Trematodes worms, also called flukes, can cause different clinical infections in humans.

All
flukes that cause infections in humans is belong to the group of digenetic trematodes.
Digenetic trematodes are unsegmented, leaf-shaped worms that are flattened dorsoventrally.
They bear two (2) suckers, one surrounding the mouth or the oral sucker, and another on the
ventral surface of the body (ventral sucker). The flukes that cause most human infections are
called Schistosoma species or the blood flukes. Trematode infections such as schistosomiasis
have emerged as important tropical infections (Parija, 2015). Schistosomiasis is common in
tropical and subtropical areas, especially in poor communities without access to safe and
clean drinking water and appropiate sanitation. It is estimated that at least 90% of those
requiring treatment for schistosomiasis live in Africa (WHO, 2018). While it is 200 million
people in the tropical countries of the world may have schistosomal infections which makes
Schistosoma infection as the second most prevalent tropical infectious disease after malaria in
sub-Saharan Africa (Parija, 2015).

Schistosomiasis have two (2) major forms-- intestinal and urogenital. It is caused by 5 major
main species of blood flukes.

Table 1. Major main species of blood flukes.

Species Geographical Distribution

Intestinal Schistosomiasis
Urogenital Schistosomiasis
Schistosoma mansoni
Schistosoma japonicum
Schistosoma mekongi
Schistosoma guineensis and
related S. intercalatum
Schistosoma haematobium
- Eggs hatch within 15 - 30
minutes
Africa, the Middle East, the
Caribbean, Brazil,
Venezuela and Suriname
China, Indonesia, the
Philippines
Several districts of
Cambodia and the Lao
People’s Democratic
Republic
Rain forest areas of central
Africa
Africa, the Middle East,
Corsica (France)

Source: World Health Organization

The commonest in intestinal schistomiasis are among spectrum of intestinal lesions, polyps.
Egg-laying worms are present in the intestinal micro-vasculature especially in the distribution
of the inferior mesenteric venous plexus. In the large intestine, ova are mainly distributed in
the loose submucosa, and to a lesser extent in the subserosa where infrequently multiple
granulomas are formed. (Assous Leshem, Maor, and Meltzer, 2015) Once parasites reach
maturity they begin to produce eggs, many of the eggs pass through the walls of the blood
vessels, and through the intestinal wall, to be passed out of the body in feces.

Schistosomiasis Haematobium lives in the vessels aroung urogenital system. Arounf the
system, S. haematobiums pairs and produce eggs that migrate through the surrounding tissue
that eventually excreted through feces or urine (Ajibola and Rowan, 2019). Since
Schostosomiasis mostly affects agricultural and fishing populations, women are at risk at
developing urogenital schistosomiasis or urogenital schistosomiasis. Women tend to do
chores in infested water such as washing clothes. Inaappropiate hygiene and contact with
infected water can increase the risk of getting the infection (WHO, 2018).
 References:

Ajibola, O., Rowan, A. D., Ogedengbe, C. O., Mshelia, M. B., Cabral, D. J., Eze, A. A., …

Belenky, P. (2019, January 29). Urogenital schistosomiasis is associated with signatures of

microbiome dysbiosis in Nigerian adolescents. Retrieved from

https://www.nature.com/articles/s41598-018-36709-1

Bocanegra, C., Gallego, S., Mendioroz, J., Moreno, M., Sulleiro, E., Salvador, F., … Molina, I.

(2015, October 16). Epidemiology of Schistosomiasis and Usefulness of Indirect Diagnostic

Tests in School-Age Children in Cubal, Central Angola. Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4608768/?

fbclid=IwAR0N9h3HNqu1FiN2z-TdmN6wEgtINPGdWGkjXetVkjK6ZFWDzrMdvF49T00

Moendeg, K. J., Angeles, J. M. M., Nakao, R., Leonardo, L. R., Fontanilla, I. K. C., Goto, Y., …

Yuichi Chigusa, S.-ichiro K. (n.d.). Geographic strain differentiation of Schistosoma

japonicum in the Philippines using microsatellite markers. Retrieved from

https://journals.plos.org/plosntds/article?

id=10.1371/journal.pntd.0005749&fbclid=IwAR2_TuNdw77iPJ9LUisCXmxxLO40vRwU3

ClsVLRM1fF1ag4hErCXbdgAeEk

Schistosomiasis. (n.d.). Retrieved from https://www.who.int/news-room/fact-

sheets/detail/schistosomiasis?

fbclid=IwAR2vFq9bOJcV7pvckgkIRATozLyvCpGsxQKgvhwLiFDxnrUalZREgXA-yEc

Trematode Infection. (2019, November 9). Retrieved from

https://emedicine.medscape.com/article/230112-overview#showall