Durban - Parasitic worms - which can live inside human beings for up to 30 years surviving on their blood and laying as many as 500 eggs a day - have been found to contribute to the high prevalence of HIV in women.
The parasites, common in KwaZulu-Natal, are responsible for an estimated 2 million South African women being infected with bilharzia.
This is according to Dr Sabina Mbabazi of the World Health Organisation’s (WHO) Department of Control of Neglected Tropical Diseases.
Speaking at a gathering of WHO, African doctors and leading researchers at the University of KwaZulu-Natal (UKZN) on Thursday, Mbabazi said the damage caused by the disease on the genitals rendered women prone to HIV and sexually transmitted diseases.
Dr Eyrun Kjetland, an honorary lecturer at UKZN and the Norwegian Centre for Imported and Tropical Disease, said the eggs of bilharzia-carrying parasites hatched in certain types of snails found in rivers and lakes. The worms could survive in the water for about 48 hours after leaving the carrier snail. They could painlessly and unnoticeably penetrate the skin of a person, living in their blood stream and laying eggs.
Although symptoms varied, some experienced a rash or itchy skin within days, and within a month or two developed a fever, chills, cough and muscle aches, said Kjetland. “Bilharzia remains undiagnosed by the vast majority of medical practitioners in SA. It is unacceptable that people are suffering from this disease and that children are still contracting it.”
Their concern has prompted them to compile a booklet to assist doctors to recognise bilharzia and effectively treat it.
UKZN Department of Gynaecology head, Dr Motshedisi Sebotloane, said most doctors and nurses relied on blood urine as a symptom of the disease and only a handful are even aware of the disease and its effects. He said if the genitals were affected, this could result in unscheduled bleeding, chronic pelvic pain and infertility.
“Children living in endemic areas should be particularly targeted with regular preventative treatments to prevent life-long damage the disease can cause to their reproductive organs.”
The UKZN research team is currently doing studies on the KZN South Coast where there is a high prevalence of the disease, known in Zulu as isicenenene. Kjetland said coastal areas, which were humid and at low altitude, were likely to have a high prevalence.
She said in such areas, treatment was currently being given to children once every two years but should instead be given at least once a year.
The director of Communicable Disease Control in the national Department of Health, Tsakani Furumele, said the drug used to treat bilharzia was on the essential drug list and available at state health facilities in areas where the disease was prevalent. There is no vaccine available and the worms could remain dormant in a person’s body for years before they experience symptoms.
The eggs travel to the intestine, liver, bladder or reproductive organs causing inflammation or scarring.
According to Kjetland, 42 million women in Africa have sustained damage to the genitals leaving them even more vulnerable to contracting sexually transmitted diseases.
However, due to lack of research, data is scarce.
“It is not necessarily life threatening so it does not strike fear and panic. It is at the bottom of neglected diseases but has devastating long-term effects,” said Mbabazi.
However, Furumele said the data being collected in the UKZN study was assisting them to come up with a programme of action for treatment and prevention of bilharzia. She said a draft document was in the pipeline.