Schistosomiasis Quiz
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Questions and Answers

Which prefix refers to the common name of schistosomiasis as 'snail fever'?

  • Hematobium
  • Trematodes
  • Bilharzia (correct)
  • Infested water

    • What is the primary mode of transmission for schistosomiasis in endemic regions?

  • Contact with infested water (correct)
  • Airborne particles
  • Insect bites
  • Contaminated food

    • Which Schistosoma species is primarily associated with genital lesions in women?

  • S japonicum
  • S mansoni
  • S haematobium (correct)
  • S bovis

    • What demographic is most likely to experience the highest prevalence of schistosomiasis infections?

    <p>Children and adolescents aged 10-19</p> Signup and view all the answers

    How many people were estimated to require preventive treatment for schistosomiasis in 2019?

    <p>236.6 million</p> Signup and view all the answers

    Which factor primarily contributes to the higher incidence of schistosomiasis in males compared to females?

    <p>Societal roles and activities</p> Signup and view all the answers

    Approximately what percentage of infected women with S haematobium may develop genital lesions?

    <p>30%</p> Signup and view all the answers

    Annually, how many deaths are attributed globally to schistosomiasis?

    <p>200,000</p> Signup and view all the answers

    What is the largest risk factor for schistosomiasis in people living in endemic regions?

    <p>Exposure to infested water</p> Signup and view all the answers

    In which regions is schistosomiasis considered endemic?

    <p>Africa, South America, the Caribbean, the Middle East, and Asia</p> Signup and view all the answers

    What is the primary reason for praziquantel's effectiveness in schistosomiasis treatment?

    <p>Reduction of egg excretion by 90%</p> Signup and view all the answers

    Which adverse effect is commonly associated with praziquantel treatment?

    <p>Fever after 24 hours</p> Signup and view all the answers

    Which of the following groups might require regular treatment with praziquantel in endemic areas?

    <p>High risk groups such as school-age children</p> Signup and view all the answers

    What additional treatment might be necessary for patients presenting with seizures during praziquantel therapy?

    <p>Anticonvulsant therapy</p> Signup and view all the answers

    What is a common symptom of Katayama Fever?

    <p>Fever and rash</p> Signup and view all the answers

    Which method is NOT an effective strategy for controlling schistosomiasis?

    <p>Allowing the incubation of untreated water for consumption</p> Signup and view all the answers

    Which clinical manifestation is associated with urinary schistosomiasis?

    <p>Dysuria</p> Signup and view all the answers

    What is a recognized complication of CNS schistosomiasis?

    <p>Paralysis</p> Signup and view all the answers

    Which drug is specifically mentioned for the treatment of S.haematobium?

    <p>Metrifonate</p> Signup and view all the answers

    What is a surgical option for treating complications from schistosomiasis?

    <p>Ligation of esophageal varices</p> Signup and view all the answers

    What type of eggs are characteristic of S.haematobium?

    <p>Oval with a spike at the tip</p> Signup and view all the answers

    Which treatment is recommended for acutely ill patients with schistosomiasis?

    <p>Antischistosomal drugs and corticosteroids</p> Signup and view all the answers

    Which of the following statements about praziquantel resistance is true?

    <p>It can develop over time with repeated treatments.</p> Signup and view all the answers

    What is the recommended action after accidental exposure to contaminated water to reduce cercarial penetration?

    <p>Dry skin and apply 70% alcohol</p> Signup and view all the answers

    Which complication can arise from schistosomiasis related to pregnancy?

    <p>Ectopic pregnancies</p> Signup and view all the answers

    Which of the following statements about schistosomes is incorrect?

    <p>Immunity from schistosomiasis is universally strong and fully understood.</p> Signup and view all the answers

    Which of the following is not a symptom of intestinal schistosomiasis?

    <p>Hematuria</p> Signup and view all the answers

    What is a common method for diagnosing schistosomiasis?

    <p>Microscopic detection of eggs</p> Signup and view all the answers

    Which statement about schistosomiasis treatment is true?

    <p>A second treatment course may be necessary several weeks later.</p> Signup and view all the answers

    Which of the following symptoms is associated with cardiopulmonary schistosomiasis?

    <p>Cough and mild wheezing</p> Signup and view all the answers

    Which schistosome species is primarily associated with Biomphalaria snails as their intermediate hosts?

    <p>Schistosoma mansoni</p> Signup and view all the answers

    What is a symptom indicating a confirmed case of urinary schistosomiasis?

    <p>Positive reagent strip for hematuria</p> Signup and view all the answers

    Which schistosome is known to cause swimmer's itch in humans?

    <p>Trichobilharzia ocellata</p> Signup and view all the answers

    Which species of Schistosoma is found in the rain forest areas of Central Africa?

    <p>Schistosoma guineensis</p> Signup and view all the answers

    What is a characteristic of the incubation period for schistosomiasis?

    <p>It includes symptoms of katayama fever</p> Signup and view all the answers

    Which schistosome species is known for causing intestinal schistosomiasis in Asia, particularly in China and the Philippines?

    <p>Schistosoma japonicum</p> Signup and view all the answers

    Which species serves as an important reservoir for Schistosoma japonicum?

    <p>Dogs and cats</p> Signup and view all the answers

    Which of the following is not a symptom of acute systemic manifestation following schistosomiasis exposure?

    <p>Hematuria</p> Signup and view all the answers

    What distinguishes a suspected case of intestinal schistosomiasis from a confirmed case?

    <p>Presence of eggs in stool</p> Signup and view all the answers

    Which schistosomiasis type is primarily spread through human reservoirs?

    <p>Urogenital schistosomiasis</p> Signup and view all the answers

    Study Notes

    Schistosomiasis Overview

    • Schistosomiasis, also known as bilharzia or snail fever, is a parasitic disease caused by flukes (trematodes) of the genus Schistosoma.
    • It's the third most devastating tropical disease globally, impacting morbidity and mortality in developing countries in Africa, South America, the Caribbean, the Middle East, and Asia.
    • More than 140 million people are currently infected, with an estimated 700 million at risk in 76 countries.
    • An estimated 200,000 deaths are attributed to schistosomiasis annually.

    Epidemiology

    • The World Health Organization (WHO) estimates 220.8 million people needed preventive treatment in 2017.
    • 102.3 million received treatment in 2017.
    • At least 236.6 million people required preventive treatment in 2019.
    • Schistosomiasis disproportionately affects men due to exposure from activities including bathing, swimming, and agriculture.
    • Children and adolescents are most heavily and frequently infected.
    • In some endemic areas, prevalence in those aged 10-19 reaches nearly 100%.
    • Affected individuals in travel show a different age distribution, with young adults at higher risk.

    Etiological Agent and Species

    • Schistosoma hematobium, Schistosoma mansoni, and Schistosoma japonicum are the prevalent species causing the most severe cases of the disease.
    • Less prevalent species, such as S. mekongi and S. intercalatum, may also cause human disease.

    Snail Hosts

    • The different species of Schistosoma have different snail intermediate hosts.
    • S. mansoni - Biomphalaria
    • S. japonicum - Oncomelania
    • S. mekongi - Tricula
    • S. hematobium and S. intercalatum- Bulinus

    Geographical Distribution

    • S. mansoni - Africa, the Middle East, the Caribbean, Brazil, Venezuela, Suriname
    • S. japonicum - China, Indonesia, the Philippines
    • S. mekongi - Districts of Cambodia and the Lao People's Democratic Republic
    • S. haematobium - Rain forests of Central Africa, the Middle East, Corsica
    • S. guineensis and related S. intercalatum- rain forest areas of central Africa

    Reservoir Hosts

    • S. haematobium- Humans
    • S. mansoni- Mainly humans but also reported in rodents
    • S. japonicum- Humans and domestic animals (dogs, cats, and wild rodents)

    Life Cycle

    • The life cycle involves a complex interplay between humans, freshwater snails, and the schistosome parasite.
    • The life cycle includes multiple steps: including miracidia, sporocysts, cercariae, schistosomulae and adult worms.

    WHO Case Definition

    • Urinary schistosomiasis:
      • Suspected: Visible hematuria or positive reagent strip for hematuria.
      • Confirmed: Eggs of S. haematobium in urine.
    • Intestinal schistosomiasis:
      • Suspected: Non-specific abdominal symptoms, blood in stool, hepatosplenomegaly.
      • Confirmed: Presence of eggs in the stool.

    Incubation Period

    • Acute systemic manifestations (Katayama fever), including fever, urticaria, malaise, and diarrhea, may occur 2-6 weeks after exposure and during the initial egg deposition.
    • This manifestation is less common with S. haematobium.
    • Communicability lasts for over 10 years with S. haematobium and S. mansoni. Snail hosts can release cercariae for several weeks to 3 months.

    Susceptibility

    • Susceptibility to infection is universal.
    • Immunity resulting from infection is variable and not fully researched.

    Clinical Manifestations

    • Intestinal schistosomiasis: Fatigue, abdominal pain, diarrhea, dysentery
    • Urinary schistosomiasis: Dysuria, urinary frequency, terminal hematuria.
    • Cardiopulmonary schistosomiasis: Larval pneumonitis with cough, mild wheezing, low-grade fever
    • CNS schistosomiasis: Focal and generalized seizures, headache
    • Female genital schistosomiasis: Postcoital bleeding, genital ulceration, irregular menstruation, pelvic pain.

    Complications

    • Gastrointestinal (GI) bleeding, GI obstruction
    • Malnutrition
    • Schistosomal nephropathy
    • Renal failure, Pyelonephritis, hematuria, hemospermia
    • Sepsis, Pulmonary hypertension
    • Cor pulmonale
    • Neuroschistosomiasis (transverse myelitis, paralysis, cerebral microinfarcts)
    • Infertility, severe anemia
    • Low birth-weight babies
    • Spontaneous abortion
    • Higher risk of ectopic pregnancies
    • End-organ disease, portal hypertension, obstructive uropathy, pregnancy complications (vulvar or fallopian granuloma), carcinoma (liver, bladder, gallbladder)

    Diagnosis

    • Microscopic detection of eggs in stool or urine sample is common.
    • S. haematobium eggs are oval with a spike.
    • S. japonicum eggs are small and almost spherical with tiny spines.
    • S. mansoni eggs have a spike on the side.
    • Immunological tests (ELISA and IFA) are also used.

    Treatment

    • Antischistosomal drugs, particularly praziquantel, are the treatment of choice.
    • Cure rates for single treatment with praziquantel often reach 65-90%.
    • Steroids can reduce the inflammatory response caused by the drugs.
    • Repeated treatments might be necessary for treatment of maturing worms.
    • Drugs are ineffective after fibrosis development, necessitating management of resulting complications.
    • Surgical interventions involve removal of tumor masses, ligation of esophageal varices, and porta-caval shunt surgeries.
    • Alternative drugs (metrifonate, niridazole, oxamniquine) exist for specific schistosome species.

    Methods of Control

    • Preventive measures:
      • Treat patients in endemic areas with praziquantel for relief and prevention.
      • Treat high-risk groups (children, women of childbearing age, unique occupational groups).
      • Educate the population about the disease and precautionary measures.
      • Dispose of feces and urine properly to prevent the contamination of water sources.
      • Control of patient, contacts, and immediate environment:
      • Report to local health authorities.
      • Sanitize the places where feces and urine are deposited.
      • Examine and test people that come in contact with contaminated sources.
      • Administer necessary medication
    • Epidemic Measures:
      • Examine and treat all infected individuals.
      • Provide clean water; avoid water contamination.
      • Treat areas with high snail populations with molluscides.
      • Provide advice for travelers visiting endemic areas.

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    Description

    Test your knowledge on schistosomiasis, commonly referred to as 'snail fever.' This quiz covers transmission modes, demographic prevalence, and associated species of the disease. Challenge yourself with facts and figures regarding this global health issue.

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