Caribbean schistosomiasis

Abstract

For the purposes of this article the Caribbean region is considered as: all the islands in the Caribbean Sea and those adjoining mainland areas which are politically, historically and culturally associated with the islands (i.e. Belize and the Guyanas). This partly artificial division excludes two continental latin-american countries, Brazil and Venezuela, with endemic schistosomiasis. The Caribbean region, as defined above, includes several hundred islands divided among more than 20 governing units. The region has a complex political and cultural history which has resulted in intra-regional heterogeneity of ethnic origins and cultural alliances. This heterogeneity extends to economic and demographic variation between countries: the Gross National Product in 1979 ranged from more than US $5000 to less than US $250 per capita; the population of some countries is less than 10 5 whilst in others it approaches 10 7 ; the national population density ranges from 07 to 557 persons/km 2 (Table 1). Standards of sanitation, domestic water supplies and health delivery services reflect this heterogeneity in socioeconomic development.

Status of Schistosomiasis Elimination in the Caribbean Region

“…Schistosomiasis mansoni was eliminated from the small island of Vieques near Puerto Rico in 1962 [13]. Caribbean localities without a history of schistosomiasis include Anguilla, St Barthélemy, Saba, Sint Eustatius, Nevis, Dominica, St Vincent and the Grenadines, Grenada, Barbados, Tobago and Trinidad, Aruba, Bonaire, Curaçao and the British and U.S. Virgin Islands in the Lesser Antilles as well as the Greater Antillean countries/territories of Jamaica, Cuba, Cayman Islands and Haiti, nor in Belize, Guyana or French Guiana which are also included in the Caribbean region [3,14].…”

Identification of Schistosoma mansoni Infection in a Nonhuman Primate from St. Kitts More than 50 Years after Interruption of Human Transmission

“…5 In the 1970s, there were no human cases, and examined snail populations, which were limited to Fountain River, were not infected. 5,7,8 Therefore, S. mansoni transmission was considered interrupted on St. Kitts in the 1950s and eliminated in the 1970s.…”

“…Although people are the definitive final host for S. mansoni in the Caribbean, rodents and nonhuman primates (NHPs) can be infected. 8,[11][12][13] There is some uncertainty regarding the role of rodents, specifically rats, in perpetuating a sylvatic cycle; however, infection in NHPs has been considered secondary to human infections, with elimination in the human population resulting in elimination in the NHP population. 5,8 On St. Kitts, African green monkeys (C. a. sabaeus) were introduced over 350 years ago, and populations also exist on Barbados, St. Maarten (St. Martin), and Tortola.…”

“…8,[11][12][13] There is some uncertainty regarding the role of rodents, specifically rats, in perpetuating a sylvatic cycle; however, infection in NHPs has been considered secondary to human infections, with elimination in the human population resulting in elimination in the NHP population. 5,8 On St. Kitts, African green monkeys (C. a. sabaeus) were introduced over 350 years ago, and populations also exist on Barbados, St. Maarten (St. Martin), and Tortola. 14 For many years, interactions with people and the NHP population on St. Kitts were limited, with the NHPs predominately located in the mountainous region of the island and adventuring to coastal areas to predate on food crops.…”

“…This is in contradiction to what has been proposed regarding the NHP as final hosts. 8 However, Green Hill Estate, the area from which this NHP was trapped, is in the vicinity of the head of the Cayon River, one of the previous sources of this parasite. Although the last testing and documentation of Biomphalaria spp.…”