Shail Bhatt explores schistosomiasis, a neglected tropical disease.
Imagine a worm burrowing its way through the skin of your feet and entering your organs, destroying your liver and kidneys. Imagine you’re a 6-year old child playing or helping your parents in the fields and you feel something wriggling into your pores. Days later you feel sick: your stomach starts to hurt, you develop horrible rashes, you cough and you cough and you cough. But you’re one of the lucky ones; there are others whose livers swell up, who always feel tired, who get cancer, who die. Schistosomiasis.
The problem is that most people don’t even know about it, let alone imagine it. Schistosomiasis has been reported in 78 countries, affects nearly 200 million people and kills nearly 200,000 people each year. It is the second most disruptive disease in tropical and subtropical areas after malaria, in terms of socioeconomic impact, and yet media coverage and public knowledge are surprisingly sparse. It’s a neglected tropical disease. Why?
The people haunted by schistosomiasis, also known as bilharzia and snail fever, generally live in developing countries, and 90% of those requiring immediate treatment live in Africa. These diseases spread and become endemic due to poverty and poor standards of living. The victims are despondent and impoverished and lack proper representation. The lack of awareness of those in danger and a dearth of proper education only propagates the disease further. On the other hand, insufficient monitoring and guidance by international organisations and countries, and underwhelming support from non-governmental organisations (NGOs) only exacerbates the already worse situation.
Schistosomiasis is caused by the larval form of the parasitic worms released from infected snails in freshwater. In the body the worms wriggle their way through the blood vessels to the urinary tract or intestines, and the females release their eggs. The disease is transmitted when affected individuals contaminate freshwater through their faeces or urine, which allows the eggs to hatch and infect other snails. Individuals swimming, drinking, bathing, or walking in that water all risk getting plagued. Meanwhile, some eggs remain trapped in the body and cause serious wreckage to the organs, leading to bloody diarrhoea, intestinal damage, and sometimes paralysis.
Regardless of the general lack of awareness around the world, there are several advancements being made to counter schistosomiasis. The weapon of choice against the schistosome worms is praziquantel, a drug which paralyses the parasites. These immobile parasites are then taken up by the body’s cells, destroyed and digested. All it requires is a single annual dose of praziquantel to treat schistosomiasis. However, with 200 million cases each year, only 80 million of these receive the preventative treatment.
But medicine alone won’t cut it. To really reduce the number of cases each year, it requires dedication and persistence. We need to come together to depollute our freshwater bodies and make water safe enough to drink. Effective and healthy sanitation, better infrastructure for toilets, and advocating cleaner practices will all have a dramatic positive influence on the number of new cases per year.
For more information on schistosomiasis and other neglected tropical diseases, visit: www.who.int/neglected_diseases/diseases/en/