Schistosomiasis

Description:

Schistosomiasis (бильгарциоз) - the chronic helminthosis caused by sort Schistosoma trematodes with preferential defeat of urinogenital system and intestines.

More than 207 million people are around the world infected, and is exposed to risk of infection, by estimates, 700 million people in 74 endemic countries.

The schistosomiasis makes considerable impact on economy and health. At children the schistosomiasis can lead to anemia, a stunt and the lowered abilities to training in spite of the fact that, as a rule, when performing treatment of an effect of a disease are reversible. The chronic schistosomiasis can affect ability of people to work, and to lead in certain cases to death. In Africa to the South more than 200 000 people annually die of the Sahara from a schistosomiasis.

Schistosomiasis symptoms:

Reaction of an organism to eggs of worms, but not on worms is the reason of symptoms of a schistosomiasis.

At an early stage of a disease the itch, a local erythema, papular rashes can develop. During migration шистосомул in an organism, especially at their passing through lungs, cough with a dense phlegm can develop, the liver, a spleen, lymph nodes increase. The period of puberty of helminths and the beginning of a yaytsekladka is characterized by set of the chronic inflammatory phenomena. In a late stage of a disease embolisms of veins of a liver and lungs, псевдоэлефантиаз generative organs, obliterating endoarteritis, myocarditis, etc. are possible chronic colitis.

In 5-8 days after infection the acute form of a schistosomiasis develops. On site penetrations of a parasite there is an allergic reaction in the form of a small tortoiseshell. Patients complain of a febricula, a headache, a fever, a joint pain, muscles. The leukocytosis, the eosinophilia raised by SOE are noted.

Later 6-8 weeks after infection the disease passes into a latent stage which proceeds 3-4 weeks, sometimes - up to 3 months.

The intestinal schistosomiasis can cause pains in a stomach, diarrhea and emergence of blood in excrements. In the started cases increase in a liver is observed that it is often connected with accumulation of liquid in an abdominal cavity and hypertensia of abdominal blood vessels. In such cases increase in a spleen can be also observed.

Various defeats of urinogenital system are noted 4-6 months later after infection.

Classical sign of an urinogenital schistosomiasis is the hamaturia (availability of blood in urine). In the started cases fibrosis of a bladder and ureters often develops and kidneys are surprised.

With accession of consecutive infection the urination becomes speeded up and painful. At strictures of ureters there are aching pains in lumbar area, sometimes attacks of renal colic that is caused by obstruction of the narrowed department clots, mucopurulent separated.

Possible complication at the last stages is bladder cancer. At women the urinogenital schistosomiasis can lead to damages of genitals, vaginal bleeding, pain during sexual intercourse and to formation of nodes on external genitals, to colpitises, polyps on a mucous membrane of a vagina and a neck of uterus. At men the urinogenital schistosomiasis can lead to development of pathology of seed bubbles, a prostate and other bodies. This disease can have and other long irreversible effects, including infertility.

Patients complain of weakness, small appetite, bystry fatigue, frustration of a dream, headaches. Sometimes at a chronic current of an urinogenital schistosomiasis patients do not show complaints; the disease is found during dispensary inspection.

The urinogenital schistosomiasis is considered also risk factor of HIV infection, especially among women.

Schistosomiasis reasons:

The schistosomiasis activator at the person are Schistosoma haematobium (an urinogenital schistosomiasis), Schistosoma mansoni (an intestinal schistosomiasis) and Schistosoma japonicum (the Japanese schistosomiasis with the allergy phenomena, development of colitis, hepatitis, cirrhosis). The schistosomiasis of urinogenital system which was for the first time found by Bilgarts received the name of a bilgartsioz.

The schistosomiasis strikes, generally the people who are going in for agriculture and fishery. The women using in homework the water infected with parasites, for example for washing of linen are also exposed to risk. Children because of their habits connected with hygiene and games are especially vulnerable before an infection.

In the northeast of Brazil and in Africa movements of refugees and population shift to urban areas promote penetration of a disease into new areas. Growth of population and, respectively, the needs for energy and water often leads to such schemes of development and changes in the environment which also promote transmission of infection.

In process of development of ecotourism and trips to "not hackneyed places" the increasing number of tourists catches a schistosomiasis, sometimes in the form of a heavy acute infection and with development of unusual symptoms, including paralysis.

Treatment of the Schistosomiasis:

The strategy of WHO on fight against a schistosomiasis is directed to reduction of incidence by means of periodic, purposeful treatment prazikvantely. Such treatment means regular treatment of all people from risk groups.

Target groups for treatment are:
• children of school age in endemic areas;
• adults from risk groups in endemic areas, for example the pregnant women and nursing mothers, people by the nature of activity contacting to the water infected with parasites such as fishermen, farmers and irrigational workers, and also the women contacting to the water infected with parasites during homework.
• the whole communities living in endemic areas.

The schistosomiasis is safely and effectively treated prazikvantely. Medicine is prescribed to children in the dose depending on body weight (50 mg of a prazikvantel on 1 kg of body weight). For purpose of the correct dose of children or weigh or, what is easier, measure their growth. Growth and weight are connected among themselves therefore growth can be used instead of weight for calculation of quantity of tablets of a prazikvantel which should be prescribed the child. It is the simplest to make it by means of "tabletkomer" (‘tablet pole’) which represents a lath for measurement of growth of children with the divisions put on it with the indication of the quantity of tablets corresponding to growth of the child. For determination of the correct quantity of tablets for each child, it just lean against "tabletkomer".

Praziquantel for treatment of a schistosomiasis it is possible without threat for health to appoint along with the albendazole applied to treatment of the infections caused by intestinal geohelminths, such as round worms, threadworms and ankylostomas.

Repeated infection of a shistosomama is very probable therefore the course of treatment should be repeated in a year if the child was again infected. It is treated with the doctor or the medical and sanitary worker, and also the teachers trained in treatment of children at school.

Who cannot be treated?
• If children already ail for any other reason, for example, have the increased temperature, the course of treatment should be postponed until improvement of health.
• If girls are pregnant, it is not necessary to appoint by it a course of treatment within the first three months of pregnancy.
• Children with a chronic disease, such as drepanocytic anemia.
• Children aged up to one year.

Whether any side effects are observed?
The praziquantel is absolutely safe, and most of people does not feel any side effects from its reception; only the insignificant number of patients report about easy and short-term symptoms. They can include a headache, the increased temperature, a stomach ache, diarrhea and vomiting. Manifestation of side effects at people with a severe form of helminthosis is the most probable. If heavy and ongoing side effects are observed, children should be sent to hospital. Children before drug intake should give a small portion of the main food for prevention of any side effects.

What benefit is brought by treatment?
The schistosomiasis can result in very serious condition of the patient and therefore it is important, in order to avoid some infection effects described above, to treat children. After treatment at children overall health improves, they pass school because of diseases much less, they improve ability to concentrate and they work during school lessons more actively.