Bilharzia – a deadly and neglected disease

By Lahja Nashuuta

NAMIBIA is among the Southern Africa countries whereby it is not uncommon for women and young girls to find themselves waist-deep in rivers and streams washing clothes and fishing. 

It is a normal way of life for them, although they remain unaware of the fact that by doing so exposes them to Schistosomiasis parasites that can cause irreparable damage to their uterus.

Schistosomes are water-borne flatworms or blood flukes that enter the human body through the skin.

Some symptoms of schistosomiasis include fever, arthralgias, abdominal pain, bloody diarrhea, and hematuria. Women suffer considerably from female genital schistosomiasis that causes infertility, pre-term labour, anaemia, menstrual disorders, and dyspareunia.

Schistosomiasis, like many tropical diseases, is endemic in areas where poor living conditions and poverty are prevalent.

Women and children (peaking at age 10 to 19 years) are at high risk. Children play in water and women use water for their daily chores. 

Given the increased migration from rural to urban centres, the disease preference is also higher in informal settlements due to limited access to clean water and with inadequate sanitation provision.

The World Health Organization (WHO) said the harder to pronounce Schistosomiasis, which also known as Bilharzia or snail fever is one among 18 neglected tropical diseases and its global health impact is grossly underestimated.

In terms of impact, the Center for Disease Control of the United States reveals that this disease is second only to malaria as the most devastating parasitic disease.

WHO data indicates that currently, Schistosomiasis infects more than 200 million people worldwide. The estimated 166 million cases in sub-Saharan Africa represent 90 percent of the world’s cases.

The Study titled “The impact of human schistosomiasis in sub-Saharan Africa”, published in the Brazilian Journal of Infectious Diseases reveals that Schistosomiasis is second only to malaria as the most devastating parasitic disease in tropical countries and is considered one of the most devastating helminthic diseases among rural populations that cause about 534,000 deaths annually.

Despite Namibia having reached the leprosy elimination target of less than one case per 10,000 inhabitants nationally, there are still pockets of the disease in the northern regions particularly in Caprivi, Kavango and Omusati regions.

A study conducted the Ministry of Health and Social between 2000 and 2001 noted that the prevalence of schistosomiasis in Namibia ranges from 17 percent – 100 percent in Kavango region, 0 percent – 54 percent in Caprivi and Omusati regions.

The disease is associated with lack of hygiene and contact with infested water. However, little attention in terms of health public education and enrolling treatment has been done.

The World Health Organization has set itself the goal of controlling or eliminating neglected tropical diseases, among them schistosomiasis, by 2020 in order to improve and save the lives of hundreds of millions of people around the world.

Therefore in order to achieve the set goal countries should priorities and diverting some if the resources to the prevention and rolling out Bilharzia treatment especially in rural areas and schools. More efforts need to be done to ensure people have access to safe water, sanitation and health education through inter-sectoral collaboration as well as making sure those that are infected have access to treatment.

June 2017
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