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Bilharzia: war against the worm

BMJ 2003; 327 doi: https://doi.org/10.1136/sbmj.0312472 (Published 01 December 2003) Cite this as: BMJ 2003;327:0312472
  1. Bishoy Morris, final year medical student1
  1. 1Assiut University, Egypt

The parasitic disease bilharzia is endemic in more than 70 tropical countries. Bishoy Morris takes a look at the battle against this waterborne flatworm

If I were asked to make a brief documentary about schistosomiasis, I would select the following snapshots. Children swimming in an infested canal, a local doctor talking with some patients who are obviously anxious after discovering blood in their urine or stool. Patients walking around with hugely distended abdomens because of splenomegaly and ascites. The tempo is now mounting as we see the same patients starting to vomit blood; an experience they never forget--if they are lucky enough to survive it. Finally a split screen with a terminal patient on one side and two nasty worms embracing each other and staring defiantly at the audience on the other, while the word “bilharzia” flashes on the screen.

The facts

Schistosomiasis, also known as bilharzia, is one of the most prevalent parasitic diseases in the world.1 It is caused by five species of waterborne flatworms called schistosomes.12 The main route of infection is contact with infested …

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