The unacknowledged impact of chronic schistosomiasis

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


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.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Anemia / parasitology
  • Animals
  • Chronic Disease
  • Comorbidity
  • Developing Countries
  • Humans
  • Quality of Life
  • Schistosoma / immunology
  • Schistosoma / pathogenicity*
  • Schistosomiasis* / complications
  • Schistosomiasis* / parasitology
  • Schistosomiasis* / prevention & control