Which populations are at risk for schistosomiasis (bilharzia)?

Updated: Jun 11, 2020
  • Author: Shadab Hussain Ahmed, MD, AAHIVS, FACP, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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Today, 120 million people are symptomatic with schistosomiasis, with 20 million having severe clinical disease. [1] More than 200,000 deaths per year are due to schistosomiasis in sub-Saharan Africa. [13] Women washing clothes in infested water are at risk. [14] Hygiene and playing in mud and water make children vulnerable to infection. Forty million women of childbearing age are infected. [15] Approximately 10 million women in Africa have schistosomiasis during pregnancy. [15] In endemic areas, the infection is usually acquired as a child. [4]

In Brazil and Africa, refugee movements and migration to urban areas are introducing the disease to new locations. Increasing population size and corresponding needs for power and water have led to increased transmission. Infections are not uniformly distributed within communities. It has been estimated that 5-10% of an endemic community may be heavily infected, and the remainder has mild to moderate infections. The risk of infection is highest amongst those who lived near lakes or rivers. [16] In Uganda, almost no transmission was found to have occurred at altitudes greater than 1400 m or where the annual rainfall was less than 900 mm. [16]

With the rise of tourism and travel, an increasing number of tourists are contracting it. Tourists often present with severe acute infection and unusual problems including paralysis.

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