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SCI Case Study
Schistosomiasis in mothers and infants – a case report
Author: José Carlos Sousa Figueiredo
Sophie Ngweno is like every other mother. She wakes up in the early hours of the day, prepares breakfast for her children and goes to work – she is a fishmonger in a rural village of Uganda, on the shores of Lake Albert. Upon her return home, the eldest son helps her carry water from the lake and the eldest daughter does the washing up. Before dinner, they all bathe, including her two youngest – Balongo, a boy aged five, and Afoyocan, the baby girl aged three. Every day the ritual is the same, and it would be completely harmless if it weren’t for one thing – schistosomiasis.
Even for a women like Sophie, who knows about schistosomiasis (also known as bilharzia, bilharziosis or snail fever) and how it is transmitted, there are very few things she can do. There are no water pumps in her village, making the lake the only source of water for this, and many other families. The children often swim in the lake to hide from the blazing hot days when air temperature reaches 40° Celsius. For these reasons, the risk of infection for this family is as high as it gets. Although Sophie recognizes the symptoms of chronic schistosomiasis in her family, such as bloody stools, chronic stomach pains and diarrhoea, enlarged belies and general malaise, there is very little she can do.
Then something changed: Uganda became one of the first African countries to commence preventive chemotherapy (PCT) with albendazole for geohelminths and praziquantel for schistosomiasis. More importantly, a study was taking place in her village, aimed at treating mothers and preschool-aged children. That morning, the routine changed dramatically: by 8a.m. Sophie was already the first in the queue to be recruited into the cohort study.
Fig. 1 – Sophie and her children, Balongo and Afoyocan. Holding a new health card with her photos and their names, Sophie’s family was the first recruited from Bugoigo village into the Schistosomiasis in Mothers and Infants (SIMI) project.
As part of this project, mothers and children are diagnosed for schistosomiasis and geohelminth infection, they are treated and followed-up twice every year, where the ritual is repeated. Over the course of three years, Sophie and her children do not miss a single opportunity to be treated. In fact, Sophie is now the Community Mobilizer for the project. Due to her wonderful work, almost 4 in every 5 families reported to every survey, and came for treatment. Mothers that had moved homes as far as 40 Km away, if informed, would spend the 9 US dollars necessary to come to the village to get treatment; all because they saw the benefits.
Three years into the initiative, Sophie became a volunteer Community Drug Distributer and is finally empowered to help her children and fellow villagers receive treatment. As for Balongo and Afoyocan, they are now in school. Unlike schoolchildren from a mere five years ago, they are entering school without any obvious symptoms of schistosomiasis. Balongo and Afoyocan are lucky. Lucky because circumstances changed. Lucky because for only 0.50 cents a year they are able to fight an infection as ubiquitous as schistosomiasis. And while the daily routine is still the same, the prospects for this family have changed completely.
Fig. 2 – Where Sophie is today.
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