Bilharzia infection from dirty water still common in Ethiopia

In 2019, for the first time, a study showed that nearly 1 in 5 people in Ethiopia suffered from Schistosoma mansoni infections, also called Bilharzia. The disease is caused by parasitic worms that live in dirty water, so researchers recommend restricted access to open water sources, better water treatment and water safety education for communities.

Africa is responsible for about 75% of global Bilharzial infections. The parasite enters through the skin when people drink, wash with, swim in or relieve themselves in dirty water. From the bloodstream, it can travel to the liver, intestines and other organs, causing severe symptoms like fever, joint and muscle pain, stomach ache, rash, coughing, headaches and chills.

Unfortunately, even in areas where treatments are available, infections are common. In this study, researchers wanted to find just how common it is in Ethiopia.

They conducted a meta-analysis, which involves gathering information about a certain topic from different studies. They looked at scientific papers published between 1999 and 2018 focussing on Bilharzia in Ethiopia. 

They found 140 articles, but only included 84 in this study. They found that since 2014, many had the infection -  nearly 20% of the Ethiopian population. They noticed that most cases were found in the southern part of Ethiopia, in the rural areas, and in males. 

The researchers said however that most of their data came from people in cities or towns, and so some of the cases in rural areas may have not been recorded. They also cautioned that the individual studies they looked at each had their own limitations, which may skew the results of this meta-analysis.

Based on the high number of people that have Bilharzia in Ethiopia, the authors suggested that the government should try to stop access to open water sources, and they should educate the communities about the dangers of dirty water. They also recommended boosting water treatment programs in Ethiopia. 

The authors of this study were from Ethiopia. 

Abstract

Background Schistosomiasis is the most predominant helminthic infection in tropics and subtropics mainly in sub-Saharan African countries including Ethiopia. S. mansoni infection is still becoming a public health problem since the risk of reinfection and recurrent disease remain, even in areas with high treatment coverage. There is no summarized data regarding prevalence of S. mansoni infection in Ethiopia. Therefore, this review was done to determine the pooled prevalence of S. mansoni infection in Ethiopia.

Methods The PRISMA guidelines protocol was followed to perform the systematic review and meta-analysis. Published studies from January 1999 to September 1 2018 were searched in Medline, PubMed, Google scholar, HINARI and Cochrane Library. The study search terms were: “prevalence”, “incidence”, “schistosomiasis” “Bilharziasis”, “Ethiopia”. The heterogeneity of studies was assessed using Cochran’s Q test and I2 test statistics. Publication bias was assessed by Egger’s test.
Results Eighty four studies were included in this review and meta–analysis. The pooled prevalence of S. mansoni among Ethiopian population was 18.7% (95%CI: 14.7-23.5). Southern regions of Ethiopia had a higher S.mansoni prevalence of 33.6% 995% CI: 20.2-50.4). S.mansoni was higher in rural areas and among males with a pooled prevalence, 20.8% (95% CI: 14.2-29.4) and 29.4% (95%CI: 23.2-36.6), respectively. Similarly, the prevalence of S.mansoni have been increased over the past 15 years.
Conclusion The review showed a moderate prevalence of S.mansoni infection in Ethiopia and disease is still a major health problem. Therefore, integrated control approach could be implemented to reduce the burden of this parasite in Ethiopia. Interventions leading to reduction of open water sources exposure to reduce schistosomiasis transmission, strengthen of deworming program, giving appropriate health education on the risk of schistosomal infection and transmission should be applied.

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