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SCHISTOSOMIASIS/   BILHARZIOSIS              BY:       INUSAH ADAMS      4th yr med. Student        TDMU, Ukraine         ...
Bilhazia in Ghana
PLAN OF PRESENTATION DEFINITION EPIDEMIOLOGY ETIOLOGY MODE OF TRANSMISSION/LIFE CYCLE PATHOGENESIS SIGNS &SYMPTOMS ...
DEFINITION• Schistosomiasis is a chronic, parasitic  disease caused by blood flukes  (trematode worms) of the genus  Schis...
EPIDEMEOLOGYThe disease is found in Africa, South America, East Asia and Middle EastOver 230 million people require trea...
ETIOLOGY• Parasitic worms of schistosoma speciesMain species are;a. Schistosoma haematobiumb. Schistosoma mansonic. S. jap...
Two forms of schistosomiasis exist 1. Intestinal schistosomiasis and  2. Urogenital schistosomiasis
SCHISTOSOMA MANSONI (lateral spine)
SCHISTOSOMA HAEMATOBIUM(terminal spine)     • TT
RISK FACTORS• wading or swimming in lakes, ponds and  other bodies of water which are infested  with the snails• Fishing (...
LIFE CYCLE• : parasite eggs are released(by way of urination  or defecation) into the environment from infected  individua...
LIFE CYCLE
LIFE CYCL con’t
Schistosoma dermatitis or “swimmers itch”
1.           PATHOGENESIS forms of the     People become infected when larval     parasite – released by freshwater snails...
SIGNS & SYMPTOMS     • Clinical picture: low grade fever. Fatigue, weight loss and                                 anemia ...
DIFFERENTIAL DIAGNOSIS              UROGENITAL SCHISTOSOMIASIS• Renal tuberculosis ("golf-hole" (gaping) ureteral orifice ...
DIAGNOSTIC PLAN1.    stool examination for S. mansoni and ova2.    Urinalysis and urine for S. hematobium and ova3.    Gen...
clusters of the parasite eggs with      intense eosinophilia
Calcification of the urinary bladder
Yellow raised nodules surrounded by ahalo of hyperemia (TB of bladder)
Cystoscopy in tumor of kidney     (gross hematuria)
TREATMENT• Drug:     Prazequnatel          Dose: 40mg/kg single oral dose60mg/kg in 2 divided doses if quantity of ova is...
Urogenital schistosomiasis1.   cystitis2.   Urinary bladder cancer3.   Polyps, ulcers of urinary bladder4.   Hemospermia5....
• Always good especially with prompt  diagnosis and treatment         PROGNOSIS
PREVENTIONEducationEliminating the water-borne snails which are natural reservoirs for the diseaseAnnual dose of prazeq...
• GHANA AND BILHARZIA
Schistosomiasis
Schistosomiasis
Schistosomiasis
Schistosomiasis
Schistosomiasis
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Schistosomiasis

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i presented this lecture to members of the ghana medical association ternopil branch, ukraine

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Schistosomiasis

  1. 1. SCHISTOSOMIASIS/ BILHARZIOSIS BY: INUSAH ADAMS 4th yr med. Student TDMU, Ukraine DEC, 1ST, 2012 TDMU
  2. 2. Bilhazia in Ghana
  3. 3. PLAN OF PRESENTATION DEFINITION EPIDEMIOLOGY ETIOLOGY MODE OF TRANSMISSION/LIFE CYCLE PATHOGENESIS SIGNS &SYMPTOMS DIAGNOSIS DIFFERENTIALS TREATMENT COMPLICATIONS PROGNOSIS
  4. 4. DEFINITION• Schistosomiasis is a chronic, parasitic disease caused by blood flukes (trematode worms) of the genus Schistosoma• Also, called snail fever
  5. 5. EPIDEMEOLOGYThe disease is found in Africa, South America, East Asia and Middle EastOver 230 million people require treatment for schistosomiasis yearly90% of those requiring treatment for schistosomiasis live in Africa.More than 200,000 deaths per year are due to schistosomiasis in sub- Saharan Africa
  6. 6. ETIOLOGY• Parasitic worms of schistosoma speciesMain species are;a. Schistosoma haematobiumb. Schistosoma mansonic. S. japonicumd. S. mekongi ande. S intercalatum
  7. 7. Two forms of schistosomiasis exist 1. Intestinal schistosomiasis and 2. Urogenital schistosomiasis
  8. 8. SCHISTOSOMA MANSONI (lateral spine)
  9. 9. SCHISTOSOMA HAEMATOBIUM(terminal spine) • TT
  10. 10. RISK FACTORS• wading or swimming in lakes, ponds and other bodies of water which are infested with the snails• Fishing (both men and women)• Women washing clothes in infested water are at risk• People with STIs
  11. 11. LIFE CYCLE• : parasite eggs are released(by way of urination or defecation) into the environment from infected individuals.• The eggs hatch on contact with fresh water to release the free-swimming miracidium• Miracidium penetrates a water snail tissue where it develops into cercaria• Cercaria is release into the water from the snail• cercaria penetrates the skin of human (definitive host), circulate to organs (GIT, urinary tract)
  12. 12. LIFE CYCLE
  13. 13. LIFE CYCL con’t
  14. 14. Schistosoma dermatitis or “swimmers itch”
  15. 15. 1. PATHOGENESIS forms of the People become infected when larval parasite – released by freshwater snails – penetrate their skin during contact with infested water.2. the larvae develop into adult schistosomes3. Adult schistosomes live in the blood vessels where the females release eggs4. Some of the eggs are passed out of the body in the faeces or urine to continue the parasite life-cycle5. Others become trapped in body tissues (intestinal and urinary system), causing an immune reaction and progressive damage to organs.
  16. 16. SIGNS & SYMPTOMS • Clinical picture: low grade fever. Fatigue, weight loss and anemia • INTESTINAL SCHISTOSOMIASIS1. Abdominal pain2. Diarrhea3. Blood in stool, fresh or melena4. Hematemesis5. Liver enlargement UROGENITAL SCHISTOSOMIASIS1. Hematuria (terminal)2. dysuria3. Frequent need to urinate (polykauria)4. In females; genital lesions, vaginal bleeding, pain during sexual intercourse and nodules on the vulva, irregular menstruation
  17. 17. DIFFERENTIAL DIAGNOSIS UROGENITAL SCHISTOSOMIASIS• Renal tuberculosis ("golf-hole" (gaping) ureteral orifice is seen during cystoscopy, Yellow raised nodules) surrounded by a halo of hyperemia in bladder)• Urogenital tract cancer ( total hematuria, hematuria may stop and recur in a week, month or year time)• Urolithiasis (colicky pain) INTESTINAL SCHISTOSOMIASIS• Peptic ulcer disease (heartburns, GERD, endoscopically, ulcer in GIT)• Pancreatitis (H-like pain, vomiting that is worsened with eating, high diastase level, etc.)• cutaneous leishmaniasis (non-healing raised, scaling lesions on the skin)
  18. 18. DIAGNOSTIC PLAN1. stool examination for S. mansoni and ova2. Urinalysis and urine for S. hematobium and ova3. General blood analysis:4. Serological: hemagglutination test; reaction is positive @ a dilution of 1: 16 or more5. BUN and creatinine level6. Ureterocystoscopy7. Biopsy of rectum or urinary bladder8. Plain abdominal X-ray: chronic cases may show calcification and fibrosis of ureters, urinary bladder, ascites9. Intravenous urography: may show the level of ureter stricture10. Ultrasound of abdomen: hepatosplenomegaly, bilharzial hepatic fibrosis, ascites
  19. 19. clusters of the parasite eggs with intense eosinophilia
  20. 20. Calcification of the urinary bladder
  21. 21. Yellow raised nodules surrounded by ahalo of hyperemia (TB of bladder)
  22. 22. Cystoscopy in tumor of kidney (gross hematuria)
  23. 23. TREATMENT• Drug: Prazequnatel Dose: 40mg/kg single oral dose60mg/kg in 2 divided doses if quantity of ova is highReview in 2 weeks
  24. 24. Urogenital schistosomiasis1. cystitis2. Urinary bladder cancer3. Polyps, ulcers of urinary bladder4. Hemospermia5. Infertility6. Spontaneous abortion7. Renal failure8. anemia Intestinal schistosomiasis1. Liver fibrosis2. Intestinal cancer3. Portal hypertension/Pulmonary hypertension/ Cor pulmonale4. Ascites5. Esophageal varices6. MalnutritionCOMPLICATIONS
  25. 25. • Always good especially with prompt diagnosis and treatment PROGNOSIS
  26. 26. PREVENTIONEducationEliminating the water-borne snails which are natural reservoirs for the diseaseAnnual dose of prazequanteladding niclosamide, acrolein, copper sulfate, etc., to the water sources in order to kill the snails.Avoid swimming and contact with fresh water in endemic areasBoiling water for 1 minute will kill the parasite. (Filtration of drinking water )
  27. 27. • GHANA AND BILHARZIA

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