Definition

• Others in limited areas are S. mekongi, S.

• It is a blood fluke (trematode) infection with adult intercalatum, S. malayesis, S. mattheei.
worms living within mesenteric or vesicle veins of
the host over a life span of many years. • Most prevalent species in Africa are S. mansoni
and S. hematobium.
• Infectious agent
Schistosomiasis • The major schistoma species that cause
• Snail vectors are:
• Bulinus-S. hematobium
schistosomiasis of humans are:
• Biomphalaria-S. mansoni
• Schistosoma mansoni
• Onchomelania-S. japonicum
• Schistosoma Japonicum
• Schistosoma Hematobium

• Epidemiology • Reservoir-The principal reservoir for S. mansoni, S.

hematobium and S. intercalatum is man. Other animals,
• Susceptibility and resistance-Susceptibility is
• Occurrence- S. mansoni is found in South like dog, cat, pig, cattle, water buffalo, horse and wild universal. Resistance is poorly defined.
America, Caribbean Islands, Africa and the rodents, are hosts for S. japonicum. • Clinical Manifestation
Middle East. S. hematobium is found in Africa and • Mode of transmission-Infection is acquired from water • The stages of schistosomiasis are:
the Middle East. S. Japonicum is found in the Far containing free-swimming larval forms (cercariae) that
East. • A. invasion
have developed in snails.
• B. maturation
• The disease occurs worldwide and 2 million • Incubation period-Acute systemic manifestations
people are expected to be infected; however, (katayama fever) may occur in primary infections 2-6 • C. established infection and
most infected individuals show few or no signs weeks after exposure, immediately before and during • D. late stage.
and symptoms, and only a small minority develop initial egg deposition. The infection in humans can
persist up to 10 years. Snails release cercariae as long
significant disease. as they live (from several weeks to 3 months).

• A. Invasion stage
• Cercariae penetrate skin
• Cercarial dermatitis with itching papules and
local edema
• Cercariae remain in skin for 5 days before they
enter the lymphatic system and reach the liver.

• B. Maturation • C. Established infection • The inflammatory reaction, resulting in fibrosis,

• Schistosoma mature in the liver. • This is a stage of egg production and eggs causes signs and symptoms of
• Fever, eosinophilia, abdominal pain and reach to the lumen of bladder and bowel. schistosomiasis.
transient generalized urticaria (known as • Some eggs penetrate the tissue, reach the • Sign of colitis with bloody diarrhea and cramps
katayama syndrome) bladder and intestinal wall are discharged with in S. mansoni infection. Terminal haematuria
• Worms descend the portal vein. S. manson; urine and feces. and dysuria in S. haematobium infection.
migrates to mesenteric veins in the intestinal • Eggs that could not penetrate the tissue are • D. Late stage
wall and S. haematobium to bladder plexus. carried with blood to the liver and lungs. • This is the stage of fibrosis, which occurs
• This stage may be diagnosed as clinical • Other eggs that fail to reach the lumen of the where there are eggs in the tissues. Around the
malaria or may pass unnoticed. bladder or bowel provoke an inflammatory bladder this may result in:
reaction.

• Prevention and control

- Stricture of urethra leading to urine retention • Diagnosis 1. Treatment of cases
or fistula. • Demonstration of ova in urine or feces, 2. Intermittent irrigation
- Dilatation of ureters (hydroureter) and kidney • Biopsy of urine and feces are repeatedly 3. Drainage of water bodies
(hydronephrosis) possibly leading to kidney negative (rectal snip, liver biopsy, bladder 4. Clearing of vegetation in water bodies to deprive snails of
failure biopsy). food and resting place
- Calcification of bladder. 5. Flooding
• Treatment 6. Straightening and deepening margins of water bodies
• In the liver portal hypertension leads to
hypersplenism and anemia, eosophageal • Praziquantel and oxamniquine are the drugs of 7. Educating the public about the mode of transmission and
varices and bleeding. choice but in Africa praziquantel is best because ways of prevention
of resistance strain of oxamniquine. 8. Proper disposal of human feces and urine
• In the lungs fibrosis results in pulmonary
9. Avoid swimming in water bodies known to have the
hypertension, which leads to congestive infection
cardiac failure. 10.Use rubber boots to prevent exposure to contaminated
water.