Schistosomiasis: a water based disease

1. Schistosomiasis: a water based disease By Mbaember J. David Wuam PUBH 6165-09

2. Welcome The Director-General, Dr LEE Jong-Wook, of the World Health Organization stated, “Water and Sanitation is one of the primary drivers of public health. I often refer to it as “Health 101”, which means that once we can secure access to clean water and to adequate sanitation facilities for all people, irrespective of the difference in living conditions, a huge battle against all kinds of disease will be won” ( WHO Facts & figures, 2004). The Director-General, Dr LEE Jong-Wook ( WHO Facts & figures, 2004).

3. Prevalence of Schistosomiasis According to the world health organization, it is estimated that the morbidity and mortality from schistosomiasis vary a great deal. • About 779 million people of which, 10% of the world’s population were in the mid-2003 at risk of being infected with schistosomiasis. • An estimated 200 million people in the tropical and subtropical zones are infected with the parasite, but a recent estimate has the number at 207 by 2003. • 120 million infected people are symptomatic while 20 million will develop severe disease. • It is endemic in 76 countries. Active transmission is reported in 67 countries. Of these, 46 are in Africa.

4. Types of Schistosomiasis • Schistosomamansoni, ( located in the intestinal tract of human host) and region most found are in Arabian Peninsula, Africa, Caribbean, and South America; • Schistosoma haematobium, ( located in the genitourinary tract of human host) and region most found are in the Middle East, and Africa; • SchistosomaJaponicum, ( located in the intestinal tract of human host) and region most found are in Japan, China, and the Philippines ( has a range of mammals as definitive host); • Schistosomamekongi, (located in intestinal tract of human host) region most found are West and Central Africa. • Schistosoma intercalatum,( located in intestinal tract of human host)West and central Africa

5. Geographic distribution

6. The life cycle of a blood fluke • Image from: The University of Cape Town; ImmunologyInstitute of Infectious Disease and Molecular Medicinehttp://www.iidmm.uct.ac.za/fbrombacher/images/schistosomiasis1.jpg

7. Why should we care? • First discovered by Dr. Theodor Bilharz in 1851 • Also known as bilharz after the Dr. who discovered this disease • It occurs in more than 200 million people world wide. • Affects 22 million Nigerians. Of which 16 million are children( Cater foundation) • http://www.cartercenter.org/news/documents/features/schistotx.html

8. Who is affected? Carter center photo By: E. Staub

9. Progression of the disease • At the acute stage of infection individuals are invaded as the parasite penetrates the skin, and then migrates to within the circulatory system to where it matures to induce acute schistosomiasis. • Urinary schistosomiasis induces fever, dysuria and haematouria (blood in the urine). • Intestinal schistosomiasis it may induce fever and abdominal pain, bloody diarrhea and tender hepatosplenomegaly (enlarged liver & spleen).

10. Progression of the disease cont' Carter center photo By: E. Staub http://ww w.cartercenter.org/resources/images/schistofebjs.jpg

11. Snail intermidiate • Biomphalariasp., the intermediate host for S. mansoni From:http://www.dpd.cdc.gov/dpdx/HTML/ImageLibrary/Schistosomiasis_il.htm

12. Snail intermidiate • Bulinus sp., the intermediate host for S. haematobium and S. intercalatum. • From:http://www.dpd.cdc.gov/dpdx/HTML/ImageLibrary/Schistosomiasis_il.htm

13. How is it Diagnosed • Urine and stool samples can used to make the diagnosis of Schistosomiasis. CDC schistosomiasis facts: from http://www.dhpe.org/infect/schisto.html

14. Treatment and prevention • Praziquantal cost about $0.20 • Carter center photo By: E. Staub

15. Treatment and prevention cont' • Along with the Carter center, the Nigerian government is still only able to buy a fraction of the needed medication. • Health Education of the general public with regards to the seriousness of this disease is also a measure that will help in reducing as well as minimizing the disease in the community.

16. Treatment & prevention cont’ • Prevention • Control community contamination of rivers or streams with fecal matter be educations, providing latrines. • No swimming in infected water • Control snails by scooping

17. Treatment & prevention cont’ • Sanitation of the environment • Control of community infections • Education of individual in principles of personal hygiene • Organization of medical and nursing services for the early diagnosis and preventive treatment of disease • Development of social machinery that will ensure to every individual in the community a standard of living adequate for the maintenance of health. Schneider, M. J. (2006). Introduction to public health (2nd ed.). Sudbury, MA: Jones and Bartlett.

18. Potential reduction for Schistosomiasis as a result of Improvements in water supply and sanitation • Will Increase quality and years of a healthy life • Eliminate or minimize health disparities brought on by this parasite. • School age children are said to be more alert in school and there is noticeable growth increase. Schneider, M. J. (2006). Introduction to public health (2nd ed.). Sudbury, MA: Jones and Bartlett.

19. Conclusion • Schistosomiasis is one of many diseases of the developing nations that has been significantly ignored. It is a public health problem that affects people with limited access to healthcare and In information. There is a medication that is affordable and has been used successfully to treat this disease and should be given priority at the international, national and local levels. - • Thank you all for your attention. I hope this was informative for some of you and at the same time , that those who can help would join the carter foundation currently working in Nigeria to help treat those infected and also educate people on sanitary measures. Schistosomiasis can not be eradicated but it can be treated and controlled.

20. References • Brunn, B., Aagaard-Hansen,J.(2008) The social Context of Schistosomiasis and its control: An introduction and bibliography. World Health Organization on behalf of the Special Programme for Research and Training in Tropical Diseases. • Schneider, M. J. (2006). Introduction to public health (2nd ed.). Sudbury, MA: Jones and Bartlett. • Wilson et al (2001) Current Diagnosis & treatment in infectious diseases, Lange: McGraw-Hill • World Health Organization: Water, sanitation and hygiene links to health Fact & figures update 2004. From http://www.who.int/water_sanitation_health/publications/facts2004/en/print/html • World Health Organization: Division of Control of Tropical Diseases (2007) From http://www.microbiologybyes.com/introduction/Schisto.html • Image references • Center for disease control: dvision of parasitic disease • http://www.dpd.cdc.gov/dpdx/HTML/ImageLibrary/Schistosomiasis_il.htm Carter center photo By: E. Staub •  http://www.cartercenter.org/news/documents/features/schistotx.html • Image from: The University of Cape Town; ImmunologyInstitute of Infectious Disease and Molecular Medicinehttp://www.iidmm.uct.ac.za/fbrombacher/images/schistosomiasis1.jpg