Day 10 – Schistosomiasis in a Muslim School

Today we visited a Muslim school of almost 900 children. They scream for us as if we are celebrities. We ask why and we are told they were hoping the Mazungos (white people) were bringing them pens. Yes, just simple pens to write. We are introduced as “doktores” and unfortunately we are here looking for schistosomiasis, a water born parasite. This school has a high rate of infection. There is a stream nearby and the children bathe and urinate in the water there perpetuating the cycle. In order for this parasite to live it must have a fresh water (slow moving) stream, snails and a human. The snail is the host until the human arrives, then it penetrates human skin and eventually makes it way to the liver. It matures here into adult worms and eventually migrates to other areas including the bladder. Symptoms can vary based on the infection from rash, fever, diarrhea to blood in the urine. Screening for blood in the urine is the first step in looking for the disease in these children. In Swahili the teacher asks one classroom if anyone has had blood in their urine. Eight boys raise their hands and step forward to give us urine samples. The children are use to being screened, every six months the entire school is treated for the parasite because the infection rate is so high. If left untreated, the parasite can cause inflammation and damage to multiple organs, increase the rate of bladder cancer and eventually can cause death. We test the boy’s urine and all eight tests are positive for blood, an early sign for the disease. We then went to the river and collect the snails from the water. At the lab we see the parasite in both the boys’ urine and the water from the river.