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The unacknowledged impact of chronic schistosomiasisCenter for Global Health and Diseases, Case Western Reserve University School of Medicine 10900 Euclid Avenue, Cleveland, Ohio 44106-7286, USA, chk{at}cwru.edu
Columbia University, New York, NY 10027, USA Objectives: To summarize new knowledge on the range of disease due to chronic schistosomiasis and examine the debilitating burden of both light and heavy infection; to outline goals of disease prevention, including current age-targeted strategies and more extended programmes aimed at preventing transmission. Methods: A systematic search of 2004—2007 papers via PUBMED and related databases using `schistosom' and disability- or treatment-related subject headings. Reports were independently reviewed for inclusion. Results: Sixty-eight papers met review objectives. These suggest new evidence for a causative link between schistosome infection, antiparasite inflammation, and risk for anaemia, growth stunting and undernutrition in affected populations, as well as exacerbation of co-infections and impairment of cognitive development and work capacity. Formal quality-of-life assessment defines a significant 9.5—24% disability with the most aggressive schistosome species, Schistosoma japonicum. Discussion: Schistosomiasis represents a serious but under-recognized disease burden for many developing countries. Infection (and not intensity of infection) should be considered the defining feature of morbidity formation. Links between infection and long-term disabilities reduce the chances of combating rural poverty. Changes in our appreciation of schistosomiasis-related disease burden means it is no longer appropriate to leave infected persons untreated, and newer approaches to control should focus on preventing transmission.
Key Words: Burden of illness • Developmental disabilities • Parasitic diseases • Quality-of-life • Schistosomiasis
Chronic Illness, Vol. 4, No. 1,
65-79 (2008) This article has been cited by other articles:
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