1. Schistosomiasis (Bilharzia)
Alexis Flen| Infectious Diseases | UNC Chapel Hill
Treatment
Schistosomiasis
Rational Drug Treatment Strategy
Neglected Tropical Disease
Nematode Worm Fluke
Zoonotic Strains
Praziquantel
If 50% of children have bloody stool the area is treated
Cause
Vaccination is not available
PZQ resistance in two endemic areas and limitations
Strategy
Molecular Masking
Modification of host immune response
Malaria Drugs
Plant derived products
Cause and Effect
World Distribution
Endemic
Impoverished tropical areas that have unsanitary water conditions
Symptoms
Fever, chills, sweating, headache, diarrhea
Liver damage leads abdominal swelling
Morbidity
Extended life span
Schistosoma become resistant to treatment
Immunosuppression and lesions
Death
Predominately 90% of cases occur in Africa
70 million DALYS
Cercarie mortality before and after treatment
Sanguinarine caused paralysis
Plumbagin caused muscle contractions and head splitting
Intervention Strategies
Transmission
Intestinal
Urogenital
Rare Cases of Spinal and Cerebral
1.88 lg/ml for Plumbagin and lg/ml for Sanguinarin resulted in100% mortality in 48 hours
Can both alter the tegumental structure of the worms, which impacts the interface between the host and parasite
Country
Time
Strategy
Status
Brazil
Morbidity control (preventive chemotherapy using oxaminquine), health education, water supply and sanitation. Additionally, limited snail control (niclosamide)
Controlled
China
1940s-present
Chemical molluscicides environmental management, large-scale community participation and mechanization of agriculture, fencing of water buffalos
Japan s
Multisector Health Campaign continual surveillance, lining of canals and deworming of schools
Eliminated
Saudi Arabia
N/A
Snail control (chemical control using molluscicides) and environmental management; occasionally chemotherapy and health education. Later, biological control (competitor snails)
Close to Elimination
Immune Response
Works Cited
TH1 response leads to inflammation
TH2 response leads to granulomas
Chronic infection results in inability to combat infection with granulomas and subsequent fibrosis
Blanchard, Tom J. "Schistosomiasis." Travel Medicine and Infectious Disease 2.1 (2004): Print.
Pearce, Edward J., and Andrew S. Macdonald. "The Immunobiology of Schistosomiasis." Nature Reviews Immunology 2.7 (2002): Print.
"Prevention & Control." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 07 Nov Web. 18 Mar
Rollinson, David, Stefanie Knopp, Sarah Levitz, J. Russell Stothard, Louis-Albert Tchuem Tchuenté, Amadou Garba, Khalfan A. Mohammed, Nadine Schur, Bobbie Person, Daniel G. Colley, and Jürg Utzinger. "Time to Set the Agenda for Schistosomiasis Elimination." Acta Tropica (2013): Print.
"Schistosomiasis (bilharzia) ." Schistosomiasis (bilharzia). N.p., n.d. Web. 18 Mar
Tchuenté, Louis-Albert Tchuem, Sabine C. Momo, J. Russell Stothard, and David Rollinson. "Efficacy of Praziquantel and Reinfection Patterns in Single and Mixed Infection Foci for Intestinal and Urogenital Schistosomiasis in Cameroon." Acta Tropica (2013): Print.
Zhang, Si-Ming, and Kristen A. Coultas. "Identification of Plumbagin and Sanguinarine as Effective Chemotherapeutic Agents for Treatment of Schistosomiasis." International Journal for Parasitology: Drugs and Drug Resistance 3 (2013): Print.