Schistosomiasis In Africa

Schistosomiasis in Africa is an unpleasant disease spread by contact with fresh water. The disease is also known as bilharzia.

schistosomiasis map
Darker areas = prevalent disease - WHO 2020

Schistosomiasis Facts

  • In Africa there are 2 types of worm, whose life cycles require fresh water snails, that cause schistosomiasis or bilharzia.
  • These worms either inhabit the bladder veins causing urinary schistosomiasis or inhabit the walls of the intestines causing intestinal schistosomiasis.
  • Worm eggs leave the body via urine or faeces and hatch in fresh water where they need water snails to develop further.
  • More larvae are produced and swim freely in fresh water seeking to penetrate the skin of a human host
  • Schistosomiasis in Africa is contracted through the skin from fresh water contaminated with urine or faeces of an infected person.
  • Baboons can also be responsible for water contamination. So even places with minimal human habitation, bilharzia can still flourish in fresh water.
  • It is second only to malaria as a public health problem in tropical and sub-tropical areas.
  • Any hunter in areas where schistosomiasis is endemic is at risk. This includes most of Africa.

Schistosomiasis Symptoms

  • Watch out for a tingling skin sensation and/or rash (swimmer's itch) a few hours after being in infected water.
  • Though this subsides, it does not mean you have not got bilharzia.
  • See a doctor if you get fevers, general malaise, abdominal pain and blood in the urine or stool.

Summary For African Travellers and Hunters

  • Never assume fresh water to be free from bilharzia in any endemic area. Even deep water, far offshore cannot be regarded as safe. Salt, brackish and polluted waters are safe.
  • Hunters should avoid paddling or swimming in fresh water lakes, streams, rivers or slow running water. Sometimes it may be unavoidable if you need to cross a small, shallow river when out hunting. A good hunter's tip is to carry a couple of strong bin bags and put one on each leg to wade the water.
  • Cross rivers upstream of human habitation if possible.
  • Avoid neglected swimming pools.
  • Wear long trousers and long sleeves and dry out immediately after getting wet.
  • Quick drying of exposed areas can offer some protection, due to larvae needing water to survive.
  • Wear water-proof boots when possible.
  • If you know you have been in potentially infected water, get a medical check-up when home, 30-40 days after infection. Any earlier and the eggs may not show up as they take 30-40 days to be produced. Make sure stool and urine samples are taken.

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Page Updated: Mar 2024

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