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Chronic Illn. 2008 Mar;4(1):65-79. doi: 10.1177/1742395307084407.

The unacknowledged impact of chronic schistosomiasis.

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1
Center for Global Health and Diseases, Case Western Reserve University School of Medicine 10900 Euclid Avenue, Cleveland, Ohio 44106-7286, USA. chk@cwru.edu

Abstract

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.

PMID:
18322031
DOI:
10.1177/1742395307084407
[Indexed for MEDLINE]
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