|
|
| (27 intermediate revisions by 9 users not shown) |
| Line 1: |
Line 1: |
| __NOTOC__ | | __NOTOC__ |
| {{Infobox_Disease |
| |
| Name = {{PAGENAME}} |
| |
| Image = Schistosomiasis_itch.jpeg |
| |
| Caption = Skin vesicles created by the penetration of Schistosoma. Source: CDC |
| |
| DiseasesDB = |
| |
| ICD10 = {{ICD10|B|65||b|65}} |
| |
| ICD9 = {{ICD9|120}} |
| |
| ICDO = |
| |
| OMIM = |
| |
| MedlinePlus = |
| |
| MeshID = D012552 |
| |
| }}
| |
| {{Schistosomiasis}} | | {{Schistosomiasis}} |
| {{CMG}} | | {{CMG}}; {{AE}} {{ADG}} {{JH}}. |
|
| |
|
| | '''For patient information, click [[Schistosomiasis (patient information)|here]]''' |
|
| |
|
| | {{SK}} Bilharzia; Bilharziasis, Bilharziosis; Katayama fever, Blood fluke infection |
| | ==[[Schistosomiasis overview|Overview]]== |
|
| |
|
| | ==[[Schistosomiasis historical perspective|Historical Perspective]]== |
|
| |
|
| | ==[[Schistosomiasis classification|Classification]]== |
|
| |
|
| Occasionally [[central nervous system]] lesions occur: cerebral granulomatous disease may be caused by ectopic ''S. japonicum'' eggs in the [[brain]], and granulomatous lesions around ectopic eggs in the [[spinal cord]] from ''S. mansoni'' and ''S. haematobium'' infections may result in a transverse [[myelitis]] with flaccid [[paraplegia]]. Continuing infection may cause granulomatous reactions and [[fibrosis]] in the affected organs, which may result in manifestations that include:
| | ==[[Schistosomiasis pathophysiology|Pathophysiology]]== |
|
| |
|
| * Colonic [[polyposis]] with bloody diarrhea (''Schistosoma mansoni'' mostly);
| | ==[[Schistosomiasis causes|Causes]]== |
| * [[Portal hypertension]] with [[hematemesis]] and [[splenomegaly]] (''S. mansoni'', ''S. japonicum'');
| |
| * [[Cystitis]] and ureteritis (''S. haematobium'') with [[hematuria]], which can progress to [[bladder cancer]];
| |
| * [[Pulmonary hypertension]] (''S. mansoni'', ''S. japonicum'', more rarely ''S. haematobium'');
| |
| * [[Glomerulonephritis]]; and central nervous system lesions.
| |
|
| |
|
| ==Laboratory diagnosis== | | ==[[Schistosomiasis differential diagnosis|Differentiating Schistosomiasis from other Diseases]]== |
| Microscopic identification of eggs in [[feces|stool]] or [[urine]] is the most practical method for diagnosis. The stool exam is the more common of the two. For the measurement of eggs in the feces of presenting patients the scientific unit used is [[epg]] or [[eggs per gram]]. Stool examination should be performed when infection with ''S. mansoni'' or ''S. japonicum'' is suspected, and urine examination should be performed if ''S. haematobium'' is suspected.
| |
|
| |
|
| Eggs can be present in the stool in infections with all ''Schistosoma'' species. The examination can be performed on a simple smear (1 to 2 mg of fecal material). Since eggs may be passed intermittently or in small amounts, their detection will be enhanced by repeated examinations and/or concentration procedures (such as the formalin-ethyl acetate technique). In addition, for field surveys and investigational purposes, the egg output can be quantified by using the [[Kato-Katz technique]] (20 to 50 mg of fecal material) or the Ritchie technique.
| | ==[[Schistosomiasis epidemiology and demographics|Epidemiology and Demographics]]== |
|
| |
|
| Eggs can be found in the urine in infections with (recommended time for collection: between noon and 3 PM) S. japonicum' and with S. intercalatum. Detection will be enhanced by [[centrifugation]] and examination of the sediment. Quantification is possible by using filtration through a [[nucleopore]] membrane of a standard volume of urine followed by egg counts on the membrane. Investigation of ''S. haematobium'' should also include a pelvic x-ray as bladder wall calcificaition is highly characteristic of chronic infection.
| | ==[[Schistosomiasis risk factors|Risk Factors]]== |
|
| |
|
| Recently a field evaluation of a novel handheld microscope was undertaken in Uganda for the diagnosis of intestinal schistosomiasis by a team led by Dr. Russell Stothard who heads the Schistosomiasis Control Iniative at the Natural History Museum, London. His report abstract may be found here: [http://looksmall.com/news.asp]
| | ==[[Schistosomiasis natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
|
| |
|
| [[Image:Schistosoma bladder histopathology.jpeg|thumb|left|Photomicrography of bladder in ''S. hematobium'' infection, showing clusters of the parasite eggs with intense eosinophilia, Source: CDC]]
| | ==Diagnosis== |
| Tissue [[biopsy]] (rectal biopsy for all species and biopsy of the bladder for ''S. haematobium'') may demonstrate eggs when stool or urine examinations are negative.
| |
|
| |
|
| The eggs of ''S. haematobium'' are ellipsoidal with a terminal spine, ''S. mansoni'' eggs are also ellipsoidal but with a lateral spine, ''S. japonicum'' eggs are spheroidal with a small knob.
| | [[Schistosomiasis history and symptoms|History and Symptoms]] | [[Schistosomiasis physical examination|Physical Examination]] | [[Schistosomiasis laboratory findings|Laboratory Findings]] | [[Schistosomiasis other imaging findings|Imaging Findings]] | [[Schistosomiasis other diagnostic studies|Other Diagnostic Studies]] |
| | |
| [[Antibody]] detection can be useful in both clinical management and for [[epidemiologic]] surveys. | |
|
| |
|
| ==Treatment== | | ==Treatment== |
| Schistosomiasis is readily treated using a single oral dose of the drug [[Praziquantel]]. While Praziquantel is safe and highly effective in curing an infected patient, it does not prevent re-infection by cercariae and is thus not an optimum treatment for people living in endemic areas. As with other major parasitic diseases, there is ongoing and extensive research into developing a vaccine that will prevent the parasite from completing its life cycle in humans.
| |
|
| |
| [[Antimony]] has been used in the past to treat the disease. In low doses, this [[toxic]] metalloid bonds to [[sulfur]] atoms in [[enzymes]] used by the parasite and kills it without harming the host. This treatment is not referred to in present-day peer-review scholarship; [[Praziquantel]] is universally used. Outside of the US, there is a second drug available for treating ''Schistosoma mansoni'' (exclusively) called [[Oxamniquine]].
| |
|
| |
| Mirazid, a new Egyptian drug, is under investigation for oral treatment of the disease.
| |
|
| |
| Experiments have shown medicinal [[Castor oil]] as an oral anti-penetration agent to prevent Schistosomiasis and that praziquantel's effectiveness depended upon the vehicle used to administer the drug (e.g., Cremophor / Castor oil).<ref>{{cite web | title=Schistosoma mansoni: experimental chemoprophylaxis in mice using oral anti-penetration agents. | url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=2507345&query_hl=1itool=pubmed_docsum | format=| publisher=pubmed | accessdate=2007-01-25}}</ref>
| |
|
| |
| Additionally Dr Chidzere of Zimbabwe researched the Gopo Berry (''Phytolacca dodecandra'') during the 1980's and found that the Gopo Berry could be used in the control of the freshwater snails which carry the bilharzia disease (Schistosomiasis parasite). Dr Chidzere in his interview to Andrew Blake (1989) reported concerns of muti-national chemical companies keen to rubbish the Gopu Berry alternative for snail control <ref> The Gopu Berry p33. Part 4 School Journal number.2 1989 Dept of Education Wellington N.Z </ref>. Reputedly Gopo Berries from hotter Ethiopia climates yield the best results. Later studies were between 1993-95 by the Danish Research Network for international health. <ref> http://enrecahealth.ku.dk/postgrad_dbl_en/chihaka_abs/ </ref>
| |
|
| |
| ==Prevention through good design==
| |
|
| |
| The main focus of prevention is eliminating the water-borne snails which are [[natural reservoir]]s for the disease. This is usually done by identifying bodies of water, such as lakes, ponds, etc., which are infested, forbidding or warning against swimming and adding niclosamide, [[acrolein]], [[copper sulfate]], etc., to the water in order to kill the snails.
| |
|
| |
| Unfortunately for many years from the 1950s onwards, despite the efforts of some clinicians to get civil engineers to take it into account in their designs, civil engineeers built vast dam and irrigation schemes, oblivious of the fact that they would cause a massive rise in water-borne infections from schistosomiasis, even though with a little care the schemes could have been designed to minimise such effects, the detailed specifications having been laid out in various UN documents since the 1950s. Irrigation schemes can be designed to make it hard for the snails to colonise the water, and to reduce the contact with the local population.
| |
| <ref>Charnock, Anne (1980) Taking Bilharziasis out of the irrigation equation. New Civil Engineer, 7 August. 1980 Bilharzia caused by poor civil engineering design due to ignorance of cause and prevention</ref>
| |
|
| |
| Failure for engineers to take this into account is an interesting example of the Relevance Paradox and is a good example of the failure of formal education and information systems to transmit tacit knowledge.
| |
|
| |
| ==Prevention and hygiene==
| |
| Prevention is best accomplished by eliminating the water-dwelling snails which are the [[natural reservoir]] of the disease. [[Acrolein]], [[copper sulfate]], and niclosamide can be used for this purpose. Recent studies have suggested that snail populations can be controlled by the introduction or augmentation of existing crayfish populations; as with all ecological interventions, however, this technique must be approached with caution.
| |
|
| |
| Individuals can guard against schistosomiasis infection by avoiding bodies of water known or likely to harbor the carrier snails.
| |
|
| |
| In 1989, Aklilu Lemma and Legesse Wolde-Yohannes received the Right Livelihood Award for their research on the sapindus-Plant (''Phytolacca dodecandra''), as a preventative measure for the disease.
| |
|
| |
|
| == Histopathology: Rectum, Schistosomiasis==
| | [[Schistosomiasis medical therapy|Medical Therapy]] | [[Schistosomiasis prevention|Prevention]] | [[Schistosomiasis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Schistosomiasis future or investigational therapies|Future or Investigational Therapies]] |
|
| |
|
| {{#ev:youtube|9VpqxnPRvL8}}
| | ==Case Studies== |
| | [[Schistosomiasis case study one|Case #1]] |
|
| |
|
| == See also == | | == Related Chapters== |
| * [[Tropical disease]] | | * [[Tropical disease]] |
| | * [[Schistosoma]] |
| | * [[Swimmer's itch]] |
|
| |
|
| ==References==
| |
| <references/>
| |
| * [[Center for Disease Control]], ''[http://www.dpd.cdc.gov/dpdx/HTML/Schistosomiasis.htm Schistosomiasis]''. (2004)
| |
|
| |
| ==External links==
| |
| * [http://www.who.int/wormcontrol/en/ World Health Organization Partners for Parasite Control website]
| |
| * [http://www.who.int/wormcontrol/documents/fact_sheets/schistosomiasis/en/ World Health Organization fact sheet on the disease]
| |
| * [http://www.wellcome.ac.uk/en/labnotes5/animation_popups/schisto.html Wellcome animation of the life cycle of the parasite]
| |
| * [http://www.schisto.org Schistosomiasis Control Initiative]
| |
| * [http://www.eu-contrast.eu CONTRAST, a research project on optimized schistosomiasis control in Sub-saharan Africa]
| |
| * [http://www.who.int/tdr/ World Health Organization Tropical Disease Research programme]
| |
| * [http://www.path.cam.ac.uk/~schisto Cambridge University Schistosomiasis Research Group]
| |
| * [http://www.york.ac.uk/res/schisto/ York University Schistosomiasis Research Group]
| |
| * [http://www.cartercenter.org/healthprograms/program4.htm Schistosomiasis (Bilharzia) Control and Prevention: The Carter Center Schistosomiasis Control Program]
| |
| * [http://www.lib.uiowa.edu/hardin/md/schistosomiasis.html Links to Schistosomiasis pictures (Hardin MD/Univ of Iowa)]
| |
| * [http://bioinfo.cpqrr.fiocruz.br FIOCRUZ - Schistomiasis Research Group]
| |
| * [http://www.ucsf.edu/mckerrow/slide.html Sandler Center for Basic Research in Parasitic Diseases, University of California San Francisco]
| |
| * [http://www.neighbourhoodnews.com.au/default.asp?sourceid=&smenu=1&twindow=&mad=&sdetail=3948&wpage=1&skeyword=&sidate=&ccat=&ccatm=&restate=&restatus=&reoption=&retype=&repmin=&repmax=&rebed=&rebath=&subname=&pform=&sc=1175&hn=neighbourhoodnews&he=.com.au Vacine developed in Queensland, Australia]
| |
| *[http://www.dblnet.dk DBL - Centre for Health Research and Development]
| |
| *10. Charnock, Anne (1980) Taking Bilharziasis out of the irrigation equation. New Civil Engineer, 7 August. Bilharzia caused by poor civil engineering design due to ignorance of cause and prevention.
| |
|
| |
| <!-- [[Category:Diving medicine]] No connection with diving made in the article! -->
| |
|
| |
|
| {{Link FA|it}} | | {{Link FA|it}} |
| Line 118: |
Line 59: |
| [[tr:Şistozomiyaz]] | | [[tr:Şistozomiyaz]] |
|
| |
|
| | | [[Category:Disease]] |
| [[Category:Water-borne diseases]] | | [[Category:Water-borne diseases]] |
| [[Category:Parasitic diseases]] | | [[Category:Parasitic diseases]] |
| Line 125: |
Line 66: |
| [[Category:Hepatology]] | | [[Category:Hepatology]] |
| [[Category:Neglected diseases]] | | [[Category:Neglected diseases]] |
| [[Category:Infectious disease]]
| | |
|
| |
|
| {{WikiDoc Help Menu}} | | {{WikiDoc Help Menu}} |
| {{WikiDoc Sources}} | | {{WikiDoc Sources}} |