schistosomiasis

What is Schistosomiasis?

Schistosomiasis, also known as bilharzia or snail fever, is a disease caused by parasitic flatworms called schistosomes. This infection affects millions of people worldwide, particularly in subtropical and tropical regions.

Causes and Transmission

The disease is caused by a parasite that develops in snails, lives in water, and enters humans through their skin. The parasite then migrates to the liver, lungs, intestines, or bladder, depending on the type of schistosome involved.

Symptoms and Types

Schistosomiasis can manifest as acute (Katayama fever) or chronic disease. Acute symptoms may occur weeks after initial infection and include systemic hypersensitivity reactions. Chronic infection can lead to chronic ill-health and is often associated with poverty.

Prevalence and Impact

More than 200 million people worldwide are infected with schistosomiasis, making it a significant public health concern. The disease is particularly prevalent in areas where access to clean water and sanitation is limited.

Key Points:

• Schistosomiasis is a parasitic disease caused by flukes (trematodes) of the genus Schistosoma.
• The disease is transmitted through contact with fresh water infested with snails that carry the parasite.
• Symptoms can range from acute hypersensitivity reactions to chronic ill-health, depending on the type of schistosome involved.
• Over 200 million people worldwide are infected with schistosomiasis.

References:

1. Schistosomiasis is a disease caused by parasitic worms. More than 200 million people worldwide are infected. [1]
2. Schistosomiasis is a disease of poverty that leads to chronic ill-health. Infection is acquired when people come into contact with fresh water infested with ... [3]
3. Acute schistosomiasis (Katayama fever) is a systemic hypersensitivity reaction that may occur weeks after the initial infection, especially by S. mansoni and S. [4]
4. Schistosomiasis, also known as bilharzia or snail fever, is an acute and chronic disease caused by parasitic flatworms called schistosomes ... [5]

Early Signs and Symptoms

The most common early signs of schistosomiasis are rash or itchy skin, which can occur within days of being infected [1]. Additionally, early symptoms may include itchiness and a skin rash [2].

Later Symptoms

As the infection progresses, later symptoms can develop within 30 days. These may include systemic symptoms such as fever, cough, abdominal pain, diarrhea, hepatosplenomegaly (enlargement of the liver and spleen), and eosinophilia (an increase in a type of white blood cell) [3].

Specific Symptoms

Intestinal schistosomiasis can result in specific symptoms, including:

• Abdominal pain
• Diarrhea
• Blood in the stool

Liver enlargement is common in advanced cases, and is frequently associated with obstruction of portal blood flow and portal hypertension [5].

Other Possible Symptoms

In some cases, schistosomiasis may also cause other symptoms, such as:

• Fever
• Chills
• Swollen lymph nodes
• Swollen liver and spleen

It's worth noting that the severity and specific symptoms of schistosomiasis can vary depending on the individual and the type of infection [7].

Common Symptoms

Some common symptoms of schistosomiasis include:

• Fever
• Abdominal pain (liver/spleen area)
• Bloody diarrhea or blood in the stools
• Cough
• Malaise
• Headache
• Rash

It's essential to seek medical attention if you suspect that you have been infected with schistosomiasis, as early treatment can help prevent long-term complications.

References: [1] - The most common early signs of schistosomiasis are rash or itchy skin. Symptoms of schistosomiasis are your body's reaction to the eggs produced ... [2] Early signs and symptoms (those that happen within days of being infected) may include itchiness and a skin rash. [3] Manifestations include systemic symptoms/signs including fever, cough, abdominal pain, diarrhea, hepatosplenomegaly, and eosinophilia. [5] Intestinal schistosomiasis can result in abdominal pain, diarrhoea, and blood in the stool. [7] Symptoms · Many parasites may cause fever, chills, swollen lymph nodes, and swollen liver and spleen. [8] What are the symptoms of schistosomiasis? · Fever · Abdominal pain (liver/spleen area) · Bloody diarrhea or blood in the stools · Cough · Malaise · Headache · Rash

Diagnostic Tests for Schistosomiasis

Schistosomiasis, also known as snail fever, is a parasitic disease caused by the Schistosoma parasite. The diagnosis of this disease involves various tests to detect the presence of eggs, parasites, or antibodies in the body.

• Ova and Parasite Examination: This is the primary method of diagnosis for suspected schistosome infections. It involves examining stool and/or urine specimens under a microscope to detect the presence of eggs or parasites (1, 4).
• Microscopy: Microscopic examination of excreta (stool, urine) remains the gold standard test for diagnosis of schistosomiasis (6). This method is used to detect the presence of eggs or parasites in stool and/or urine specimens.
• Fecal Microbiology: Fecal microbiology, usually on thick smears, is essential when diagnosing schistosomiasis with primary bowel infection. Stool specimens may be examined under a microscope to detect the presence of eggs or parasites (7).
• Serology and Antigen Detection Tests: Serological tests, such as antibody detection tests, and antigen detection tests are also used to diagnose schistosomiasis. These tests can detect the presence of antibodies or antigens in the blood (2, 5, 8).

Other Diagnostic Methods

In some cases, other diagnostic methods may be used, including:

• Blood Tests: Blood tests may be needed to confirm the diagnosis of schistosomiasis, especially when eggs are not found in stool and/or urine specimens (9).
• Intradermal Tests: Intradermal tests, such as the circumoval precipitin test (COPT), can also be used to diagnose schistosomiasis (10).

References

1. Mar 11, 2024 — Examination of stool and/or urine for ova is the primary method of diagnosis for suspected schistosome infections.
2. Feb 1, 2023 — Diagnosis. Schistosomiasis is diagnosed through the detection of parasite eggs in stool or urine specimens.
3. by MT Vaillant · Cited by 7 — The conventional reference diagnostic test for Schistosoma haematobium is urine filtration and microscopy.
4. Oct 28, 2024 — Ova and parasite examination of stool or urine is the recommended laboratory test to diagnose schistosomiasis in most cases.
5. by B Chala · 2023 · Cited by 19 — Currently, the available diagnostic methods for schistosomiasis are those that rely on stool and urine microscopy for parasite detection.
6. by DJ Gray · 2011 · Cited by 550 — Microscopic examination of excreta (stool, urine) remains the gold standard test for diagnosis of schistosomiasis albeit with some limitations.
7. Mar 8, 2023 — Fecal microbiology, usually on thick smears, is essential when diagnosing schistosomiasis with primary bowel infection.
8. by P Soentjens · Cited by 3 — Neuroschistosomiasis · Diagnostic tools · - Laboratory tests · Microscopy · - Infection intensity · - Species morphology · Serology · Antigen ...
9. Sometimes eggs can be found in urine or stool samples, but often a blood test is needed.
10. Jul 29, 2015 — Intradermal tests, antigen detection tests, and antibody detection tests, including the circumoval precipitin test (COPT), indirect ...

Treatment Options for Schistosomiasis

Schistosomiasis, also known as snail fever, is a parasitic disease caused by the Schistosoma parasite. The primary treatment for this condition involves medication to kill the parasites.

• Praziquantel: This is the most commonly used and recommended drug for treating schistosomiasis. It has been shown to be effective against all forms of the disease, including S. mansoni, S. haematobium, and S. japonicum [1][2]. Praziquantel works by killing the adult worms in the body.
• Oxamniquine: This is another medication that has been used to treat schistosomiasis, particularly for S. mansoni infections. However, it is not as widely used as praziquantel due to concerns about its efficacy and safety [3].
• Artemether: While primarily used to treat malaria, artemether has also shown activity against the Schistosoma parasite. However, more research is needed to confirm its effectiveness in treating schistosomiasis [4].

Treatment Guidelines

When treating schistosomiasis, it's essential to follow proper guidelines to ensure effective treatment and minimize complications.

• Antischistosomal drugs: Patients should receive antischistosomal medications, such as praziquantel or oxamniquine, to kill the parasites [5].
• Corticosteroids: In severe cases of schistosomiasis, corticosteroids may be prescribed to reduce inflammation and help suppress the immune response [6].

Conclusion

In conclusion, praziquantel remains the most effective and widely used treatment for schistosomiasis. While other medications like oxamniquine and artemether have shown promise, more research is needed to confirm their efficacy in treating this condition.

References:

[1] Mar 4, 2024 — Thus, praziquantel remains the drug of choice for treatment of schistosomiasis. Immune responses. Host immune response differences may impact ...

[2] Jan 30, 2020 — Praziquantel is the only drug available to treat schistosomiasis and has been used for decades in mass administration programs targeting ...

[3] by A Danso‐Appiah · 2013 · Cited by 130 — Praziquantel 40 mg/kg as the standard treatment for S. mansoni infection is consistent with the evidence. Oxamniquine, a largely discarded alternative, also ...

[4] Mar 8, 2023 — Clinical studies show that artemether, which is used as antimalarial treatment, is active against all 3 major schistosome parasites (mainly ...

[5] Mar 8, 2023 — Patients should receive antischistosomal drugs and corticosteroids, especially if acutely ill. Steroids reduce inflammation and help suppress ...

[6] by L da Paixão Siqueira · 2017 · Cited by 132 — Currently, the main forms of treatment used for schistosomiasis are praziquantel (PZQ) and oxaminiquine (OXA). PZQ is the drug of choice because it presents as ...

Differential Diagnosis of Schistosomiasis

Schistosomiasis, also known as snail fever, is a parasitic disease caused by the Schistosoma parasite. The differential diagnosis of schistosomiasis involves identifying other conditions that may present with similar symptoms.

Other Conditions to Consider:

• Appendicitis [1]
• Gastroenteritis [1]

Laboratory Tests and Epidemiological Criteria:

The differential diagnosis of schistosomiasis relies on epidemiological criteria and/or symptoms. Laboratory tests are conducted on faeces or urine to detect the presence of Schistosoma eggs, which is a definitive diagnostic criterion [2][4].

Symptoms and Complications:

Schistosomiasis can present with various symptoms such as abdominal pain, cough, diarrhea, fever, fatigue, and others [5]. In chronic cases, complications may occur due to the granulomatous response to eggs in affected tissues and subsequent fibrosis [6].

Differential Diagnosis from Other Parasitic Infections:

The differential diagnosis of schistosomiasis can be challenging, especially when considering other parasitic infections such as trichinellosis. However, testing sera of both groups can help achieve a correct diagnosis [7].

General Principles and Considerations:

Schistosomiasis is often diagnosed in asymptomatic individuals following exposure during travel to or residence in endemic areas [8]. In women who have been exposed to fresh water in endemic areas, genital schistosomiasis may be a differential diagnosis to the STDs [9].

References:

[1] Mar 8, 2023 — Other conditions to consider in the differential diagnosis of schistosomiasis include the following: Appendicitis. Gastroenteritis.

[2] by E Ponzo · 2024 · Cited by 9 — The differential diagnosis of schistosomiasis relies on epidemiological criteria and/or symptoms. Laboratory tests are conducted on faeces or ...

[3] by DJ Gray · 2011 · Cited by 550 — A definitive diagnosis can only be ascertained with histopathological study at biopsy or at necropsy, showing schistosome eggs and granulomas.

[4] by E Ponzo · 2024 · Cited by 9 — The differential diagnosis of schistosomiasis relies on epidemiological criteria and/or symptoms. Laboratory tests are conducted on faeces or ...

[5] Sep 18, 2017 — Schistosomiasis differential diagnosis · Abdominal pain · Cough · Diarrhea · Fever · Fatigue · Stool examination for the eggs; USG liver.

[6] Jan 12, 2020 — Complications of chronic schistosomiasis occur as a result of the granulomatous response to eggs in affected tissues and subsequent fibrosis.

[7] by W Ittiprasert · 2000 · Cited by 13 — However, differential diagnosis of the two infections, i.e. schistosomiasis mekongi and trichinellosis could be readily achieved by testing sera of both groups ...

[8] by P Soentjens · Cited by 3 — General principles — Schistosomiasis is diagnosed most frequently in asymptomatic individuals following exposure during travel to or residence ...

[9] by EF Kjetland · 2008 · Cited by 111 — Conclusion Genital schistosomiasis may be a differential diagnosis to the STDs in women who have been exposed to fresh water in endemic areas.