SCHISTOSOMIASIS

Also known as Bilhariasis or snail fever

CAUSATIVE AGENTS
Schistosoma Japonicum
Schistosoma mansoni
S. Haematobium
MODE OF TRANSMISSION
Skin comes in contact with contaminated fresh water which certain types of snails that carry schistosomes are
living
STATISTICS
Endemic in 10 regions, 24 provinces, 183 municipalities, and 1,212 barangays with an estimated population of 6.7
million
In these areas, there are about 3, 391 snail colonies with an approximate area of 11,250 hectares.
High prevalence: Region 5, Region 8, Region 11
RISK FACTORS
Living in risk-prone areas
Bathing or washing in the open
age
Poor hygiene
FORMS OF SCHISTOSOMIASIS
Intestinal schistosomiasis
Urogenital schistosomiasis
SIGNS AND SYMPTOMS
Diarrhea
Bloody Stools
Enlargement of abdomen
Spleenomegaly
Weakness
Anemia
Inflamed liver
DIAGNOSTIC EXAMS

Complete blood count (CBC) - May reveal peripheral eosinophilia, particularly in acute infection and/or anemia
NORMAL VALUES:
WBC
4,500-11,000/mm3
NEUTROPHILS
2,500-8,000 cells per mm3
RBC
Male 4,700,000-6,100,000 cells/uL
Female 4,200,000-5,400,000 cells/uL
HEMOGLOBIN:
Youngsters/Adolescents: 10-15.5 g/dl
Adult Males 14-18 g/dl
Adult Females 12-16 g/dl
HEMATOCRIT:
Youngesters and Adolescents: 32-44%
Adult Men 42-52%
Adult Women 37-47%
BASOPHILS
0.5-1.0 %
EOSINOPHILS
1.0-4.0 %

Urinary and fecal microbiology

Ultrasonography
Biopsy
PHARMACOLOGICAL TREATMENT
Specific treatment: Praziquuantel (Biltricide)

Alternative treatment: Oxamniquine for S. Mansoni

Metrifonate for haematobium
COMPLICATIONS
Gastrointestinal (GI) bleeding
GI obstruction
Malnutrition
Schistosomal nephropathy
Renal failure
Pyelonephritis
Hematuria
Neuroschistosomiasis - Transverse myelitis, paralysis, and cerebral microinfarcts
Infertility
Severe anemia
Low birth-weight babies
Spontaneous abortion
Higher risk for ectopic pregnancies
Obstructive uropathy
Pregnancy complications from vulvar or fallopian granuloma
NURSING MANAGEMENT
Monitored and recorded vital signs
Encouraged relaxation techniques
Provided diet high in carbohydrates, proteins and less fatty foods
Give adequate fluid (8-10 glasses per day)
Provided adequate rest periods by limiting visitors
METHODS OF CONTROL
A. Preventive measures
Educate.
Proper disposal of feces and urine.
Improve irrigation and agriculture practices
Treat snail-breeding sites with molluscicides
Prevent exposure to contaminated water
Provide water for drinking, bathing, and washing clothes from sources free of cercariae or treatment to kill them.
Treat patients in the endemic areas
Inform travellers
B. Control of patient, contacts, and the immediate environment
Report to local health authority
Isolation: None
Quarantine: None
Immunization of contacts: None
RESOURCES:
Public Health Nursing In The Philippines
http://www.webmd.com/a-to-z-guides/complete-blood-count-cbc?page=1
http://www.primehealthchannel.com/schistosomiasis.html
http://www.who.int/mediacentre/factsheets/fs115/en/