It's time to dispel the myth of "asymptomatic" schistosomiasis.

Charles H King,Stephen T Mcgarvey

doi:10.1371/journal.pntd.0003504

Abstract

It's time to dispel the myth of "asymptomatic" schistosomiasis.

Highlights

With regard to the inputs used for the GBD 2010’s Disability-Adjusted Life-Year (DALY) calculations for schistosomiasis, I see a problem: the core team in charge of the GBD 2010 continues to systematically underestimate the burden of Schistosoma infection–related disability [2]. This underestimation is based on a flawed perception of Schistosoma infection and its related disease manifestations—IHME continues to adhere to the concept of “asymptomatic” schistosomiasis, while it is my considered opinion that no such health state exists
This construct was not supported by the data. It grew out of a misinterpretation of Warren’s population-based field surveys of schistosomiasis [5,6]. Those studies used Kato-Katz stool smears and urine filtration egg count data to show that patients with higher egg counts had greater risk of symptoms and objective morbidity in Schistosoma-endemic areas
In terms of formulating 1980s policy for schistosomiasis control, given the lack of affordable treatments without significant side effects, it is likely that low intensity infections were not prioritized and even dismissed

Summary

Introduction

This underestimation is based on a flawed perception of Schistosoma infection and its related disease manifestations—IHME continues to adhere to the concept of “asymptomatic” schistosomiasis, while it is my considered opinion that no such health state exists. The unfortunate use of the term “asymptomatic” implies that most Schistosoma-infected patients are not experiencing ongoing morbidity or disability. There was no affordable treatment for the millions of people who had Schistosoma-associated disease.

Results

Conclusion