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      Schistosomiasis among Recreational Users of Upper Nile River, Uganda, 2007

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          Abstract

          After recreational exposure to river water in Uganda, 12 (17%) of 69 persons had evidence of schistosome infection. Eighteen percent self-medicated with praziquantel prophylaxis immediately after exposure, which was not appropriate. Travelers to schistosomiasis-endemic areas should consult a travel medicine physician.

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          Schistosomiasis and water resources development: systematic review, meta-analysis, and estimates of people at risk.

          Peter Steinmann, Jennifer Keiser, Robert Bos … (2006)
          An estimated 779 million people are at risk of schistosomiasis, of whom 106 million (13.6%) live in irrigation schemes or in close proximity to large dam reservoirs. We identified 58 studies that examined the relation between water resources development projects and schistosomiasis, primarily in African settings. We present a systematic literature review and meta-analysis with the following objectives: (1) to update at-risk populations of schistosomiasis and number of people infected in endemic countries, and (2) to quantify the risk of water resources development and management on schistosomiasis. Using 35 datasets from 24 African studies, our meta-analysis showed pooled random risk ratios of 2.4 and 2.6 for urinary and intestinal schistosomiasis, respectively, among people living adjacent to dam reservoirs. The risk ratio estimate for studies evaluating the effect of irrigation on urinary schistosomiasis was in the range 0.02-7.3 (summary estimate 1.1) and that on intestinal schistosomiasis in the range 0.49-23.0 (summary estimate 4.7). Geographic stratification showed important spatial differences, idiosyncratic to the type of water resources development. We conclude that the development and management of water resources is an important risk factor for schistosomiasis, and hence strategies to mitigate negative effects should become integral parts in the planning, implementation, and operation of future water projects.
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            Schistosomiasis in Lake Malawi.

            Martin S. Cetron, Lester Chitsulo, James J. Sullivan … (1996)
            In 1992 two US Peace Corps volunteers (PCVs) developed central nervous system schistosomiasis due to infection with Schistosoma haematobium following recreational water exposure at Cape Maclear on Lake Malawi, an African lake considered by many to be free of schistosomiasis. To determine the transmission potential and risk for aquiring schistosomiasis in Lake Malawi, a cross-sectional survey of resident expatriates and visitors to Malawi was done during March and April, 1993. A volunteer cohort of expatriates and visitors representing a cross-section of Malawi's foregn population answered detailed questions about freshwater contact and provided blood specimens to determine the seroprevalence of S haematobium and S mansoni by ELISA and immunoblot analyses. A survey for vector snails was conducted along Lake Malawi's southwestern shore. The study population of 955 included 305 US citizens and 650 non-US foreign nationals. 303 of the study population had serological evidence of current or past schistosome infection. Seroprevalence was 32% (141/440) among expatriates whose freshwater exposure was limited to Lake Malawi; S haematobium antibodies were found in 135 of 141 (96%) seropositive specimens. Risk of seropositivity increased with the number of freshwater exposures at Lake Malawi resorts. Although many resort areas in the southwestern lake region posed a significant risk, Cape Maclear was the location most strongly associated with seropositivity (OR 2.9, 95% Cl 1.6-5.1). Schistosome-infected Bulinus globosus, the snail vector of S haematobium in Malawi, were found at Cape Maclear and other locations along the lakeshore. S haematobium infection is highly prevalent among expatriates and tourists in Malawi. Recreational water contact at popular resorts on Lake Malawi is the most likely source of infection. Transmission of schistosomiasis is occurring in Lake Malawi, a previously under-recognised site of transmission.
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              Outbreak of schistosomiasis among travelers returning from Mali, West Africa.

              A Polderman, P Stuiver, Richard Visser (1995)
              Schistosomiasis in travelers often remains unrecognized because doctors are unfamiliar with the clinical presentation and diagnosis of this imported disease. We describe the epidemiological, clinical, and laboratory characteristics associated with an outbreak of schistosomiasis among nonimmune travelers. Of 30 travelers in two consecutive groups, 29 who had swum in freshwater pools in the Dogon area of Mali, West Africa, were followed for 12 months. Twenty-eight (97%) of those 29 became infected; 10 (36%) of the 28 had cercarial dermatitis, and in 15 (54%), Katayama fever developed. Eggs were found in 22 (79%) of the infected travelers: eggs of Schistosoma mansoni or terminally spined eggs (probably of Schistosoma intercalatum) were in the stools of 19 and 10 patients, respectively, and eggs of Schistosoma haematobium were in the urine of 7 patients. The eggs of 2 of these Schistosoma species were present in 6 cases, and in 4 cases eggs of all 3 species were found. The limited exposure of this group of travelers resulted in a high rate of infection with all three of the Schistosoma species that are prevalent in Africa. A diagnosis of schistosomiasis should be considered for any traveler with a history of exposure to fresh water in an area of endemicity. The only effective method of prevention is avoiding all contact with fresh water in these areas.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Emerg Infect Dis
                Journal ID (publisher-id): EID
                Title: Emerging Infectious Diseases
                Publisher: Centers for Disease Control and Prevention
                ISSN (Print): 1080-6040
                ISSN (Electronic): 1080-6059
                Publication date (Print): May 2010
                Volume: 16
                Issue: 5
                Pages: 866-868
                Affiliations
                [1]Centers for Disease Control and Prevention, Atlanta, Georgia, USA (O.W. Morgan, G. Brunette, B.K. Kapella, I. McAuliffe, W. Li, N. Marano, S.J. Olsen, W.E. Secor, J.W. Tappero, P.P. Wilkins, S.P. Montgomery)
                [2]Ugandan Virus Research Institute, Entebbe, Uganda (E. Katongole-Mbidde)
                [3]Ministry of Health, Kampala, Uganda (S. Okware)
                Author notes
                Address for correspondence: Oliver W. Morgan, Centers for Disease Control and Prevention, Mailstop C12, 1600 Clifton Rd NE, Atlanta GA 30333, USA; email: omorgan@ 123456cdc.gov
                Article
                Publisher ID: 09-1740
                DOI: 10.3201/eid1605.091740
                PMC ID: 2954006
                PubMed ID: 20409387
                SO-VID: 83166f0a-3143-4ec9-8744-2275a6e3da26
                History
                Categories
                Subject: Dispatch

                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: dispatch,schistosomiasis,vector-borne infections,uganda,parasites,travel,nile river
                Data availability:
                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: dispatch, schistosomiasis, vector-borne infections, uganda, parasites, travel, nile river

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