infected person, usually 2) provision of first aid, 3) manual extraction of the worm, on the lower limb. Pain and secondary bacterial infection can and 4) application of occlusive bandages, complements the cause temporary or permanent disability that disrupts work four main interventions. and schooling. In 1986, the World Health Assembly (WHA) Countries enter the WHO precertification stage of eradica- called for dracunculiasis elimination (1), and the global tion after completing 1 full calendar year without reporting any Guinea Worm Eradication Program, supported by The Carter indigenous cases (i.e., one incubation period for D. medinensis). Center, World Health Organization (WHO), United Nations A case of dracunculiasis is defined as infection occurring in Children’s Fund (UNICEF), CDC, and other partners, began * Transmission from a patient with dracunculiasis is contained if all of the assisting ministries of health of dracunculiasis-endemic coun- following conditions are met: 1) the disease is detected <24 hours after worm tries in meeting this goal. At that time, an estimated 3.5 million emergence; 2) the patient has not entered any water source since the worm cases occurred each year in 20 countries in Africa and Asia emerged; 3) a volunteer has managed the patient properly, by cleaning and bandaging the lesion until the worm has been fully removed manually and by (1,2).
    [Show full text]
  • PROGRESS Against Neglected Tropical Diseases
    PROGRESS SHEET Significant progress towards the elimination and eradication of neglected tropical diseases has been made in the last decade. Development of public-private partnerships, drug donations from major pharmaceutical companies, increased country and international agency commitment, and effective intervention strategies have led to dramatic declines in rates of infection from these debilitating diseases. Over the last five years, neglected tropical diseases (NTDs)— Elimination Program for the Americas (Merck & Co.), a group of debilitating infectious diseases that contribute to Global Programme to Eliminate Lymphatic Filariasis extreme poverty—have been the focus of increased attention. (GlaxoSmithKline, Merck & Co.), International Trachoma Countries, supported by a variety of global initiatives, have Initiative (Pfizer), Children Without Worms (Johnson & made remarkable headway in combating NTDs—including Johnson), and the WHO Program to Eliminate Sleeping diseases such as leprosy, lymphatic filariasis (elephantiasis), Sickness (Bayer, sanofi-aventis) to provide treatment for those onchocerciasis (river blindness), schistosomiasis (snail fever), NTDs. For schistosomiasis control, praziquantel has been and trachoma—and guinea worm may be the next disease provided via WHO by Merck KGaA and by MedPharm to the eradicated from the planet. Schistosomiasis Control Initiative. Drugs for leprosy control are provided free by Novartis. Global Progress This collection of programs and alliances has been successful in bringing together partners to address NTDs, but there The prospects for reducing the enormous burden caused are others who also provide support to national programs by NTDs have changed dramatically in just the past few fighting these diseases. years, in part due to the growing recognition of the linkages between the fight against these debilitating diseases and The Carter Center spearheads efforts with theCenters for progress towards the United Nations Millennium Disease Control (CDC), WHO, and UNICEF to eradicate guinea Development Goals (MDGs).
    [Show full text]
  • Mini-FLOTAC As an Alternative, Non-Invasive Diagnostic Tool For
    Catalano et al. Parasites Vectors (2019) 12:439 https://doi.org/10.1186/s13071-019-3613-6 Parasites & Vectors RESEARCH Open Access Mini-FLOTAC as an alternative, non-invasive diagnostic tool for Schistosoma mansoni and other trematode infections in wildlife reservoirs Stefano Catalano1,2* , Amelia Symeou1, Kirsty J. Marsh1, Anna Borlase1,2, Elsa Léger1,2, Cheikh B. Fall3, Mariama Sène4, Nicolas D. Diouf4, Davide Ianniello5, Giuseppe Cringoli5, Laura Rinaldi5, Khalilou Bâ6 and Joanne P. Webster1,2 Abstract Background: Schistosomiasis and food-borne trematodiases are not only of major public health concern, but can also have profound implications for livestock production and wildlife conservation. The zoonotic, multi-host nature of many digenean trematodes is a signifcant challenge for disease control programmes in endemic areas. However, our understanding of the epidemiological role that animal reservoirs, particularly wild hosts, may play in the transmission of zoonotic trematodiases sufers a dearth of information, with few, if any, standardised, reliable diagnostic tests avail- able. We combined qualitative and quantitative data derived from post-mortem examinations, coprological analyses using the Mini-FLOTAC technique, and molecular tools to assess parasite community composition and the validity of non-invasive methods to detect trematode infections in 89 wild Hubert’s multimammate mice (Mastomys huberti) from northern Senegal. Results: Parasites isolated at post-mortem examination were identifed as Plagiorchis sp., Anchitrema sp., Echinostoma caproni, Schistosoma mansoni, and a hybrid between Schistosoma haematobium and Schistosoma bovis. The reports of E. caproni and Anchitrema sp. represent the frst molecularly confrmed identifcations for these trematodes in defni- tive hosts of sub-Saharan Africa.
    [Show full text]
  • Early Serodiagnosis of Trichinellosis by ELISA Using Excretory–Secretory
    Sun et al. Parasites & Vectors (2015) 8:484 DOI 10.1186/s13071-015-1094-9 RESEARCH Open Access Early serodiagnosis of trichinellosis by ELISA using excretory–secretory antigens of Trichinella spiralis adult worms Ge-Ge Sun, Zhong-Quan Wang*, Chun-Ying Liu, Peng Jiang, Ruo-Dan Liu, Hui Wen, Xin Qi, Li Wang and Jing Cui* Abstract Background: The excretory–secretory (ES) antigens of Trichinella spiralis muscle larvae (ML) are the most commonly used diagnostic antigens for trichinellosis. Their main disadvantage for the detection of anti-Trichinella IgG is false-negative results during the early stage of infection. Additionally, there is an obvious window between clinical symptoms and positive serology. Methods: ELISA with adult worm (AW) ES antigens was used to detect anti-Trichinella IgG in the sera of experimentally infected mice and patients with trichinellosis. The sensitivity and specificity were compared with ELISAs with AW crude antigens and ML ES antigens. Results: In mice infected with 100 ML, anti-Trichinella IgG were first detected by ELISA with the AW ES antigens, crude antigens and ML ES antigens 8, 12 and 12 days post-infection (dpi), respectively. In mice infected with 500 ML, specific antibodies were first detected by ELISA with the three antigen preparations at 10, 8 and 10 dpi, respectively. The sensitivity of the ELISA with the three antigen preparations for the detection of sera from patients with trichinellosis at 35 dpi was 100 %. However, when the patients’ sera were collected at 19 dpi, the sensitivities of the ELISAs with the three antigen preparations were 100 % (20/20), 100 % (20/20) and 75 % (15/20), respectively (P < 0.05).
    [Show full text]
  • Schistosomiasis (Bilharzia) Frequently Asked Questions
    COMPILED DECEMBER 2018 OUTBREAK RESPONSE UNIT, DIVISION OF PUBLIC HEALTH SURVEILLANCE AND RESPONSE Schistosomiasis (Bilharzia) Frequently Asked Questions 1. What is Schistosomiasis (Bilharzia)? Schistosomiasis, also known as bilharzia, is a disease caused by parasitic worms. There are two forms of the disease, namely intestinal schistosomiasis caused by Schistosoma mansoni and S. japonicum, and urinary schistosomiasis caused by S. haematobium. Less commonly, S. mekongi and S. intercalatum also cause disease in humans. Infection with Schistosomes may present as an acute infection or as a chronic disease. Schistosomiasis ranks second to malaria as the most common parasitic disease in Africa. 2. Who can get Schistosomiasis (Bilharzia)? Schistosomiasis can affect anyone. Persons at risk are those living in or traveling to areas where schistosomiasis is endemic and who come into direct (skin) contact with fresh water sources where infected intermediate hosts (snails of the Bulinus genus) live. 3. Where does Schistosomiasis (Bilharzia) occur in South Africa? Schistosomiasis is a major neglected public health problem in South Africa. Endemic areas include Limpopo and Mpumalanga provinces, the northern and eastern parts of Gauteng Province, the lower-altitude areas of KwaZulu-Natal Province, and the coastal regions from KwaZulu-Natal Province extending into the Eastern Cape Province as far south as Port Elizabeth. There are about four million people at risk of schistosomiasis, most of whom are children. The prevalence in children in some South African endemic locations is up to 95%. However, the total number of infected people in South Africa is unknown. 4. How is Schistosomiasis (Bilharzia) transmitted? Schistosomiasis is transmitted to humans by contact with freshwater (lakes, ponds, rivers, dams) contaminated with ‘cercariae’.
    [Show full text]
  • Trichuriasis Importance Trichuriasis Is Caused by Various Species of Trichuris, Nematode Parasites Also Known As Whipworms
    Trichuriasis Importance Trichuriasis is caused by various species of Trichuris, nematode parasites also known as whipworms. Whipworms are common in the intestinal tracts of mammals, Trichocephaliasis, although their prevalence may be low in some host species or regions. Infections are Trichocephalosis, often asymptomatic; however, some individuals develop diarrhea, and more serious Whipworm Infestation effects, including dysentery, intestinal bleeding and anemia, are possible if the worm burden is high or the individual is particularly susceptible. T. trichiura is the species of whipworm normally found in humans. A few clinical cases have been attributed to Last Updated: January 2019 T. vulpis, a whipworm of canids, and T. suis, which normally infects pigs. While such zoonotic infections are generally thought uncommon, recent surveys found T. suis or T. vulpis eggs in a significant number of human fecal samples in some countries. T. suis is also being investigated in human clinical trials as a therapeutic agent for various autoimmune and allergic diseases. The rationale for its use is the correlation between an increased incidence of these conditions and reduced levels of exposure to parasites among people in developed countries. There is relatively little information about cross-species transmission of Trichuris spp. in animals. However, the eggs of T. trichiura have been detected in the feces of some pigs, dogs and cats in tropical areas with poor sanitation, raising the possibility of reverse zoonoses. One double-blind, placebo-controlled study investigated T. vulpis for therapeutic use in dogs with atopic dermatitis, but no significant effects were found. Etiology Trichuriasis is caused by members of the genus Trichuris, nematode parasites in the family Trichuridae.
    [Show full text]
  • Parasitic Infections: Minnesota Refugee Health Provider Guide
    Parasitic Infections at a Glance Minnesota Initial Refugee Health Assessment Yes No If yes, was Eosinophilia present? Yes No Results pending If yes, was further evaluation done? Yes No Yes No If yes, was Eosinophilia present? Yes No Results pending If yes, was further evaluation done? Yes No ( one) Yes No If why not? _________________________________________ Done Results Pending Not done Negative Positive; treated: ___yes ___no Indeterminate Results Pending Not done Negative Positive; treated: ___yes ___no Indeterminate Results Pending Not done ( one) Yes No If why not? _________________________________________ No parasites found Results Pending Nonpathogenic parasites found Blastocystis; treated: ___yes ___no Not done Pathogenic parasite(s) found () Done Results Pending Not done Treated? Yes No Treated? Yes No Treated? Yes No Species: __________________________ Treated? Yes No Treated? Yes No Treated? Yes No Treated? Yes No Negative Positive; treated: ___yes ___no Indeterminate Results Pending Not done Treated? Yes No Treated? Yes No (specify)Treated? Yes No Treated? Yes No Treated? Yes No _______________________ If not treated, why not? Negative Positive; treated: ___yes ___no Indeterminate Results Pending Not done (check one) Not screened for malaria (e.g., No symptoms and history not suspicious of malaria) Screened, no malaria species found in blood smears Screened, malaria species found (please
    [Show full text]