Posts or Comments 28 September 2021

Schistosomiasis &water Bill Brieger | 20 Aug 2021 05:22 am

Schistosomiasis in Mozambique, the Importance of WASH

As part of the class blog in the Course, Social and Behavioral Foundations in Primary Health Care at the Johns Hopkins Bloomberg School of Public Health, students occasionally write about tropical diseases. Below we are re-posting one such blog by an author going by the username of “kamilinea.”

Photo by mrjn Photography on Unsplash

Schistosomiasis is a parasitic disease, estimated to affect more than 240 million people globally, in which transmission and propagation is dependent upon human exposure to contaminated freshwater. This disease, which has a prevalence of approximately 50% in Mozambique, can cause significant morbidity including blood in the urine or stool, scarring and calcification of the bladder, kidney damage, liver and spleen enlargement, scarring of the liver, genital lesions, vaginal bleeding, infertility, and eventual possible cancer of the bladder along with rare spinal cord damage. Children, who are particularly susceptible to this disease through playing in freshwater, can develop anemia, stunted growth, and intellectual delays.

Exposure typically occurs while bathing, washing clothes, swimming, fishing, or working in contaminated fresh water including lakes, streams, and rivers. Although mass drug administration (MDA) with praziquantel is a main focus of disease control, treatment does not prevent reinfection. Multiple studies have concluded that elimination is currently impossible without infrastructure changes resulting in improvements in water, sanitation, and hygiene (WASH) throughout Mozambique. Providing these changes would allow citizens to avoid exposure to schistosomiasis as well as many other infectious diseases.

Figure 2.

Distribution of Schistosomiasis haematobium in Mozambique, The American Journal of Tropical Medicine and Hygiene Am J Trop Med Hyg

A policy that implements infrastructure changes throughout Mozambique to increase WASH is necessary to improve control and progress toward elimination. More specifically, a policy that would support development of safe-water wells throughout rural regions of Mozambique would allow for sustainable access to safe water. For this policy to be effective, buy-in and support from many stakeholders is imperative including the communities themselves, the government, and the Ministry of Health and organizations such as the WHO, the Schistosomiasis Control Initiative, and the Water and Sanitation Program. The government would need to provide financial support, however funding could be obtained through the World Bank which already supports some WASH programs throughout the country.

Schistosomiasis is a disease that could be eliminated in Mozambique through various control efforts, however elimination is currently not possible without improvements in WASH. All efforts should be made to encourage the government of Mozambique to prioritize this effort and involve supporting organizations in order to eliminate schistosomiasis.

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