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Bilharzia health hazard highlighted

Water-hyacinth IRIN
Water-hyacinth
Health officials have expressed concern over the high rates of bilharzia - a waterborne parasite that attacks the liver, lungs and eyes of humans - among children living around the vital regional water resource of Lake Victoria. Scientifically known as schistosomiasis, after the schistosome parasites which cause the disease, bilharzia is contracted when blood flukes enter the body by way of contact with infested surface water, mainly among people engaged in agriculture and fishing. Despite efforts to control it in a number of countries, an estimated 200 million people are still infected, of whom 120 million show symptoms and 20 million are severely affected, according to the United Nations World Health Organisation (WHO). About 80 percent of all cases, and all those most severely affected, are now concentrated in Africa, the agency adds. Bilharzia is of concern throughout East Africa, especially among people living around bodies of water such as lakes, rivers, irrigation schemes and swamps, where the snails which spread the bilharzia-causing parasites [schistosomes] thrive, according to Joyce Onsongo of Kenya's communicable and vector disease control department. Studies in Kenya, had shown prevalence rates in local populations as high as 60 percent in specific geographical areas, especially around Lake Victoria, Onsongo told IRIN. "Children are especially vulnerable to bilharzia, because most of them walk barefooted and play in swampy waters," she added. In many areas where it is prevalent, bilharzia infects a large proportion of children, according to the WHO. Although the disease is slow to kill, it attacks the internal organs and causes other complications if treatment is delayed for years, Onsongo told IRIN. In countries where urinary bilharzia is endemic, it causes a specific type of bladder cancer. In some areas of Africa, the incidence of bladder cancer linked with the disease is 32 times higher than that of simple bladder cancer in the USA, according to the WHO fact sheet on the disease. The economic and health effects of bilharzia should not be underestimated, it says, citing retardation of the school performance and growth patterns of infected children, although the effects are (on average) 90 percent reversible with treatment. In Egypt and Sudan, the work capacity of rural inhabitants is severely reduced due to weakness and lethargy caused by the disease, it adds. In Uganda, meanwhile, up to 67 percent of children living in districts close to Lake Victoria are infected with bilharzia, the independent Monitor newspaper reported on Friday. Elly Tumushabe, the director of health services in Mukono, one of the 10 districts gazetted by Uganda's health ministry as suffering from a high prevalence of the disease, said the infection rate in the Lake Victoria region, was "alarming and deserved medical attention to save the young generation", the report stated. The vector control division of the Ugandan health ministry in November 2001 indicated that between 31 and 67 percent of all school-going children along the waters of the River Nile and Lake Victoria were infected with bilharzia, the government-owned The New Vision newspaper reported on 27 November. Another 43 to 79 percent suffered from other worm infections, a major cause of school absenteeism, it added. Some 3.5 million people in Uganda are reported to be at risk from bilharzia infection. The districts most affected include Bundibugyo, Busia, Mpigi, Mukono, Hoima, Kibale, Iganga and Bugiri, according to health workers. In Kenya, the health ministry and WHO are working out a national bilharzia control strategy, to be launched soon. The WHO Kenya country head of disease prevention and control, Dr Dominic Mutie, told IRIN on Tuesday that tackling bilharzia in Kenya would be costly, and needed interventions to be "designed very well" in order to succeed. This would require an "inter-ministerial and inter-sectoral approach which would deal with treatment, as well as prevention - through sanitation programmes", he said. "We know the problem needs attention, because it is an important disease and can cause cancer of the bladder and the liver, but there are no cheap ways to controlling it," he added. Lake Victoria - around which Uganda, Kenya and Tanzania converge - occupies an area of 69,485 square kilometres and is drained by the River Nile. An estimated 30 million people live in the Victoria littoral, one of the most densely populated parts of the continent, and depend on the lake for their livelihoods. However, in recent years, the ecological deterioration of Lake Victoria has begun to undermine the economic and physical wellbeing of local communities. In addition to direct pollution by raw sewage and industrial waste, another serious - and recent - threat to the lake has been the water hyacinth, a floating weed native to the Amazon region of South America, which infested Lake Victoria through the rivers flowing into it, following its original introduction into Africa as an ornamental plant. Since the early 1990s, this floating weed has starved fish and plankton of oxygen and sunlight, blocked waterway traffic, caused water in the lake to stagnate, and rendered the shoreline a breeding ground for malaria-spreading mosquitoes - and the snails which are host to bilharzia parasites. Controlling bilharzia-related illness with drug treatment is a feasible and effective strategy, provided funding is available, while other major interventions are health education and the provision of safe water, humanitarian sources say. Approaches to the problem in the longer term depend on the disease's pattern, resources and the culture of each country, but undoubtedly represent "a long-term commitment", says the WHO. While short-term objectives to reduce prevalence can be achieved (up to 75 percent within two years in many endemic areas), surveillance and maintenance must continue for 10 to 20 years, according to the agency.

This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions

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