July is Schistosomiasis Month

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Tuesday, July 15, 2014


EVERY year, the month of July is charted among health departments and health ministries worldwide as the schistosomiasis awareness month.

Likewise, I have written an article regarding this infectious disease in this column, which was published last year.

I’ve thought it as an obligation to write something about this pathology as a health professional and a medical journalist.

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Because as a health professional, it is my responsibility to promote health by any means possible since the day I had sworn my oath as a nurse and a midwife.

And consistent to this idealism is the fact that I am privileged to become a regular columnist of a community paper, which can be instrumental in getting the health-related messages across to readers.

To jumpstart the topic, schistosomiasis, as defined by the World Health Organization (WHO), is an acute and chronic parasitic disease caused by blood flukes, which are “trematode worms” that are of the genus “schistosoma.”

WHO informs that transmission of schistosomiasis occurs when an already infected person contaminate freshwater sources with their excreta containing parasite eggs which hatch in water.

Last year, I explained in my column the life cycle of this communicable disease which can be summarized as follows:

Firstly, free-swimming larvae of this parasite search for a snail, which is its intermediate host;

Secondly, once inside the snail, it transforms into another form of larva called “cercariae”;

Thirdly, once these cercariae are mature enough, they would be released to the water to wait for a human host;

Fourthly, if a human host’s body has breaks in the skin and comes in contact with the cercariare-infested water, then these parasites readily enter the host’s body.

Once inside the body, these parasites travel to the intestines and then the liver, where they mature and multiply.

As parasites, the products of their conception are eggs that are released in the human host’s urine and feces.

The life cycle then is completed and ready to undergo the same process with another intermediate snail and susceptible hosts with favorable portal of entry—a broken skin such as cuts or wounds that are exposed to contaminated water.

Considering the host’s organs involved with this parasitic infection, the following are the signs and symptoms of schistosomiasis: (1) diarrhea; (2) bloody stools; (3) liver and spleen enlargement; (4) weakness; and (5) inflammation of the liver or hepatitis.

Bladder cancer and kidney damage are the common complications of schistosomiasis.

Schistosomiasis can be diagnosed through microscopic examination of the victim’s stool and urine specimens, intradermal tests and serological tests.

According to Merck Manual of medical Information, medical treatment of schistosomiasis includes antiparasitic agents such as praziquantel, oxamniquine and metrifonate.

This pathology is common among farmers who use the traditional ways of farming in the absence of personal protective equipment such as boots.

Likewise, the magnitude of schisotosmiasis prevalence is reflective of the extent of poverty and socio-economic problems in a country infested with infectious disease at the sociological level.

As a matter of fact, WHO maintains that schistosomiasis is prevalent in tropical and sub-tropical areas, especially in poor communities without access to safe drinking water and adequate sanitation. Take note, the Philippines is a tropical country.

To prevent infection, experts advise the following:

(1) People living in endemic areas must be educated regarding the mode of transmission and methods of protection;

(2) Dispose of feces and urine so that viable eggs will not reach bodies of fresh water containing intermediate snail host;

(3) Treat snail-breeding sites with molluscicides;

(4) Prevent exposure to contaminated water. If accidental exposure deso occur, apply 70 percent alcohol immediately to skin to kill surface cercariae;

(5) Travellers visiting endemic areas should be advised of the risks and informed about the preventive measures; and

(6) Lastly and most importantly, maintain a healthy intact skin that is free of wounds, cuts or abrasions as these may provide an opportunistic portal of entry of mature cercariae.

Sources: The Merck manual of Medical Information, World Health Organization Data bank; and Public Health Nursing in the Philippines.

[E-mail: polo.journalist@gmail.com]

Published in the Sun.Star Cagayan de Oro newspaper on July 15, 2014.

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