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The impact of schistosomiasis on human nutrition

Published online by Cambridge University Press:  06 April 2009

L. Stephenson
L. Stephenson
Affiliation:
214 Savage Hall, Division of Nutritional Sciences, Cornell University Ithaca, New York, 14853-6301, USA
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Summary

This article reviews studies that examine the negative effects of urinary and intestinal schistosomiasis on the following nutritional parameters in humans: urinary and faecal blood and iron loss, anaemia and haemoglobin levels, proteinuria, child growth and adult protein-energy status, physical fitness, physical activity, appetite and symptomatology. The conclusions reached are (1) that community-level treatment and control of schistosomiasis in areas where the infection, protein-energy malnutrition, and anaemia are common are to be encouraged and are likely to improve child growth, appetite, physical fitness and activity levels and to decrease anaemia and symptoms of the infection, and (2) that further studies are needed to determine how much and by what means decreases in and treatment of schistosomal infection may improve nutritional status, cognitive and school performance and attendance, and work capacity and productivity in communities with different amounts of parasitism and malnutrition.

Keywords

schistosomiasishumansprotein-energy malnutritionanaemiaphysical fitness
Type
Research Article
Information
Parasitology , Volume 107 , supplement S1: Human nutrition and parasitic infection , January 1993 , pp. S107 - S123
Copyright
Copyright © Cambridge University Press 1993

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References

REFERENCES

Abdel-Rahman, T. A., Collins, K. J. & Dore, C. (1990). Oxylog studies of energy expenditure and schistosomiasis in the Sudan. Journal of Tropical Medicine and Hygiene 93, 365–71.Google ScholarPubMed
Abdel-Salam, E. & Abdel-Fattah, M. (1977). Prevalence and morbidity of Schistosoma haematobium in Egyptian children. American Journal of Tropical Medicine and Hygiene 26, 463–9.CrossRefGoogle ScholarPubMed
Abdel-Wahab, M. F., Esmat, G., Ramzy, I., Fouad, R., Abdel-Rahman, M., Yosery, A., Narooz, S. & Strickland, G. T. (1992). Schistosoma haematobium infection in Egyptian school children: demonstration of both hepatic and urinary tract morbidity by ultrasonography. Transactions of the Royal Society of Tropical Medicine and Hygiene 86, 406–9.CrossRefGoogle Scholar
Asahi, H., Moribayashi, A., Sendo, F. & Kobayakawa, T. (1984). Hemolytic factors in Schistosoma japonicum eggs. Infection and Immunity 46, 514–18.CrossRefGoogle ScholarPubMed
Beaver, P. C., Jung, R. c. & Cupp, E. w. (1984). Clinical Parasitology, 9th edn.Philadelphia: Lea & Febiger.Google Scholar
Beet, E. A. (1949). Observations on haemoglobin values in African children. Transactions of the Royal Society of Tropical Medicine and Hygiene 43, 317–28.CrossRefGoogle ScholarPubMed
Chandiwana, S. K. (1983). Human bilharziasis in a peri-urban area of Zimbabwe with special reference to its relationship to malnutrition in school children. Central African Journal of Medicine 29, 23–6.Google Scholar
Cheever, A. W., Kuntz, R. E., Myers, B. J., Moore, J. A. & Huang, T. C. (1974). Schistosomiasis haematobia in African, hamadryas and gelada baboons. American Journal of Tropical Medicine and Hygiene 23, 429–48.CrossRefGoogle ScholarPubMed
Chin-Hsin, H. & Yi-Hsien, W. (1963). Endocrine disturbances in late schistosomiasis: a clinical study of 17 cases. Chinese Medical Journal 82, 519–27.Google Scholar
Chugh, K. S., Harries, A. D., Dahniya, M. H., Nwosu, A. C., Gashau, A., Thomas, J., Thaliza, T. D., Hogger, S., Ajewski, Z. & Onwuchekwa, A. C. (1986). Urinary schistosomiasis in Maiduguri, northeast Nigeria. Annals of Tropical Medicine and Parasitology 80, 593–9.CrossRefGoogle Scholar
Cline, B. L., Ryzmo, W. T., Hiatt, R. A., Knight, W. B. & Berrios-Duran, L. A. (1977). Morbidity from Schistosoma mansoni in a Puerto Rican community: a population-based study. American Journal of Tropical Medicine and Hygiene 26, 109–17.CrossRefGoogle Scholar
Cook, J. C., Baker, S. T., Warren, K. S. & Jordan, P. (1974). A controlled study of morbidity of schistosomiasis mansoni in St Lucian children, based on quantitative egg excretion. American Journal of Tropical Medicine and Hygiene 23, 625–33.CrossRefGoogle Scholar
Corbett, E. L., Butterworth, A. E., Fulford, A. J. C., Ouma, J. H. & Sturrock, R. F. (1992). Nutritional status of children with Schistosomiasis mansoni in two different areas of Machakos District, Kenya. Transactions of the Royal Society of Tropical Medicine and Hygiene 86, 266–73.CrossRefGoogle ScholarPubMed
Domingo, E. O., Tiu, E., Peters, P. A., Warren, K. S., Mahmoud, A. A. F. & Houser, H. B. (1980). Morbidity in schistosomiasis japonica in relation to intensity of infection: study of a community in Leyte, Philippines, American Journal of Tropical Medicine and Hygiene 29, 858–67.CrossRefGoogle ScholarPubMed
Doumenge, J. P., Mott, K. E., Cheung, C., Villenave, D., Chapuis, O., Perrin, M. F. & Reaud-Thomas, G. (1987). Atlas of the Global Distribution of Schistosomiasis. CEGET-CNRS. Geneva: WHO.Google Scholar
Fairley, N. H. (1920). A comparative study of experimental bilharziasis in monkeys contrasted with the hitherto described lesions in man. Journal of Pathology and Bacteriology 23, 289–314.CrossRefGoogle Scholar
Farid, Z., Bassily, S., Schulert, A. R., Raasch, F., Zeind, A. S., Rooby, A. S. El & Sherif, M. (1967). Blood loss in chronic Schistosoma mansoni infection in Egyptian farmers. Transactions of the Royal Society of Tropical Medicine and Hygiene 61, 621–5.CrossRefGoogle ScholarPubMed
Farid, Z., Bassily, S., Schulert, A. R., Zeind, A. S., McConnell, E. & Wahab, M. F. Abdel (1968). Urinary blood loss in Schistosoma haematobium infection in Egyptian farmers. Transactions of the Royal Society of Tropical Medicine and Hygiene 62, 496–500.CrossRefGoogle ScholarPubMed
Farid, Z., Patwardhan, V. N. & Darby, W. J. (1969). Parasitism and anemia. American Journal of Clinical Nutrition 22, 498–503.CrossRefGoogle ScholarPubMed
Forsyth, D. M. & Bradley, D. J. (1964). Irreversible damage by Schistosoma haematobium in school children. Lancet ii, 169–71.CrossRefGoogle Scholar
Gerritsen, T., Walker, A. R. P., Meillon, B. & Yeo, R. M. (1953). Long term investigations of blood loss and egg load in urinary schistosomiasis in the adult African Bantu. Transactions of the Royal Society of Tropical Medicine and Hygiene 47, 134&40.CrossRefGoogle ScholarPubMed
Gilles, H. M. (1982). Infection with S. haematobium. In Schistosomiasis: Epidemiology, Treatment and Control (ed. Jordan, P. & Webbe, G.), pp. 79–104. London: Heinemann Medical.Google Scholar
Gryseels, B. & Polderman, A. M. (1987). The morbidity of Schistosomiasis mansoni in Maniema (Zaire). Transactions of the Royal Society of Tropical Medicine and Hygiene 81, 202–9.CrossRefGoogle ScholarPubMed
Hallberg, L., Hogdahl, A. M., Nilsson, L. & Rybo, G. (1966). Menstrual blood loss – a population study. Variation at different ages and attempts to define normality. Obstetrica Gynecologica Scandinavica 45, 320–51.CrossRefGoogle ScholarPubMed
He, Y. J. (1984). Endocrine changes in 28 young patients with schistosomiasis dwarfism. Journal of Parasitology and Parasitic Diseases 2, 150–3.Google ScholarPubMed
Hiatt, R. A. & Gebre-Medhin, M. (1977). Morbidity from Schistosoma mansoni infections: an epidemiologic study based on quantitative analysis of egg excretion in Ethiopian children. American Journal of Tropical Medicine and Hygiene 26, 473–81.CrossRefGoogle ScholarPubMed
Holzer, B., Saladin, B., Dennis, E. & Degremont, A. (1983). The impact of schistosomiasis among rural populations in Liberia. Acta Tropica 40, 239–59.Google ScholarPubMed
Horn, J. S. (1969). Chapter 10. Death to the snails! The fight against schistosomiasis. In Away With All Pests: an English Surgeon in People's China 1954–1969. New York: Monthly Review Press, pp. 94–106.Google Scholar
Ibrahim, S. M. K. (1992). The relationship of schistosomiasis to food intake, nutritional status and immunity in Egyptian children. Ph.D. thesis. Cornell University, Ithaca, New York.Google Scholar
Jordan, P. & Randall, K. (1962). Bilharziasis in Tanganyika: observations on its effects and the effects of treatment in school children. Journal of Tropical Medicine and Hygiene 65, 1–6.Google Scholar
Kassuku, A., Christensen, N. O., Nansen, P. & Monrad, J. (1986). Clinical pathology of Schistosoma bovis infection in goats. Research in Veterinary Science 40, 44–7.CrossRefGoogle ScholarPubMed
Kimura, E., Moji, K., Uga, S., Kiliku, F. M., Migwi, D. K., Mutua, W. R., Muhoho, N. D. & Aoki, Y. (1992). Effects of Schistosoma haematobium infection on mental test scores of Kenyan school children. Tropical Medicine and Parasitology 43, 155–8.Google ScholarPubMed
King, C. H., Lombardi, G., Lombardi, C., Greenblatt, R., Hodder, S., Kinyanjui, H., Ouma, J., Odiambo, O., Bryan, P. J., Muruka, J., Magak, P., Weinert, D., Ransohoff, D., Houser, S., Koech, D., Siongok, T. K. Arap & Mahmoud, A. A. F. (1990). Chemotherapy-based control of schistosomiasis haematobia. II. metrifonate vs. praziquantel in control of infection-associated morbidity. American Journal of Tropical Medicine and Hygiene 42, 587–95.CrossRefGoogle ScholarPubMed
Kurz, K. M., Stephenson, L. S., Latham, M. C. & Kinoti, S. N. (1986). The effectiveness of metrifonate in reducing hookworm infections in Kenyan children. American Journal of Tropical Medicine and Hygiene 35, 571–4.CrossRefGoogle Scholar
Kvalsvig, J. D. (1986). The effects of Schistosomiasis haematobium on the activity of school children. Journal of Tropical Medicine and Hygiene 89, 85–90.Google ScholarPubMed
Kvalsvig, J. D. (1988). The effects of parasitic infection on cognitive performance. Parasitology Today 4, 206–8.CrossRefGoogle ScholarPubMed
Kvalsvig, J. D. & Becker, P. J. (1988). Selective exposure of active and sociable children to schistosomiasis. Annals of Tropical Medicine and Parasitology 82, 471–4.CrossRefGoogle ScholarPubMed
Latham, M. C. (1984). Strategies for the control of malnutrition and the influence of the nutritional sciences. Food and Nutrition 10, 5–31.Google ScholarPubMed
Latham, M. C. (1989). Nutrition and work performance, energy intakes, and human well-being in Africa. Proceedings of the 14th International Congress of Nutrition 1, 314–17.Google Scholar
Latham, M. C., Stephenson, L. S., Hall, A., Wolgemuth, J. C., Elliott, T. C. & Crompton, D. W. T. (1983). Parasitic infections, anaemia and nutritional status: a study of their inter-relationships and the effects of prophylaxis and treatment on workers in Kwale District, Kenya. Transactions of the Royal Society of Tropical Medicine and Hygiene 77, 41–8.CrossRefGoogle Scholar
Latham, M. C., Stephenson, L. S., Kinoti, S. N., Zaman, M. S. & Kurz, K. M. (1990 a). Improvements in growth following iron supplementation in young Kenyan school children. Nutrition – an International Journal 6, 159–62.Google ScholarPubMed
Latham, M. C., Stephenson, L. S., Kurz, K. M. & Kinoti, S. N. (1990 b). Metrifonate or praziquantel treatment improves physical fitness and appetite of Kenyan school boys with Schistosoma haematobium and hookworm infections. American Journal of Tropical Medicine and Hygiene 43, 170–9.CrossRefGoogle ScholarPubMed
Latham, M. C., Lawless, J. W., Stephenson, L. S., Kinoti, S. N., Pertet, A. & Adams, E. (1991). Iron supplementation improves appetite in Kenyan children. FASEB Journal 5, A720.Google Scholar
Lawless, J. W., Latham, M. C., Stephenson, L. S., Pertet, A., Kinoti, S. N. & Adams, E. (1991). Iron supplementation and physical growth in Kenyan children. FASEB Journal 5, A720.Google Scholar
Lehman, J. S., Mott, K. E., Morrow, R. H., Muniz, T. M. & Boyer, M. H. (1976). The intensity and effect of infection with Schistosoma mansoni in a rural community in northeast Brazil. American Journal of Tropical Medicine and Hygiene 25, 285–94.CrossRefGoogle Scholar
Mahmood, A. (1966). Blood loss caused by helminthic infections. Transactions of the Royal Society of Tropical Medicine and Hygiene 60, 766–9.CrossRefGoogle ScholarPubMed
Mahmoud, A. A. F. (1982). Schistosomiasis: clinical features and relevance to hematology. Seminars in Hematology 19, 132–40.Google ScholarPubMed
Mansour, M. M., Francis, W. M. & Farid, Z. (1985). Prevalence of latent iron deficiency in patients with chronic S. mansoni infection. Tropical and Geographical Medicine 37, 124–8.Google ScholarPubMed
McGarvey, S. T., Aligui, G., Daniel, B. L., Peters, P., Olveda, R. & Olds, R. G. (1992). Child growth and schistosomiasis japonica in northeastern Leyte, the Philippines: cross-sectional results. American Journal of Tropical Medicine and Hygiene 46, 571–81.CrossRefGoogle ScholarPubMed
McGarvey, S. T., Wu, G., Zhang, S., Wang, Y., Peters, P., Olds, R. G. & Wiest, P. M. (1993). Child growth, nutritional status and schistosomiasis japonica in Jiangzi, People's Republic of China. American Journal of Tropical Medicine and Hygiene 48, 547–53.CrossRefGoogle Scholar
Mott, K. E. (1982). S. japonicum and S. japonicum-like infections. In Schistosomiasis: Epidemiology, Treatment and Control (ed. Jordan, P. & Webbe, G.), pp. 128–49. London: Heinemann Medical.Google Scholar
Nafeh, M. A., Medhat, A., Swifae, Y., Moftah, F. M., Mohamed, A., Soliman, A.-G. A. & Strickland, G. T. (1992). Ultrasonographic changes in the liver in Schistosoma haematobium infection. American Journal of Tropical Medicine and Hygiene 47, 225–30.CrossRefGoogle ScholarPubMed
Ndamba, J. (1986). Schistosomiasis: its effects on the physical performance of school children in Zimbabwe. Central African Journal of Medicine 32, 289–93.Google ScholarPubMed
Nooman, Z. M., Nafeh, M. A., El-Kateb, A., Atta, S. M. & Ezzat, E. S. (1974). Hepatosplenic disease caused by Bilharzia haematobium in Egypt. Journal of Tropical Medicine and Hygiene 77, 42–8.Google Scholar
Norden, D. A. & Gelfand, M. (1973). Urinary loss of protein and amino acids in Schistosoma haematobium infection. A quantitative estimate. Transactions of the Royal Society of Tropical Medicine and Hygiene 67, 607–8.CrossRefGoogle ScholarPubMed
Olveda, R. M., Tiu, E., Fevidal, P., Veyra, F. De, Icatlo, F. C. & Domingo, E. O. (1983). Relationship of prevalence and intensity of infection to morbidity in schistosomiasis japonica: a study of three communities in Leyte, Philippines. American Journal of Tropical Medicine and Hygiene 32, 1312–21.CrossRefGoogle ScholarPubMed
Ongom, V. L. & Bradley, D. J. (1972). The epidemiology and consequences of Schistosoma mansoni infection in West Nile, Uganda. Transactions of the Royal Society of Tropical Medicine and Hygiene 66, 835–51.CrossRefGoogle ScholarPubMed
Oomen, J. M. V., Meuwissen, J. H. E. TH. & Gemert, W. (1979). Differences in blood status of three ethnic groups inhabiting the same locality in northern Nigeria. Anaemia, splenomegaly and associated causes. Tropical and Geographic Medicine 31, 587–606.Google ScholarPubMed
Peters, W. & Gilles, H. M. (1977) A Colour Atlas of Tropical Medicine and Parasitology. London: Wolfe Medical Publications, Ltd.Google Scholar
Pope, R. I., Cline, B. L. & Alamy, M. A. El (1980). Evaluation of schistosomal morbidity in subjects with high intensity infections in Qalyub, Egypt. American Journal of Tropical Medicine and Hygiene 29, 416–25.CrossRefGoogle ScholarPubMed
Prata, A. (1982). Infection with S. mansoni. In Schistosomiasis: Epidemiology, Treatment and Control (ed. Jordan, P. & Webbe, G.), pp. 105–127. London: Heinemann Medical.Google Scholar
Prual, A., Daouda, H., Develoux, M., Sellin, B., Galan, P. & Hercberg, S. (1992). Consequences of Schistosoma haematobium infection on the iron status of schoolchildren in Niger. American Journal of Tropical Medicine and Hygiene 47, 291–7.CrossRefGoogle ScholarPubMed
Recommended Dietary Allowances (1980). Food and Nutrition Board, National Research Council, 9th edn.Washington, D. C.: National Academy of Sciences.Google Scholar
Robinson, A. & Lewert, R. M. (1980). The production and nature of anemia in Schistosoma japonicum infections. American Journal of Tropical Medicine and Hygiene 29, 1301–6.CrossRefGoogle ScholarPubMed
Rothwell, N. J. & Grimble, R. F. (1992). Metabolic and nutritional effects of TNF. In Tumor Necrosis Factors: the Molecules and their Emerging Role in Medicine (ed. Beutler, B.), pp. 237–54. Raven Press: New York, N. Y.Google Scholar
Salih, S., Marshall, T. F. De C. & Radalowicz, A. (1979). Morbidity in relation to the clinical forms and to intensity of infection in Schistosoma mansoni infections in the Sudan. Annals of Tropical Medicine and Parasitology 73, 439–49.CrossRefGoogle Scholar
Savioli, L. & Mott, K. E. (1989). Urinary schistosomiasis on Pemba Island: low-cost diagnosis for control in a primary health care setting. Parasitology Today 5, 333–7.CrossRefGoogle Scholar
Spurr, G. B., Reina, J. C., Dahners, H. W. & Barc-Nieto, M. (1983). Marginal malnutrition in school-aged Colombian boys: functional consequences in maximum exercise. American Journal of Clinical Nutrition 37, 834–47.CrossRefGoogle ScholarPubMed
Stephenson, L. S. (1987). The Impact of Helminth Infections on Human Nutrition: Schistosomes and Soil-Transmitted Helminths. London: Taylor and Francis, Ltd.Google Scholar
Stephenson, L. S. (1989). Urinary schistosomiasis and malnutrition. Clinical Nutrition 8, 256–64.Google Scholar
Stephenson, L. S., Latham, M. C., Kinoti, S. N. & Oduori, M. L. (1984). Sensitivity and specificity of reagent strips in screening of Kenya children for Schistosoma hematobium infection. American Journal of Tropical Medicine and Hygiene 33, 862–71.CrossRefGoogle Scholar
Stephenson, L. S., Latham, M. C., Kurz, K. M., Miller, D., Kinoti, S. N. & Oduori, M. L. (1985 a). Urinary iron loss and physical fitness of Kenyan children with urinary schistosomiasis. American Journal of Tropical Medicine and Hygiene 34, 322–30.CrossRefGoogle ScholarPubMed
Stephenson, L. S., Latham, M. C., Kurz, K. M., Kinoti, S. N., Oduori, M. L. & Crompton, D. W. T. (1985 b). Relationships of Schistosoma haematobium, hookworm and malarial infections and metrifonate treatment to hemoglobin level in Kenyan school children. American Journal of Tropical Medicine and Hygiene 34, 519–28.CrossRefGoogle ScholarPubMed
Stephenson, L. S., Latham, M. C., Kinoti, S. N. & Oduori, M. L. (1985 c). Regression of splenomegaly and hepatomegaly in children treated for Schistosoma haematobium infection. American Journal of Tropical Medicine and Hygiene 34, 119–23.CrossRefGoogle ScholarPubMed
Stephenson, L. S., Latham, M. C., Kurz, K. M., Kinoti, S. N., Oduori, M. L. & Crompton, D. W. T. (1985 d). Relationships of Schistosoma haematobium, hookworm and malarial infections and metrifonate treatment to growth of Kenyan school children. American Journal of Tropical Medicine and Hygiene 34, 1109–18.CrossRefGoogle ScholarPubMed
Stephenson, L. S., Latham, M. C., Kurz, K. M., Miller, D. M. & Kinoti, S. N. (1986). Relationships of Schistosoma haematobium, hookworm, and malarial infections and metrifonate treatment to nutritional status of Kenyan coastal school children: a 16-month follow-up. In Schistosomiasis and Malnutrition (ed. Stephenson, L. S.) pp. 27–65. Cornell International Nutrition Monograph Series no. 16. Ithaca, N. Y.: Cornell International Nutrition Program.Google Scholar
Stephenson, L. S., Kinoti, S. N., Latham, M. C., Kurz, K. M. & Kyobe, J. (1989 a). Single dose metrifonate or praziquantel treatment in Kenyan children. I. Effects on S. haematobium, hookworm, hemoglobin levels, splenomegaly and hepatomegaly. American Journal of Tropical Medicine and Hygiene 41, 444–52.Google ScholarPubMed
Stephenson, L. S., Latham, M. C., Kurz, K. M. & Kinoti, S. N. (1989 b). Single dose metrifonate or praziquantel treatment in Kenyan children. II. Effects on growth in relation to Schistosoma haematobium and hookworm egg counts. American Journal of Tropical Medicine and Hygiene 41, 453–61.Google ScholarPubMed
Stephenson, L. S., Latham, M. C., Adams, E. J., Kinoti, S. N. & Pertet, A. (1993). Physical fitness, growth and appetite of Kenyan school boys with hookworm, Trichuris trichiura and Ascaris lumbricoides infections are improved four months after a single dose of albendazole. Journal of Nutrition 123, 1036–46.Google ScholarPubMed
Tracey, K. J. & Cerami, A. (1989). Studies of cachexia in parasitic infection. Annals of the New York Academy of Sciences 569, 211–18.CrossRefGoogle ScholarPubMed
Vengesa, P. B. & Leese, H. J. (1979). Sugar absorption by the mouse small intestine following infection with Schistosoma mansoni. Transactions of the Royal Society of Tropical Medicine and Hygiene 73, 55–60.CrossRefGoogle ScholarPubMed
Warren, K. S., Mahmoud, A. A. F., Muruka, J. F., Whittaker, L. R., Ouma, J. H. & Siongok, T. K. Arap (1979). Schistosomiasis haematobia in Coast Province Kenya: Relationship between egg output and morbidity. American Journal of Tropical Medicine and Hygiene 28, 864–70.CrossRefGoogle ScholarPubMed
Warren, K. S., De-LONG, S., Zhao-Yue, X., Hong-Chang, Y., Peters, P. A., Cook, J. A., Mott, K. E. & Houser, H. B. (1983). Morbidity in schistosomiasis japonica in relation to intensity of infection: a study of two rural brigades in Anhui Province, China. New England Journal of Medicine 309, 1533–9.CrossRefGoogle ScholarPubMed
Wiest, P. M., Wu, G., Zhang, S., Yuan, J., Peters, P. A. S., McGarvey, S. T., Tso, M., Olveda, R. & Olds, R. G. (1992). Morbidity due to Schistosomiasis japonica in the People's Republic of China. Transactions of the Royal Society of Tropical Medicine and Hygiene 86, 47–50.CrossRefGoogle ScholarPubMed
Wilkins, H. A., Goll, P., Marshall, T. F. DE C. & Moore, P. (1979). The significance of proteinuria and hematuria in Schistosoma haematobium infection. Transactions of the Royal Society of Tropical Medicine and Hygiene 73, 74–80.CrossRefGoogle ScholarPubMed
Wilkins, H. A., Goll, P. H. & Moore, P. J. (1985) Schistosoma haematobium infection and haemoglobin concentrations in a Gambian community. Annals of Tropical Medicine and Parasitology 79, 159–61.CrossRefGoogle Scholar
World Health Organization (1967). Measurement of the Public Health Importance of Bilharziasis. Geneva: W.H.O. Technical Report Series No. 349.Google Scholar
World Health Organization (1985). The Control of Schistosomiasis, Report of a W.H.O. Expert Committee. Geneva: W.H.O. Technical Report Series no. 728.Google Scholar
World Health Organization (1987). Progress in assessment of morbidity due to Schistosoma haematobium infection: a review of the recent literature. Geneva: WHO (WHO/SCHISTO/87.91).Google Scholar
World Health Organization (1988 a). A health and nutrition atlas. World Health. May, p. 28. Geneva, Switzerland.Google Scholar
World Health Organization (1988 b). Progress in assessment of morbidity due to Schistosoma mansoni infection: a review of the recent literature (WHO/SCHISTO/88.97). Geneva, Switzerland.Google Scholar
World Health Organization (1988 c). Progress in assessment of morbidity due to Schistosoma japonicum infection: a review of the recent literature (WHO/SCHISTO/88.95). Geneva, Switzerland.Google Scholar
World Health Organization (1992). Health of school children: Treatment of intestinal helminths and schistosomiasis (WHO/CDS/IPI/CTD 92.1). Geneva, Switzerland.Google Scholar
Yason, C. V. & Novilla, M. N. (1984). Clinical and pathologic features of experimental Schistosoma japonicum infection in pigs. Veterinary Parasitology 17, 47–64.CrossRefGoogle ScholarPubMed
Yuesheng, L., Dongbao, Y., Yi, L., Yang, X. & Meng, X. (1992). Morbidity and health impact of schistosomiasis japonica in Dongting Lake area. A final report. Hunan Institute of Parasitic Diseases, P. R. China. W.H.O. Collaborating Centre for Research and Control on Schistosomiasis in Lake Region.Google Scholar
Zwingenberger, K., Irschick, E., Siqueira, J. G. Vergetti, Dacal, A. R. Correia & Feldmeier, H. (1990). Tumour necrosis factor in hepatosplenic schistosomiasis. Scandinavian Journal of Immunology 31, 205–11.CrossRefGoogle ScholarPubMed