SCHISTOSOMIASIS

Adult male and female worms. 

INTRODUCTION

PATIENT: Doctor I'm seeing blood in my urine. It usually comes when I'm almost done urinating though I don't feel any pain but I am really worried.

DOCTOR: Do you wade or swim in slowly flowing river?

PATIENT: Yes doctor. I do that a lot with my friends. Oh wait a minute doc, my friends also has this same complaint. Could walding in slowing flowing river be the reason for passing out blood after urinating?
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     Schistosomiasis, a disease famous for its unique symptom which is "making people to pass blood in their urine" is Solely found among people that wades in slowly flowing rivers.

WHAT CAUSES SCHISTOSOMIASIS
     A worm called Schistosoma hematobium that gets into our body by penetrating our intact skin. Matures inside the veins that is very close to our liver into male and female adult worms and from there moves on to the veins that surrounds our bladder (our bladder is the organ that temporarily stores the urine that is made by our kidneys. It is connected to our kidneys by pipes called "ureters").

     From within these bladder veins, the mature male and female worms mates each other and the female subsequently releases fertilized eggs. The fertilized eggs thus released then bore its way from the veins through the wall of the bladder to its lumen from where it is subsequently passed out in the urine. However as the eggs Burrow through the veins and the bladder wall, they cause bleeding from the veins into the bladder. This is the reason why we see blood in our urine.
     Should an infected individual pee into the river, the fertilized eggs passed in the urine can develop into an infective form again if they are picked up by the snails in the river in which they develop into a "cercariae"- the infective form that is capable of penetrating the skin of any person that comes to wade in the water

Life cycle of Schistosoma hematobium
 (Fgiclinic acknowledges Netterimages for this picture)

WHO GETS INFECTED WITH SCHISTOSOMIASIS?
     People (especially children) who wade or swim in contaminated water, farmers, fishermen and in communities where people depends on infected rivers for daily living (for laundries etc)

COMPLICATIONS OF SCHISTOSOMIASIS
Despite passing blood in the urine, it is all a painless process and simply because it is painless, most people tend to ignore it. In fact, schistosomiasis has been listed by the WORLD HEALTH ORGANISATION (WHO) as one of the TROPICAL NEGLETED DISEASES. The truth is if left untreated, such individual might develop "Cancer of the bladder".

PREVENTION
     Avoid wading or swimming in river. I'd recommend a swimming pool as a suitable alternative. Go to the hospital as soon as you start to see blood in your urine so that early diagnosis and treatment can be instituuted. Report any case of bloody urine to any public health officer or to the health centre in your area.

CONCLUSION
     Passing blood in your urine is what doctors calls "Hematuria" and there are several other causes of passing blood in the urine which makes schistosomiasis seem like "one in a million". Hence one more reason to go to the hospital as soon as you start to see blood your urine which is the only place where other causes of this can be excluded. Please don't ignore HEMATURIA. Thanks.