Why did schistosomiasis disappear from the southern part of the Eastern Cape?
Keywords:
Eastern Cape, urogenital schistosomiasis, bilharzia, Schistosoma haematobium, Bulinus africanus, Schistosoma haematobium/mattheei hybrid, outbreak area, history
Abstract
We reviewed the early literature and maps of the occurrence of urogenital schistosomiasis (bilharzia) in the Eastern Cape, South Africa from the 1860s until its decline from about 1900 and reappearance in 2002. Although this decline in transmission has received little attention to date, clinical descriptions of the disease over this period indicate that infection was common, probably patchy, although sometimes with severe morbidity. The long period of quiescence between 1900 and 2002 is thought to be as a result of several factors, but primarily because of the impact of the area’s cold winters and drought-prone climate on the survival and reproduction of both the snail intermediate host Bulinus africanus and the intramolluscan stages of the parasite. The concept of an outbreak area is invoked to describe the occurrence of intense urogenital schistosomiasis transmission in localised areas for relatively short periods of up to 35 years in this the southernmost part of its range in Africa, a suboptimal environment for transmission.References
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7.Chute HM. Intermittent haematuria. S Afr Med J. 1886;(3):38–39.
8.Haw WH. A paper on African haematuria – endemic haematuria – or bilharzia haematobia. S Afr Med J. 1894;(Jan):171–178.
9.Spencer HA. Bilharzia haematobia. S Afr Med J. 1899;6:269–271.
10.Schneider J. Bilharziasis with particular reference to South Africa. Johannesburg: Cape and Transvaal Printers; 1970.
11.Cobbold TS. On the development of Bilharzia haematobia. Br Med J. 1872;2:89–92. http://dx.doi.org/10.1136/bmj.2.604.89, PMCid:2296977
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13.Watkins-Pitchford W. Note on schistosomiasis. S Afr Med J. 1915;13:226.
14.Cawston FG. Schistosomiasis in Natal. S Afr Med J. 1916;14:53–54.
15.Hartler EB. Bilharzia haematobia. S Afr Med J. 1887;(5):200–201.
16.Anonymous. Parasitic diseases in South Africa. S Afr Med J. 1898;6:1–5.
17.Haw WH. Review of volume II of Allbutt’s system of medicine. S Afr Med J. 1899;7:65.
18.Van der Werf MJ, De Vlas S. Morbidity and infection with schistosomes or soil-transmitted helminths. Report to Parasitic Diseases and Vector ControlDivision. Geneva: World Health Organization; 2001.
19.Temple Mursell H. Remarks of fulguration for bladder growths. S Afr Med J. 1921;19:25–27.
20.Bhagwandeen SB. The clinico-pathological manifestations of schistosomiasis in the African and the Indian in Durban. Pietermaritzburg: University ofNatal Press; 1968.
21.Cooppan RM, Schutte CHJ, Mayet FM, Dingle CE, Van Deventer JMG, Mosese PG. Morbidity from urinary schistosomiasis in relation to intensity of infection in the Natal Province of South Africa. Am J Trop Med Hyg. 1986;35:765–776. PMid:3089036
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23.Turner GA. Pulmonary bilharziosis in South Africa. Transvaal Med J. 1908;4:107–110.
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25.Batho E. On endemic haematuria at the Cape of Good Hope and Natal. Br Army Med Rep. 1870;12:502–504.
26.Porter A. Larval Trematoda found in certain South African Mollusca with special reference to schistosomiasis (bilharzia). Publ S Afr Inst Med Res. 1938;62:1–492.
27.Gale GW. Bilharzia (human redwater) disease. Information Brochure 339. Pretoria: Department of Health; 1946.
28.De Meillon B. Aspects of the natural history of bilharzia in South Africa. S Afr Med J. 1948;22:253–260. PMid:18862892
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31.Pitchford RJ. Report on visit to Transkei, 3–11 September 1981. Unpublished report to the Medical Services, Transkei. Cape Town: South African Medical Research Council; 1981.
32.Mqoqi NP, Dye AH. Schistosoma haematobium in Transkei: A preliminary survey conducted in the Ngqaleni district. S Afr J Sci. 1992;88:445–447.
33.Mqoqi NP, Appleton CC, Dye AH. Prevalence and intensity of Schistosoma haematobium (urinary schistosomiasis) in the Port St Johns district of Transkei.S Afr Med J. 1996;86:76–80. PMid:8685788
34.Le Roux PL. Notes on the life-cycle of Schistosoma mattheei and observations on the control and eradication of schistosomiasis in man and animals. 15th Ann Rep Dir Vet Ser Union of South Africa. 1929:407–438.
35.Pitchford RJ, Visser PS. The use of behaviour patterns of larval schistosomes in assessing the bilharzia potential of non-endemic areas. S Afr Med J. 1969;43:983–995. PMid:5821211
36.Veglia F, Le Roux PL. On the morphology of a schistosome (Schistosoma mattheei sp. nov.) from the sheep in the Cape Province. 15th Ann Rep Dir Vet SerUnion of South Africa. 1929:335–346.
37.Van Wyk JA. Transmission of Schistosoma mattheei from animals to man. In: Gear JHS, editor. Medicine in a tropical environment. Proceedings of an international symposium. Pretoria: A.A. Balkema, 1976; p. 705–717.
38.Pitchford RJ. Some aspects of bilharzia in southern Africa. S Afr Med J. 1986;70(suppl):80–82. PMid:3726706
39.World Health Organization (WHO). Guidelines for the evaluation of soil-transmitted helminthiasis and schistosomiasis at community level. WHO/CTD/ SIP/98.1. Geneva: WHO; 1998.
40.Appleton CC, Stiles G. Geology and geomorphology in relation to the distribution of snail intermediate hosts of bilharzia in South Africa. Ann Trop Med Parasitol. 1976;70:189–198. PMid:938124
41.Connolly M. A monographic survey of the South African non-marine Mollusca. Ann S Afr Mus. 1939;33:1–660.
42.Heeg J. A note on the drastic effects in total dissolved solids on the aquatic pulmonate snail Bulinus (Physopsis) africanus (Krauss). J Limnol Soc S Afr. 1975;1:29–32.
43.Appleton CC. The population fluctuations of five freshwater snail species in the eastern Transvaal lowveld, and their relation to known bilharzia transmission patterns. S Afr J Sci. 1974;70:145–150.
44.De Kock KN. [The population dynamics of five freshwater snail species of medical and veterinary importance under controlled temperature conditions].DSc thesis, Potchefstroom, Potchefstroom University, 1973. Afrikaans.
45.Pitchford RJ, Visser PS. Some further observations on schistosome transmission in the eastern Transvaal. Bull WHO. 1965;32:83–104. PMid:14292065, PMCid:2555205
46.Green MS, Swartz T, Mayshar E, et al. When is an epidemic an epidemic? Isr Med Assoc J. 2002;4:3–6. PMid:11802306
47.Cawston FG. Some effects of a prolonged drought on disease-carriers. J Trop Med Hyg. 1934;37:195–196.
48.Brown DS. Freshwater snails of Africa and their medical importance. Revised 2nd ed. London: Taylor & Francis; 1994.
49.De Kock KN, Wolmarans CT. Distribution and habitats of the Bulinus africanus species group, snail intermediate hosts of Schistosoma haematobium and S. mattheei in South Africa. Water SA. 2005;31:117–125.
50.Pretorius SJ, Joubert PH, De Kock KN. A review of the schistosomiasis risk in South African dams. Water SA. 1989;15:133–136.
51.Cridland CC. Resistance of Bulinus (Physopsis) globosus, Bulinus (Ph.) africanus, Biomphalaria pfeifferi and Lymnaea natalensis to experimental desiccation. Bull WHO. 1967;36:507–513. PMid:5299680, PMCid:2476301
52.Nicholson SE. The historical climatology of Africa. In: Wigley TML, Ingram MJ, Farmer B, editors. Climate and history: Studies on past climates and theirimpact on man. Cambridge: Cambridge University Press, 1981; p. 249–270.
53.Nicholson SE. Climate and environmental change in Africa during the last two centuries. Climate Res. 2001;17:123–144. http://dx.doi.org/10.3354/cr017123
54.Schulze RE. South African atlas of agrohydrology and climatology. Report TT82/96. Pretoria: Water Research Commission; 1997.
55.Shiff CJ. Studies on Bulinus (Physopsis) globosus in Rhodesia. III–Bionomics of a natural population existing in a temporary habitat. Ann Trop Med Parasitol. 1964;58:240–255. PMid:14183114
56.Loker ES. A comparative study of the life-histories of mammalian schistosomes. Parasitology. 1983;87:343–369. http://dx.doi.org/10.1017/S0031182000052689
57.Le Roux PL. The validity of Schistosoma capense (Harley, 1864) amended as a species. Trans R Soc Trop Med Hyg. 1958;52:12–13.
58.Pitchford RJ. Cattle schistosomiasis in man in the eastern Transvaal. Trans R Soc Trop Med Hyg. 1959;53:285–290. http://dx.doi.org/10.1016/00359203(59)90010-0
59.Pitchford RJ. Observations on a possible hybrid between the two schistosomes S. haematobium and S. mattheei. Trans R Soc Trop Med Hyg. 1961;55:44–51. http://dx.doi.org/10.1016/0035-9203(61)90038-4
60.W right CA, Ross GC. Hybrids between Schistosoma haematobium and S. mattheei and their identification by isoelectric focusing. Trans R Soc Trop Med Hyg. 1980;74:326–332. http://dx.doi.org/10.1016/0035-9203(80)90091-7
61.Wright CA, Southgate VR. Hydridisation of schistosomes and some of its implications. In: Taylor AER, Muller R, editors. Genetics aspects of host–parasite relationships. Symposiums of the British Society for Parasitology. 1976;11:91–109.
62.Southgate VR, Tchuem-Tchuente LA, Vercruysse J, Jourdane J. Mating behaviour in mixed infections of Schistosoma haematobium and S. mattheei. Parasitol Res. 1995;81:651–656. http://dx.doi.org/10.1007/BF00931841, PMid:8570579
63.Pitchford RJ, Visser PS. Excretion of Schistosoma mattheei eggs from man, baboons and cattle living in their natural environment. J Helminthol. 1975;49:137–142. http://dx.doi.org/10.1017/S0022149X00023269
64.Kruger FJ, Joubert PH, Pretorius SJ. Ratio of Schistosoma haematobium to S. mattheei infections in Bulinus africanus snails from rural areas in the eastern Transvaal lowveld in South Africa. Trans R Soc Trop Med Hyg. 1990;84:556. http://dx.doi.org/10.1016/0035-9203(90)90038-G
2.Department of Health. Regular treatment of children for soil-transmitted helminth infections and bilharzia – policy and implementation guidelines. Pretoria: South African National Department of Health; 2007.
3.Harley J. On the endemic haematuria of the Cape of Good Hope. Med Chir Trans. 1864;47:55–72. PMid:20896246, PMCid:2147819
4.Bilharz T. [Further observations on Distomum haematobium which lives in the portal vein of humans and its association with certain pathological manifestations]. Z Wiss Zool. 1852;4:72–76. German.
5.Harley J. A second communication on the endemic haematuria of the Cape of Good Hope and Natal. Med Chir Trans. 1869;52:379–387. PMid:20896346, PMCid:2150512
6.Harley J. A third communication on the endemic haematuria of the south-eastern coast of Africa, with remarks on the topical medication of the bladder. Med Chir Trans. 1871;54:47–62. PMid:20896377, PMCid:2150475
7.Chute HM. Intermittent haematuria. S Afr Med J. 1886;(3):38–39.
8.Haw WH. A paper on African haematuria – endemic haematuria – or bilharzia haematobia. S Afr Med J. 1894;(Jan):171–178.
9.Spencer HA. Bilharzia haematobia. S Afr Med J. 1899;6:269–271.
10.Schneider J. Bilharziasis with particular reference to South Africa. Johannesburg: Cape and Transvaal Printers; 1970.
11.Cobbold TS. On the development of Bilharzia haematobia. Br Med J. 1872;2:89–92. http://dx.doi.org/10.1136/bmj.2.604.89, PMCid:2296977
12.Chute HM. Bilharzia haematobia, Distomum haematobium, endemic haematuria. S Afr Med J. 1888;(10):85–87.
13.Watkins-Pitchford W. Note on schistosomiasis. S Afr Med J. 1915;13:226.
14.Cawston FG. Schistosomiasis in Natal. S Afr Med J. 1916;14:53–54.
15.Hartler EB. Bilharzia haematobia. S Afr Med J. 1887;(5):200–201.
16.Anonymous. Parasitic diseases in South Africa. S Afr Med J. 1898;6:1–5.
17.Haw WH. Review of volume II of Allbutt’s system of medicine. S Afr Med J. 1899;7:65.
18.Van der Werf MJ, De Vlas S. Morbidity and infection with schistosomes or soil-transmitted helminths. Report to Parasitic Diseases and Vector ControlDivision. Geneva: World Health Organization; 2001.
19.Temple Mursell H. Remarks of fulguration for bladder growths. S Afr Med J. 1921;19:25–27.
20.Bhagwandeen SB. The clinico-pathological manifestations of schistosomiasis in the African and the Indian in Durban. Pietermaritzburg: University ofNatal Press; 1968.
21.Cooppan RM, Schutte CHJ, Mayet FM, Dingle CE, Van Deventer JMG, Mosese PG. Morbidity from urinary schistosomiasis in relation to intensity of infection in the Natal Province of South Africa. Am J Trop Med Hyg. 1986;35:765–776. PMid:3089036
22.Turner GA. Bilharziosis in South Africa. Parasitology. 1908;1:195–217. http://dx.doi.org/10.1017/S0031182000003437
23.Turner GA. Pulmonary bilharziosis in South Africa. Transvaal Med J. 1908;4:107–110.
24.O’Mahoney D, Banach L, La Grange LL. A case of vulval schistosomiasis. S Afr Fam Pract. 2007;49:42–43.
25.Batho E. On endemic haematuria at the Cape of Good Hope and Natal. Br Army Med Rep. 1870;12:502–504.
26.Porter A. Larval Trematoda found in certain South African Mollusca with special reference to schistosomiasis (bilharzia). Publ S Afr Inst Med Res. 1938;62:1–492.
27.Gale GW. Bilharzia (human redwater) disease. Information Brochure 339. Pretoria: Department of Health; 1946.
28.De Meillon B. Aspects of the natural history of bilharzia in South Africa. S Afr Med J. 1948;22:253–260. PMid:18862892
29.Pitchford R, Geldenhuys PJ. Bilharziasis in the Transkei and Eastern Cape Province. S Afr J Lab Clin Med. 1960;6:237–246. PMid:13736089
30.Gear JHS, Pitchford RJ, Van Eeden JA. Atlas of bilharzia in South Africa. Johannesburg: South African Institute for Medical Research, South African Medical Research Council and Department of Health; 1980.
31.Pitchford RJ. Report on visit to Transkei, 3–11 September 1981. Unpublished report to the Medical Services, Transkei. Cape Town: South African Medical Research Council; 1981.
32.Mqoqi NP, Dye AH. Schistosoma haematobium in Transkei: A preliminary survey conducted in the Ngqaleni district. S Afr J Sci. 1992;88:445–447.
33.Mqoqi NP, Appleton CC, Dye AH. Prevalence and intensity of Schistosoma haematobium (urinary schistosomiasis) in the Port St Johns district of Transkei.S Afr Med J. 1996;86:76–80. PMid:8685788
34.Le Roux PL. Notes on the life-cycle of Schistosoma mattheei and observations on the control and eradication of schistosomiasis in man and animals. 15th Ann Rep Dir Vet Ser Union of South Africa. 1929:407–438.
35.Pitchford RJ, Visser PS. The use of behaviour patterns of larval schistosomes in assessing the bilharzia potential of non-endemic areas. S Afr Med J. 1969;43:983–995. PMid:5821211
36.Veglia F, Le Roux PL. On the morphology of a schistosome (Schistosoma mattheei sp. nov.) from the sheep in the Cape Province. 15th Ann Rep Dir Vet SerUnion of South Africa. 1929:335–346.
37.Van Wyk JA. Transmission of Schistosoma mattheei from animals to man. In: Gear JHS, editor. Medicine in a tropical environment. Proceedings of an international symposium. Pretoria: A.A. Balkema, 1976; p. 705–717.
38.Pitchford RJ. Some aspects of bilharzia in southern Africa. S Afr Med J. 1986;70(suppl):80–82. PMid:3726706
39.World Health Organization (WHO). Guidelines for the evaluation of soil-transmitted helminthiasis and schistosomiasis at community level. WHO/CTD/ SIP/98.1. Geneva: WHO; 1998.
40.Appleton CC, Stiles G. Geology and geomorphology in relation to the distribution of snail intermediate hosts of bilharzia in South Africa. Ann Trop Med Parasitol. 1976;70:189–198. PMid:938124
41.Connolly M. A monographic survey of the South African non-marine Mollusca. Ann S Afr Mus. 1939;33:1–660.
42.Heeg J. A note on the drastic effects in total dissolved solids on the aquatic pulmonate snail Bulinus (Physopsis) africanus (Krauss). J Limnol Soc S Afr. 1975;1:29–32.
43.Appleton CC. The population fluctuations of five freshwater snail species in the eastern Transvaal lowveld, and their relation to known bilharzia transmission patterns. S Afr J Sci. 1974;70:145–150.
44.De Kock KN. [The population dynamics of five freshwater snail species of medical and veterinary importance under controlled temperature conditions].DSc thesis, Potchefstroom, Potchefstroom University, 1973. Afrikaans.
45.Pitchford RJ, Visser PS. Some further observations on schistosome transmission in the eastern Transvaal. Bull WHO. 1965;32:83–104. PMid:14292065, PMCid:2555205
46.Green MS, Swartz T, Mayshar E, et al. When is an epidemic an epidemic? Isr Med Assoc J. 2002;4:3–6. PMid:11802306
47.Cawston FG. Some effects of a prolonged drought on disease-carriers. J Trop Med Hyg. 1934;37:195–196.
48.Brown DS. Freshwater snails of Africa and their medical importance. Revised 2nd ed. London: Taylor & Francis; 1994.
49.De Kock KN, Wolmarans CT. Distribution and habitats of the Bulinus africanus species group, snail intermediate hosts of Schistosoma haematobium and S. mattheei in South Africa. Water SA. 2005;31:117–125.
50.Pretorius SJ, Joubert PH, De Kock KN. A review of the schistosomiasis risk in South African dams. Water SA. 1989;15:133–136.
51.Cridland CC. Resistance of Bulinus (Physopsis) globosus, Bulinus (Ph.) africanus, Biomphalaria pfeifferi and Lymnaea natalensis to experimental desiccation. Bull WHO. 1967;36:507–513. PMid:5299680, PMCid:2476301
52.Nicholson SE. The historical climatology of Africa. In: Wigley TML, Ingram MJ, Farmer B, editors. Climate and history: Studies on past climates and theirimpact on man. Cambridge: Cambridge University Press, 1981; p. 249–270.
53.Nicholson SE. Climate and environmental change in Africa during the last two centuries. Climate Res. 2001;17:123–144. http://dx.doi.org/10.3354/cr017123
54.Schulze RE. South African atlas of agrohydrology and climatology. Report TT82/96. Pretoria: Water Research Commission; 1997.
55.Shiff CJ. Studies on Bulinus (Physopsis) globosus in Rhodesia. III–Bionomics of a natural population existing in a temporary habitat. Ann Trop Med Parasitol. 1964;58:240–255. PMid:14183114
56.Loker ES. A comparative study of the life-histories of mammalian schistosomes. Parasitology. 1983;87:343–369. http://dx.doi.org/10.1017/S0031182000052689
57.Le Roux PL. The validity of Schistosoma capense (Harley, 1864) amended as a species. Trans R Soc Trop Med Hyg. 1958;52:12–13.
58.Pitchford RJ. Cattle schistosomiasis in man in the eastern Transvaal. Trans R Soc Trop Med Hyg. 1959;53:285–290. http://dx.doi.org/10.1016/00359203(59)90010-0
59.Pitchford RJ. Observations on a possible hybrid between the two schistosomes S. haematobium and S. mattheei. Trans R Soc Trop Med Hyg. 1961;55:44–51. http://dx.doi.org/10.1016/0035-9203(61)90038-4
60.W right CA, Ross GC. Hybrids between Schistosoma haematobium and S. mattheei and their identification by isoelectric focusing. Trans R Soc Trop Med Hyg. 1980;74:326–332. http://dx.doi.org/10.1016/0035-9203(80)90091-7
61.Wright CA, Southgate VR. Hydridisation of schistosomes and some of its implications. In: Taylor AER, Muller R, editors. Genetics aspects of host–parasite relationships. Symposiums of the British Society for Parasitology. 1976;11:91–109.
62.Southgate VR, Tchuem-Tchuente LA, Vercruysse J, Jourdane J. Mating behaviour in mixed infections of Schistosoma haematobium and S. mattheei. Parasitol Res. 1995;81:651–656. http://dx.doi.org/10.1007/BF00931841, PMid:8570579
63.Pitchford RJ, Visser PS. Excretion of Schistosoma mattheei eggs from man, baboons and cattle living in their natural environment. J Helminthol. 1975;49:137–142. http://dx.doi.org/10.1017/S0022149X00023269
64.Kruger FJ, Joubert PH, Pretorius SJ. Ratio of Schistosoma haematobium to S. mattheei infections in Bulinus africanus snails from rural areas in the eastern Transvaal lowveld in South Africa. Trans R Soc Trop Med Hyg. 1990;84:556. http://dx.doi.org/10.1016/0035-9203(90)90038-G