Friday, 18 January 2013

Schistosomiasis a huge and overlooked problem in 'non endemic' areas of China

Migrants are spreading schistosomiasis to non-endemic areas
by Michael Woodhead
Urgent action is needed to improve control of schistosomiasis which is out of control in areas of China that are supposed to have no endemic disease, experts in parasitology have said.
China has an effective system of screening and treatment that has been set up in endemic areas  for schistosomiasis, which is caused by trematode blood flukes of the genus Schistosoma, says Dr Zhou Xiao-Nong of the National Institute of Parasitic Diseases at the China Centres for Disease Control.
However, a recent case in a non-endemic area showed that even patients with advanced disease are unable to get adequate and timely diagnosis  and treatment in many parts of China, he says. This especially applies to migrant farmers workers who may travel from endemic to non-endemic areas, says Dr Zhou.
He cites the example of a woman from a nonendemic area within the Anhui Province of China who had advanced schistosomiasis. During a period of one and a half months, the patient went through two hospitals, one preventive institute, and two regional schistosomiasis control stations, three of which she had been admitted into for medical treatments. Although the patient was not misdiagnosed from the beginning, she did go through five medical or health service facilities in pursuing medical treatment, covering a distance of nearly 1,000 km. Dr Zhou says diagnosis and treatment of schistosomiasis with praziquantel should be relative straightforward if a system is in place.
"Due to an unprecedented migration rate of populations in China as well as in other developing countries the number of such missed or ignored advanced cases could be huge.  Therefore, an improvement in the current monitoring system and aid-project management (i.e., enrolling vulnerable populations who have migrated from an endemic to nonendemic areas)  is clearly and urgently needed. This seems of great importance when the control and elimination of schistosomiasis has been put on the agenda," he concludes.
Source: PLOS Medicine

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