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Treatment and prevention of schistosomiasis

Authors
Patrick Soentjens, MD
Joannes Clerinx, MD, DTM
Section Editor
Peter F Weller, MD, FACP
Deputy Editor
Elinor L Baron, MD, DTMH

INTRODUCTION

Schistosomiasis is a disease caused by infection with parasitic blood flukes. The three major species are Schistosoma mansoni (Africa and South America), S. japonicum (East Asia), and S. haematobium (Africa and the Middle East). The two minor species are S. mekongi (Laos, Cambodia) and S. intercalatum (West and Central Africa).

The treatment and prevention of schistosomiasis will be reviewed here. The epidemiology, pathogenesis, clinical features, and diagnosis of schistosomiasis are discussed separately. (See "Epidemiology, pathogenesis, and clinical manifestations of schistosomiasis" and "Diagnosis of schistosomiasis".)

TREATMENT

Treatment of schistosomiasis serves three purposes: reversing acute or early chronic disease, preventing complications associated with chronic infection, and preventing neuroschistosomiasis. The goal of treatment is reduction of egg production via reduction of worm load; this reduces morbidity and mortality even in the absence of complete worm eradication [1].

Benefits of treatment include reversal of hydronephrosis and regression of periportal fibrosis and portal hypertension. Treatment is not beneficial for reversing late-stage fibrosis of the hepatic or urinary tract or reversing secondary complications such as esophageal varices or cor pulmonale.

Clinical approach

Acute infection

Swimmer's itch — Swimmer's itch is usually caused by nonhuman schistosome species; humans are not suitable hosts so the organism dies while in the skin. The rash typically clears within a few days; treatment consists of symptomatic management for pruritis. (See "Pruritus: Overview of management".)

             

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Literature review current through: Nov 2016. | This topic last updated: Thu Jul 28 00:00:00 GMT+00:00 2016.
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