SCHISTOSOMIASIS

Schistosomiasis is an acute and chronic parasitic disease caused by blood flukes

(trematode worms) of the genus Schistosoma.

Key facts
• Schistosomiasis is an acute and chronic disease caused by parasitic
worms.
• People are infected during routine agricultural, domestic,
occupational, and recreational activities, which expose them to infested water.
• Lack of hygiene and certain play habits of school-aged children such as
swimming or fishing in infested water make them especially vulnerable to infection.
• Schistosomiasis control focuses on reducing disease through periodic,
large-scale population treatment with praziquantel; a more comprehensive approach
including potable water, adequate sanitation, and snail control would also reduce
transmission.
• Estimates show that at least 206.4 million people required preventive
treatment for schistosomiasis in 2016, out of which more than 89 million people
were reported to have been treated.

Infection and transmission

People become infected when larval forms of the parasite – released by freshwater
snails – penetrate the skin during contact with infested water.
Transmission occurs when people suffering from schistosomiasis contaminate
freshwater sources with their excreta containing parasite eggs, which hatch in
water.
In the body, the larvae develop into adult schistosomes. Adult worms live in the
blood vessels where the females release eggs. Some of the eggs are passed out of
the body in the faeces or urine to continue the parasite’s lifecycle. Others become
trapped in body tissues, causing immune reactions and progressive damage to organs.

Symptoms
The impact of an infection depends on the type of worm and the stage of infection.
Symptoms occur when the body reacts to the worm's eggs.
Acute stage

A fever and a rash are symptoms of bilharzia.

Symptoms can take between 14 and 84 days to appear, according to the CDC.
Approximately 3 to 8 weeks after infection, the person may experience:
• a rash
• fever
• headache
• body aches, or myalgia
• breathing difficulties
Chronic stage
Many people do not show symptoms at the early stage, but they may develop symptoms
as the disease progresses. These later symptoms again depend on the type of
parasite.
If the parasites affect the liver or intestines, symptoms may include:
• diarrhea and constipation
• blood in the feces
• intestinal ulcers
• liver fibrosis
• portal hypertension, or high blood pressure around the digestive system
If the parasites affect the urinary system, there may also be:
• blood in the urine
• painful urination
• higher risk of bladder cancer
Over time, anemia can develop. In rare cases, the parasite may affect the central
nervous system.
Children may have stunted growth and a reduced capability to learn, according to
the WHO.

Risk factors:
Schistosomiasis is an important cause of disease in many parts of the world, most
commonly in places with poor sanitation. School-age children who live in these
areas are often most at risk because they tend to spend time swimming or bathing in
water containing infectious cercariae.
If you live in, or travel to, areas where schistosomiasis is found and are exposed
to contaminated freshwater, you are at risk.

Medical mngt
Safe and effective medication is available for treatment of both urinary and
intestinal schistosomiasis. Praziquantel, a prescription medication, is taken for
1-2 days to treat infections caused by all Schistosoma species.

Nsg mngt
Prevention
• Avoid washing cloths and bathing in streams
• Proper and sanitary disposal of human feces
• Destruction of snail host –control the multiplication of snails by
using snail killing chemicals.
• Improve irrigation and agriculture projects to reduce snail habitat

♦ Asses vital sign

♦ Collect stool or/and urine specimen properly including the following
information:
# Type
# Time of sample (for urine during early after noon) # Volume or amount
# Sample number
♦ Inform patient regarding his/ her disease and treatment 30

♦ Administer medication as prescribed

♦ Monitor food and fluid intake
♦ Keep the skin clean and dry (Skin care)
♦ Monitor the patient’s response to therapy
♦ Monitor for complications
♦ Monitor fecal and urine out put (frequency, amount and color)
♦ Give information for the patient about medications, their dosage and
side effects
# Some drugs cause occasional drowsiness and
dizziness and
E.g. Oxamniquine
# Some drugs cause mild gastrointestinal upsets,
giddiness, and drowsiness. E.g. Praziquantel
# Overdose causes organophosphate poisoning
E.g. Metrifonate
♦ Provide health information on prevention of schistosome infections
such as
# Seeking treatment when there is suspicion of infection
# Mobilize the community so that people in the community understand and get
motivated to act
together and prevent the disease
# Identify risk group of the community living in the
endemic areas and eligible for stool/ urine
examination.
# Take time to discuss with the patients’ living conditions
and advise them accordingly
# Make an appointment for a follow up visit
# Using safe water supply
# Avoiding contact with contaminated water
# Prevention of water from contamination with feces

REFERENCES:
WHO (2018, February 20). Schistosomiasis. Retrieved from http://www.who.int

Murrell, D. (2018, September 6). What is bilharzia, snail fever, or

schistosomiasis? Retrieved from https://www.medicalnewstoday.com

CDC (2012, Nov 7). Parasites-Schistosomiasis. Retrieved from https://www.cdc.gov