Diagnosis Of Schistosomiasis
Schistosomiasis, or bilharzia, is a common intravascular
infection caused by parasitic Schistosoma trematode worms
It is prevalent in Africa, the Middle East, South America, and Asia
Acute schistosomiasis, or Katayama syndrome, can present as fever, malaise, myalgia, fatigue, non-productive cough, diarrhoea (with or without blood), haematuria (S haematobium), and right upper quadrant pain
Chronic and advanced disease results from the host’s
immune response to schistosome eggs deposited in
tissues and the granulomatous reaction evoked by the antigens they secrete
S mansoni, S japonicum, S intercalatum, and S mekongi cause intestinal disease; S haematobium causes urinary disease
Neuroschistosomiasis is arguably the most severe clinical
syndrome associated with schistosome infection
Microscopic examination of excreta (stool, urine) is the gold standard diagnostic test but requires the adult worms to be producing eggs; serological tests can diagnose less advanced infections
Praziquantel 60 mg/kg in three doses over one day (S japonicum and S.mekongi); and 40 mg/kg in doses over one day (S mansoni, S haematobium, S intercalatum) remains the treatment of choice although others are being investigated
Preventive
chemotherapy is with a single oral dose of praziquantel 40 mg/kg
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