Bilharzia: Pathology, Diagnosis, Management and Control

Abstract

More than one billion people travel internationally each year and approximately 100 million to the tropics. Schistosomiasis is a neglected tropical disease caused by trematode blood flukes of the genus Schistosoma. It currently infects over 250 million people worldwide and results in approximately 25 million disability adjusted life years lost. Clinical manifestations depend on the affected organ. Subtle morbidities have also been documented including: growth retardation, anaemia and poor cognitive function in children. While schistosomiasis has been eradicated from Japan and significantly reduced in parts of China and Egypt, transmission in many other regions remains ongoing due to the wide-spread distribution of the intermediate snail host, poor sanitation, lack of health education and decreasing compliance to mass drug administration. Integrated control has significantly reduced the burden of disease in China but considerable financial capital is needed if similar results are to be duplicated elsewhere. Human vaccination is in various stages of development, and once found, will become an integral part of future control. This comprehensive review examines the epidemiology, pathology, diagnosis, clinical management, prevention and control of the disease.

Huge bilharzial polyp mimicking colon cancer

“…The disease is endemic in 74 countries, and it is estimated that 250 million people are infected, and approximately 700 million people are at risk of infection. Regarding the at‐risk population, an estimated 660 million are concentrated in Africa, accounting for 85% of the global at‐risk estimate …”

“…Regarding the at-risk population, an estimated 660 million are concentrated in Africa, accounting for 85% of the global at-risk estimate. 2 In case of S. mansoni infection, the adult worms migrate against the blood stream inside the intestinal venous plexus until they finally lay eggs in the bowel wall. The eggs dig their way through the wall and extrude from the mucosa, causing minute ulcers that bleed, and some eggs pass in the stool.…”

Biennial versus annual treatment for schistosomiasis and its impact on liver morbidity

“…7 Oesophageal and gastric variceal rupture are the lethal outcomes of severe disease. 8,9 The evaluation of schistosomiasis-induced liver fibrosis in the field setting is best made with a portable ultrasound (US). 8 The device is reportedly reliable and practical for detecting and assessing the degree of schistosome-induced liver abnormalities, and for monitoring pathological changes following chemotherapy.…”

Synthesis and SAR Studies of New Oxadiazole-2-oxide Derivatives with Remarkable In Vitro Activity against Schistosoma japonicum

“…Then NH 4 Table 1: Worm-killing activity on S. japonicum adult worms in vitro (Only the active compound).…”

“…It is still a neglected tropical disease because of various control effects did not work well. Mostly, three species are responsible for particular relevance; Schistosoma mansoni, which is endemic in Africa, the Arabian Peninsula, South America and the Caribbean, Schistosoma haematobium, which occurs in Africa and the Arabian Peninsula, and Schistosoma japonicum, which is only restricted to China, the Philippines and Indonesia [3,4]. The only World Health Organization (WHO) recognized drug Praziquantel (PZQ) cannot stop reinfection and doesn't work against juvenile schistosomiasis [5].…”