Why did schistosomiasis disappear from the southern part of the Eastern Cape?

Chris C Appleton,Inbarani Naidoo

doi:10.4102/sajs.v108i1/2.411

Chris C Appleton, Inbarani Naidoo

Open Access

https://doi.org/10.4102/sajs.v108i1/2.411

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Abstract

We reviewed the early literature and maps of the occurrence of urogenital schistosomiasis (bilharzia) in the Eastern Cape, South Africa from the 1860s until its decline from about 1900 and reappearance in 2002. Although this decline in transmission has received little attention to date, clinical descriptions of the disease over this period indicate that infection was common, probably patchy, although sometimes with severe morbidity. The long period of quiescence between 1900 and 2002 is thought to be as a result of several factors, but primarily because of the impact of the area's cold winters and drought-prone climate on the survival and reproduction of both the snail intermediate host Bulinus africanus and the intramolluscan stages of the parasite. The concept of an outbreak area is invoked to describe the occurrence of intense urogenital schistosomiasis transmission in localised areas for relatively short periods of up to 35 years in this the southernmost part of its range in Africa, a suboptimal environment for transmission.

Highlights

Monitoring changes in the distribution of urogenital schistosomiasis[1] in South Africa is important with respect to public health, especially the proposed national helminthiasis control programme.[2]
We review the historical literature on urogenital schistosomiasis in the Eastern Cape, south of the Buffalo River, to reconstruct the clinical epidemiology of the disease from its discovery in 1863 to circa 1900 and to examine reasons for its subsequent disappearance from this area until 2002
Some localised events may have gone unreported and Pitchford’s38 remark that ‘it is probably somewhat rare today’ suggests that he doubted that urogenital schistosomiasis had completely disappeared in the study area

Summary

Introduction

Monitoring changes in the distribution of urogenital schistosomiasis (bilharzia)[1] in South Africa is important with respect to public health, especially the proposed national helminthiasis control programme.[2]. The southernmost locality for urogenital schistosomiasis in Africa has long been considered to be the Port Elizabeth– Uitenhage areas of the Eastern Cape, that is, approximately 34°S.

Results

Conclusion