From the Guidelines
Schistosomiasis is not endemic to India, meaning it is not naturally occurring in the country. While India does report occasional cases, these are typically imported by travelers or migrants who acquired the infection in endemic regions such as Africa, the Middle East, South America, or other parts of Asia. The parasite that causes schistosomiasis, Schistosoma, requires specific freshwater snails as intermediate hosts, and these particular snail species are not widely established in India.
Key Points
- The standard treatment for schistosomiasis is praziquantel, typically administered as a single oral dose of 40-60 mg/kg body weight, with the specific dosage depending on the Schistosoma species involved 1.
- For prevention, travelers to endemic countries should avoid swimming or wading in freshwater bodies like lakes, rivers, and irrigation canals.
- If exposure to potentially contaminated water occurs, quickly drying the skin with a towel may help prevent parasite penetration.
- India's health system maintains surveillance for imported cases, and any suspected infections should be promptly evaluated by healthcare providers with experience in tropical medicine or infectious diseases.
Treatment and Prevention
- Praziquantel is the recommended treatment for schistosomiasis, with a dosage of 40 mg/kg for S. mansoni, S. intercalatum, and S. guineensis infections, and 60 mg/kg in two divided doses for S. japonicum and S. mekongi infections 1.
- Prevention measures include avoiding contact with potentially contaminated freshwater and promptly evaluating suspected cases.
From the Research
Schistosomiasis in India
- Schistosomiasis is a neglected tropical disease caused by Schistosoma mansoni, S. haematobium, and S. japonicum 2
- In India, the species responsible for schistosomiasis include Schistosoma indicum, S. spindale, S. nasale, S. incognitum, and S. haematobium 3
- The disease is typically treated with praziquantel, but resistance to this drug has been reported in some cases 4
Treatment Options
- Praziquantel is the most commonly used treatment for schistosomiasis, but its effectiveness can vary depending on the species of schistosome and the dose used 5, 6
- Oxamniquine derivatives have been shown to be effective against all three species of schistosome and may be a useful alternative to praziquantel 2
- Triclabendazole has also been shown to be effective against some species of schistosome, but its use may contribute to the development of drug resistance 3
Challenges in Diagnosis and Treatment
- Diagnosis of schistosomiasis in India can be challenging due to the low egg production of some species of schistosome 3
- The development of a single-step antigen detection test is needed to improve diagnosis and treatment of the disease 3
- International collaboration is recommended to establish an international centre on schistosomiasis in India to tackle issues related to the disease 3