SCHISTOSOMIASIS

and OTHER
INTESTINAL
HELMINTHES
SCHISTOSOMIASIS
 chronic tropical disease
 Bloodfluke called Schistosoma
Japonicum
 Transmitted through the intermediary host of a
tiny snail known as Oncomelania Quadrazi.asi.
SCHISTOSOMIASIS:
- is one of the most widespread parasitic
infection afflicting mankind for a long
time (118 years in the Philippines)
- second to malaria in Prevalence
- rank first in prevalence among waterborne diseases
-thrives where environmental
sanitation is poor.
- eggs hatch into miracidia that
penetrate snail intermediate hosts
that inhabit these fresh water bodies
-total population of 12 million
exposed to the disease
Life Cycle of Schistosomiasis
Adult worms
live in portal
and
mesenteric
veins
Mode of
infection:
SKIN
PENETRATION
OF CERCARIAE
Schistosoma
eggs
pass out with
feces
and hatch in
fresh
Water into
miracidia.
Intermediate
host:
Oncomelania
snails

An area is endemic:
1.Presence of Positive cases
2.Presence of Infected Snails
( Oncomelania quadrasi )
Transmission
WASHING OF CLOTHES
DEFECATING ON SCHISTO
INFESTED AREA.
LAUNDERING IN SCHISTO ENDEMIC AREAS
S
Adult Worm of Schistosoma
Japonicum in the Portal Vein
LIVE IN THE BLOOD VESSEL
CONNECTING THE LIVER WITH
THE INTESTINE.
AVERAGE LIFE SPAN IS 3-5 YEARS
BUT CAN SURVIVE UP TO 30
YEARS OR MORE
SCHISTOSOMA EGG PRODUCED/ EGGLAYING
500 – 2000 EGGS / DAY /FEMALE
WORM
MIRACIDIUM
Life span is 48 hrs
Infective up to 24 Hrs.
CERCARIAE
Will survive for a maximum of 3 days, &
infective for 36 hrs.
Symptomatology :

Study showed that :
37.8 % = symptomatic
62.2 % = asymptomatic
Symptoms








Early Stage:
epigastric or abdominal pain
bloody-mucoid stool
dysenteric attacks
fever
Advance Stage:
enlargement of the abdomen
enlargement of the liver and spleen
epileptic seizures of the Jacsonian type
Cor-pulmonale
Soil-transmitted Helminth Infections
(ascariasis, trichuriasis, hookworm infection)
Caused by:
 ingestion of
eggs from
contaminated soil
(Ascaris and Trichuris)
or
 skin penetration by
larvae from the soil
(hookworms)
Poor environmental
sanitation (open
defecation) and poor
personal hygiene (dirty
hands) are major factors
People dirtying the environment
for exposure
infect other people…
Open defecation!
-helminth parasites of man include the
nematodes (roundworms), trematodes
(flukes) and cestodes (tapeworms)
-major cause of poor cognitive
development and physical retardation
and anemia in children
-Persevere in areas where poverty or
poor economic condition breed poor
personal hygiene and inadequate
sanitation.
- Highly agricultural communities
found to be high prevalence of STH.
- Erratic migration of ascaris worms
can lead to a very serious conditions
and even death.
s
EFFECTS OF STH
s
Enterobius Vermicularis
-
Human ‘pinworm”
Eggs of E. Vermicularis in Scotch
Tape or Cellulose Tape Preparation
Life Cycle E. Vermicularis
Signs and Symptoms
•Frequently asymptomatic
•Perianal pruritis
•Anorexia
•Irritability
•Abdominal pain
Treatment
Mebendazole,Abendazole
Strongyloides Stercoralis
Signs and Symptoms
•Frequently asymptomatic
•Abdominal pain
•Diarrhea
•Pulmonary symptoms
Laboratory Diagnosis
Identification of larvae
(rhabditiform form) through:
•DFS –follow-up stool exams 2-4 weeks
after treatment to confirm clearance of
infection.
•FECT
Treatment
•Ivermectin
•Albendazole
INTEGRATED CONTROL
PROGRAM FOR
SCHISTOSOMIASIS AND
OTHER INTESTINAL
HELMINTHES
Case Finding:
1.1 clinical diagnosis
* history of exposure
* symptoms
1.2 Laboratory diagnosis
* stool examination
( K/K method)
* blood exam (COPT )
CASE FINDING
Use of sanitary
toilets and safe
water supply
 reduction in the
transmission of schisto by
75 % can be achieved.
Use of Sanitary Facilities
Use of Foot bridges
Control of Stray
Animals
25 % reduction of
transmission can be
achieved
environmental sanitation
through the use of latrines can
prevent contamination of the
environment with eggs of STH,
schistosomes and food-borne
helminthes thus arresting the life
cycle.
2. ENVIRONMENTAL SANITATION
Health Education
 Objective:
- change undesirable
knowledge, attitudes &
practices for the improvement
of their personal & community
health.
Health education is needed to
convince people to use toilets
and to participate in other
control and prevention
activities of the Government
The impact:
 is measured in terms of
health enhancing behaviors;
the outcome is reduction in
morbidity & mortality
Preventive chemotherapy can prevent
development of serious morbidity as well
as transmission. 85% coverage should be
achieved in this intervention.
2.
Water , Sanitation And Hygiene ( WASH)
Water , Sanitation And Hygiene
( WASH)
> serves as the cornerstone in the reduction of
diseases specially those related to intestinal
parasitism.
> is formulated in line with the UNICEF’s water,
sanitation, and hygiene strategies for 2006 – 2015.
Control of Schistosomiasis
x
Adult worms live
in portal and
mesenteric veins
CHEMOTHERAPY
x
Mode of infection:
SKIN PENETRATION
OF CERCARIAE
PERSONAL
PROTECTION
x
Schistosoma eggs
pass out with feces
and hatch in fresh
Water
ENVIRONMENTAL
SANITATION
x
Intermediate host:
Oncomelania snails
SNAIL CONTROL
DESIRED BEHAVIOUR CHANGE
SUBMIT FOR EXAMINATION & TREATMENT
USE OF SANITARY FACILITIES
USE OF FOOTBRIDGES,
CONTROL OF STRAY ANIMA
PARTICIPATE IN SNAIL CONTROL MEASURES
Summary:
s
 Schistosomiasis is still a public health
problem.
 Helminthiasis affect people of all ages
and cause profound effects esp. on
children
Kato-Katz is use to diagnose
Schistosomiasis and STH
An integrated control program can be
used for Schisto and STH
The DISEASE is influenced by the 3P’s
people,parasite,poverty
Disposal of excreta containing
Schistosome eggs into fresh
water
SCHISTOSOMIASIS IS SPREAD
BY PEOPLE AND NOT BY SNAILS
 HUMAN
PARASITES ARE
A
REASONABLE INDICATION OF LACK OF
PERSONAL
CLEANLINESS
AND
HYGIENE
SONIA G. MARGALLO, RMT
Schisto/STH/ FWBD
Assistant Program Manager