SCHISTOSOMA HAEMATOBIUM  ( Urinary Bilharziasis, Swimmer’s Itch).

Schistosomiasis mostly affects poor and rural communities, particularly agricultural and fishing populations. Women doing domestic chores in infested water, such as washing clothes, are also at risk and can develop female genital schistosomiasis. Inadequate hygiene and contact with infected water make children especially vulnerable to infection.

People become infected when larval forms of the parasite – released by freshwater snails – penetrate the skin during contact with infested water.Transmission occurs when people suffering from schistosomiasis contaminate freshwater sources with faeces or urine containing parasite eggs, which hatch in water.

FEATURES SEEN IN THE BLADDER

• Bilharzial pseudotubercles—earliest sign.
• Nodules
• Urinary Bladder -Sandy patches—calcified dead ova with degeneration of overlying epithelium.
• Granulomas
• Ulceration and papilloma.
• Fibrosis and thimble bladder formation.
• In due course of time, development of squamous cell carcinoma.
• Other pathologies: Ureteral and urethral stricture, recurrent UTI,
• bladder calculi, urinary fistula.

CLINICAL FEATURES

• Initially cutaneous lesions like utricaria develops lasting for few days.
• Then after a period of 4–8 weeks, fever, along with features of eosinophilia develops.
• Eventually, after many months it causes intermittent, painless, terminal haematuria.

PROPHYLAXIS

1. The major reason of schistomiasis is the discarding of human waste into water supplies.Hygienic disposal of waste would be enough to eradicate the disease.
2. Water for bathing and drinking should be boiled in endemic regions.
3. Contaminated water should be avoided. However, agricultural practices such as fishingand rice cultivation engage long contact with water, producing avoidance impractical.
4. Efficient eradication of snails is an efficient technique.

INVESTIGATIONS

• Cystoscopy and biopsy.
• IVU.
• Cystography.
• Urine microscopy: Last few ml of early morning urine sample
• urogenital schistosomiasis, a filtration technique using nylon, paper or polycarbonate filters is the standard diagnostic technique.
• intradermal injection of schistosome antigen.

HOMOEOPATHIC MANAGEMENT:

• ANITIM TART
• ARSENIC
• CHINA
• NIT ACID
• CANTHARIS
• MILLIFOLIUM