Schistosomiasis
The Carter Center undertakes one of the longest-running initiatives in providing health education and treatment for schistosomiasis in Nigeria, the world's most endemic country for this preventable but devastating disease.
Schistosomiasis, also known as bilharziasis or "snail fever," is a waterborne parasitic infection that damages internal organs. The most common symptoms are blood in urine and/or feces and an enlarged liver, diarrhea, abdominal pain, weakness, and anemia.
Schistosomiasis is contracted when a person has contact with contaminated water, often through daily activities such as bathing, washing laundry, and fetching water. The parasite can live for years in the veins near the bladder or intestines, laying thousands of eggs that tear and scar tissues of the intestines, liver, bladder, and lungs. Snails are infected when fresh water is contaminated by eggs excreted in human urine and feces. Infected snails release a form of the parasite that infects humans when they expose their skin to water contaminated by the snails.
It most commonly affects school-aged children, who encounter the parasite during their daily chores or at play in activities involving fresh water.
Because schistosomiasis—a parasitic infection that damages internal organs—mainly affects children, Nigeria’s strategy is to distribute treatment through schools. (The Carter Center/ R. McDowall)
In terms of socioeconomic and public health impact, schistosomiasis is among the most devastating parasitic diseases in tropical countries. Nigeria is the most endemic country for schistosomiasis, with approximately 25 million people — mostly children — needing treatment.
For communities already burdened by poverty and ravaged by scourges such as malaria and tuberculosis, schistosomiasis is especially devastating, weakening the body's resistance to other infections and preventing children from reaching their full potential. An infection with schistosomiasis can result in anemia, stunted growth and delayed development of children, chronic debility, and sometimes premature death.
Paul Nnamchi, the principal and CDD for his school in Amagunze, Enugu State, Nigeria, records treatments in his log book. (The Carter Center/ R. McDowall)
Schistosomiasis can be controlled and treated easily with a single annual dose of the donated drug praziquantel, which can reverse up to 90% of the damage caused by the parasite. It is administered mostly at schools according to a schedule set by the World Health Organization. The Carter Center assists Nigeria’s Federal Ministry of Health in providing health education and the drug praziquantel to treat schistosomiasis in nine Nigerian states, in communities where the burden of the disease is greatest. The states are Abia, Anambra, Delta, Ebonyi, Edo, Enugu, Imo, Nasarawa, and Plateau. This cooperative effort is the largest schistosomiasis treatment initiative in Nigeria.
Blood in schoolchildren's urine — a telltale sign of schistosomiasis infection — has been reduced by approximately 50% in Plateau and Nasarawa states. Since 1999, more than 32 million praziquantel treatments have delivered in areas the Center assists in Nigeria.
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Our program focuses on Nigeria, the most endemic country for schistosomiasis, with approximately 25 million people — mostly children — needing treatment.
