1. SCHISTOSOMIASIS IN AFRICA Tymeka Lewis, Ph.D. student Walden University PUBH 8165-1 Instructor: Dr. Shana Morrell Spring, 2009

2. LEARNING OBJECTIVES Schistosomiasis Definition Rate of the disease Symptoms Treatments Prevention

3. WHAT IS SCHISTOSOMIASIS? Bilharzia or snail fever (CDC, 2008) 200 million people are infected, mainly in Africa (CDC, 2008) 20 million people disabled (EPA, 2008) 280,000 die each year (EPA, 2008) Contaminated freshwater with snails carry the disease (CDC, 2008) CDC. (2008). Schistosomiasis. Retrieved April 13, 2009, from http://www.cdc.gov/ncidod/dpd/parasites/schistosomiasis/default.html http://www.cdc.gov/ncidod/dpd/parasites/schistosomiasis/default.html EPA. (2008). Scientist identify new leads for treating parasitic worm disease. Retrieved April 13, 2009, from http://www.eps.gov/aging/press/othernews/2008/2008http://www.eps.gov/aging/press/othernews/2008/2008

4. HOW YOU GET IT? Contact with contaminated freshwater with Schistosoma eggs Eggs hatch Parasites grows in snails Parasites leaves snails Parasites enters a person’s skin (CDC, 2008) CDC. (2008). Schistosomiasis: Fact sheet. Retrieved April 13, 2009, from http://www.cdc.gov. http://www.cdc.gov Figure 1. Wikipedia. Skin vesicales on the forearem, created by the penetration of Schistosoma.

5. MAIN FORMS OF HUMAN SCHISTOSOMIASIS S. mansoni Figure 2. Wikipedia. S. haematobium Figure 3. Wikipedia.

6. SYMPTOMS Rash or itchy skin Fever or chills Cough Muscle aches Inflammation -swelling and tenderness of the liver CDC. (2008). Schistosomiasis: A fact lost boys and girls of Sudan. Retrieved April 13, 2009, from http://www.cdc.gov/ncidod/dq/refugee/lostboysandgirlssudan/schistosomiasis_fact_sheet.html http://www.cdc.gov/ncidod/dq/refugee/lostboysandgirlssudan/schistosomiasis_fact_sheet.html

7. TREATMENT FOR SCHISTOSOMIASIS Praziquantel – treats all forms (CDC, 2008) Oxamniquine – treats intestinal (CDC, 2008) Metrifonate – treats urinary (WHO, 2007) No vaccine (CDC, 2008) CDC. (2008). Schistosomiasis: A fact sheet for the lost boys and girls of Sudan. Retrieved April 13, 2009, from http://www.cdc.gov/ncidod/dq/refugee/lostboy sandgirlssudan/schistosomiasis_fact_sheet.ht ml http://www.cdc.gov/ncidod/dq/refugee/lostboy sandgirlssudan/schistosomiasis_fact_sheet.ht ml WHO. (2007). Schistosomiasis. Retrieved April 13, 2009 from http://www.microbiologybytes.com/introducti on/Schisto.html http://www.microbiologybytes.com/introducti on/Schisto.html Figure 4. Generic Biltricide (Praziquantel ) 600 mg Tablets

8. PREVENTION Avoid freshwater washing, swimming, wading or bathing Drink safe water Heat bath water Use toilets CDC. (2008). Schistosomiasis. Retrieved April 13, 2009 from http://www.cdc.govhttp://www.cdc.gov Figure 5. Photo Disc Image.

9. WHO DOES IT MAINLY AFFECT? CHILDREN! Figure 6. Girl getting water. Figure 7. Kids playing in water.

10. REDUCING THE DISEASE IN AFRICA Health education Control of freshwater snails Supply of water Low cost of medicine Management of the environment Improve sanitation WHO. (2007). Schistosomiasis. Retrieved April 13, 2009 from http://www.microbiologybytes.com/intr oduction/Schisto.html http://www.microbiologybytes.com/intr oduction/Schisto.html Figure 8. WHO. New parasites (cercariae)

11. CONCLUSION Schistosomiasis is caused by parasitic flatworms (CDC, 2008). A person become infected with schistosomiasis when contaminated freshwater where snails carry schistosomes gets on the skin (CDC, 2008). There are two main forms of schistosomiasis (Britannica, 2009).

12. CONCLUSION Praziquantel is the drug that treats it (CDC, 2008). DON’T swim, wade, bath or wash in freshwater. 66 million children are affected with schistosomiasis (WHO, 2007).

13. CONCLUSION To reduce incidence in African communities Health education should be provided Freshwater snails should be under control Supply of water should be tested Praziquantel should be provided to children annually Management of the environment including improved sanitation (pipes)

14. REFERENCES CDC. (2008). Schistosomiasis. Retrieved April 13, 2009, from http://www.cdc.gov. http://www.cdc.gov CDC. (2008). Schistosomiasis: A fact sheet for the lost boys and girls of Sudan. Retrieved April 13, 2009, from http://www.cdc.gov/ncidod/dq/refugee/lostboysandgirlssudan/schistoso miasis_fact_sheet.html http://www.cdc.gov/ncidod/dq/refugee/lostboysandgirlssudan/schistoso miasis_fact_sheet.html CDC. (2009). Prevention of specific infectious diseases. Retrieved April 13, 2009, from http://wwwn.cdc.gov.travel.yellowBookCH4- Schistosomiasis.aspxhttp://wwwn.cdc.gov.travel.yellowBookCH4- Schistosomiasis.aspx CDC. (2009). Schistosomiasis. [Online Image]. Retrieved April 13, 2009, from Wikipedia. http://en.wikipedia.orghttp://en.wikipedia.org Clements, A., Garba, A., Sacko, M., Toure., Dembele, R., Landoure, A., Bosque-Olivia, E., Gabrielli, A. F., & Fenwick, A. (2008). Mapping the probability of schistosomiasis and associated uncertainty, West Africa. Emerging Infectious Diseases, 14(10), 1629-1632. DOI: 10.3201/eid1410.080366

15. REFERENCES CONTINUED Deganello, R., Cruciani, M., Beltramello, C., Duncan, O., Oyugi, V., & Montresor, A. (2007). Schistosoma hematobium and S. mansoni among children, Southern Sudan. Emerging Infectious Diseases, 13(10), 1504-1506. Doumenge, J. P., Mott, K. E., Villenave, C. D., Perrin, O. C., & Reaud- Thomas, G. (1987). Atlas of the global distribution of schistosomiasis. World Health Organization. Retrieved April 13, 2009, from http://www.who.int/wormcontrol/documents/maps/en/contents.pdf http://www.who.int/wormcontrol/documents/maps/en/contents.pdf EPA. (2008). Scientist identify new leads for treating parasitic worm disease. Retrieved April 13, 2009, from http://www.epa.gov/aging/press/othernews/2008/2008_0316_ons_1.ht m http://www.epa.gov/aging/press/othernews/2008/2008_0316_ons_1.ht m Generic Biltricide (Praziquantel). [Online Image]. Retrieved April 13, 2009, from http://www.generics.wshttp://www.generics.ws Meltzer, E., Artom, G., Marva, E., Assous, M. V., Rahav, G., & Schwartz, E. (2006). Schistosomiasis among travelers: New aspects of an old disease. Emerging Infectious Diseases, 12(11), 1696-1700.

16. REFERENCES CONTINUED Photos Disc Image. [Online Image]. Water boiling in pot on stove. Retrieved April 13, 2009, from http://images.google.comhttp://images.google.com Schistosomiasis. (2009). In Encyclopedia Britannica. Retrieved April 14, 2009, from Encyclopedia Britannica http://www.britannica.com/EBchecked/topic/527459/schistosomiasis http://www.britannica.com/EBchecked/topic/527459/schistosomiasis Taylor, M. (2008). Global trends in schistosomiasis control. World Health Organization, 86(10), 738. doi 10:2471/BLT.08.058669 WHO. (2007). Schistosomiasis. Retrieved April 13, 2009, from http://www.microbiologybytes.com/introduction/Schisto.html http://www.microbiologybytes.com/introduction/Schisto.html WHO. Schistosomiasis. [Online Image]. Retrieved April 13, 2009, from World Health Organization. http://www.microbiologybytes.comhttp://www.microbiologybytes.com Wikipedia. Schistosomiasis. [Online Image]. Retrieved April 13, 2009, from Wikipedia. http://en.wikipedia.orghttp://en.wikipedia.org

17. FOR FURTHER READING CDC. (2008).. Schistosomiasis. Retrieved April 13, 2009, from http://www.cdc.gov. http://www.cdc.gov Centron, M. S., Chitsulo, L., & Sullivan, J. J. (1996). Schistosomiasis in Lake Malawi. Lancet, 348, 1274-1278. Photograhy.com. [Online Image]. Retrieved April 13, 2009 from Photography.com Pritt, B. S., & Clark, C. G. (2008). Amebiasis. Mayo Clinic Proceedings, 83(10), 1154-1160. Schwartz, E., Kozarsky, P., Wilson, M., & Centron, M. (2005). Schistosome infection among river rafters on Omo River, Ethiopia. Journal Travel Medicine, 12, 3-8. World Health Organization. (1993). The control of schistosomiasis: Second report of the WHO Expert Committee. WHO Technical Report Series 830. Geneva.

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