A walk in the Park

Featured

This blog is dedicated to everyone who has struggled with Community Medicine. Through my posts I hope to simplify and demystify community medicine. The emphasis will be on clarifying concepts rather than providing ready-made answers to exam questions.

Feedback is crucial for the success of this endeavour, so you are encouraged to comment and criticize if you cannot understand something.

If you want a topic to be discussed sooner rather than later, please let me know via

Facebook: http://www.facebook.com/pages/Community-Medicine-for-ASSES/429533760433198  

[Alternatively, you may join the group communitymedicine4asses: 

http://www.facebook.com/groups/456698611060927/%5D

Twitter: @DocRoopesh

In addition, you could take a short survey to help improve this blog:

http://drroopesh.polldaddy.com/s/reader-survey

A single example may not be able to explain 100% of a given topic, so multiple examples may be provided to explain different parts of a single concept.

If something doesn’t seem right:

a. Write to me about it (at communitymedicine4asses@yahoo.com), and

b. Cross check with another source (textbook, expert, etc.)

I hope that my exertions will make your experience with community medicine seem like a “Walk in the Park”

Note 1. Those who wish to contact me on facebook are requested to kindly send a personal message introducing themselves along with the request. This will help save time and effort of all concerned. Please do not expect me to visit your page to try and identify you/ your areas of work/ interest, etc. It is common courtesy to introduce oneself to another when interacting for the first time. I am merely requesting that the same civil courtesy be extended here, too. Henceforth, I may not accept any friend requests/ requests to join the group on facebook unless accompanied by a note of introduction (except when I already know the sender).  

Note 2. Please understand that this blog (and the corresponding facebook page/ group) is maintained in my spare time. I have a full time job, and am available to pursue these activities only after regular working hours (after 5 pm Indian Standard Time). However urgently you may wish to receive a response from me, I will be able to respond only upon returning home from work (I am offline the rest of the time).

Note 3. Please mind your language when interacting with me/ in the group linked to this blog. Rude/ offensive language will result in expulsion from both my friends list and the said group.

Enhanced by Zemanta

WHO updates fact sheet on Schistosomiasis (19 January 2017)

The World Health Organization (WHO) has updated its fact sheet on Schistosomiasis.

Key Messages:

Schistosomiasis is an acute and chronic parasitic disease caused by blood flukes (trematode worms) of the genus Schistosoma.

Transmission occurs when people suffering from schistosomiasis contaminate freshwater sources with their excreta containing parasite eggs, which hatch in water.

People become infected when larval forms of the parasite – released by freshwater snails – penetrate the skin during contact with infested water.

In the body, the larvae develop into adult schistosomes. Adult worms live in the blood vessels where the females release eggs. Some of the eggs are passed out of the body in the faeces or urine to continue the parasite’s lifecycle. Others become trapped in body tissues, causing immune reactions and progressive damage to organs.

Schistosomiasis mostly affects poor and rural communities, particularly agricultural and fishing populations. Women doing domestic chores in infested water, such as washing clothes, are also at risk. Inadequate hygiene and contact with infected water make children especially vulnerable to infection.

Schistosomiasis is prevalent in tropical and subtropical areas, especially in poor communities without access to safe drinking water and adequate sanitation.

It is estimated that at least 90% of those requiring treatment for schistosomiasis live in Africa.

There are 2 major forms of schistosomiasis – intestinal and urogenital – caused by 5 main species of blood fluke.

Urogenital schistosomiasis is also considered to be a risk factor for HIV infection, especially in women.

Symptoms

Symptoms of schistosomiasis are caused by the body’s reaction to the worms’ eggs.

Intestinal schistosomiasis can result in

  • abdominal pain,
  • diarrhoea, and
  • blood in the stool

Liver and spleen enlargement may occur in advanced cases.

The classic sign of urogenital schistosomiasis is haematuria (blood in urine). Fibrosis of the bladder and ureter, and kidney damage are sometimes diagnosed in advanced cases. Bladder cancer is another possible complication in the later stages.

In women, urogenital schistosomiasis may present with

  • genital lesions,
  • vaginal bleeding,
  • pain during sexual intercourse, and
  • nodules in the vulva.

In men, urogenital schistosomiasis can induce pathology of the seminal vesicles, prostate, and other organs.

This disease may also have other long-term irreversible consequences, including infertility.

WHO estimates that there are about 200 000 deaths globally each year due to schistosomiasis.

Diagnosis

Schistosomiasis is diagnosed through the detection of parasite eggs in stool or urine specimens.

Antibodies and/or antigens detected in blood or urine samples are also indications of infection.

The eggs of intestinal schistosomiasis can be detected in faecal specimens through a technique using methylene blue-stained cellophane soaked in glycerine or glass slides, known as the Kato-Katz technique.

For urogenital schistosomiasis, a filtration technique using nylon, paper or polycarbonate filters is the standard diagnostic technique.

Prevention and Control

The WHO strategy for schistosomiasis control focuses on reducing disease through periodic, targeted treatment with praziquantel through the large-scale treatment (preventive chemotherapy) of affected populations. It involves regular treatment of all at-risk groups.

Groups targeted for treatment are:

  • School-aged children in endemic areas.
  • Adults considered to be at risk in endemic areas, and people with occupations involving contact with infested water, such as fishermen, farmers, irrigation workers, and women whose domestic tasks bring them in contact with infested water.
  • Entire communities living in highly endemic areas.

Praziquantel is the recommended treatment against all forms of schistosomiasis. It is effective, safe, and low-cost.

Even though re-infection may occur after treatment, the risk of developing severe disease is diminished and even reversed when treatment is initiated and repeated in childhood.

Useful Links:

Link to the updated fact sheet:

http://www.who.int/mediacentre/factsheets/fs115/en/

Link to WHO programme on schistosomiasis:

http://www.who.int/schistosomiasis/en/

Link to WHO document ‘Preventive Chemotherapy in Human Helminthiasis’ (English) [PDF] (2006):

http://apps.who.int/iris/bitstream/10665/43545/1/9241547103_eng.pdf