The only schistosome species found in stool specimens in the local population of the republic of São Tomé is Schistosoma intercalatum. An initial survey of schoolchildren showed an overall prevalence of 10.9%, with some schools reaching 29%. No S. haematobium egg was found in 782 urine specimens from the local population, although some were seen in the urine of Angolan soldiers stationed near the capital city. One village in the endemic area, San Marçal, had an S. intercalatum prevalence of 43%, with 14 persons > 40 years of age harbouring severe infections. The transmission area is restricted to the north-east of the main island, where 5 foci apparently account for most of the infections. Seven cases recorded from Principe may be explained by the fact that the children were attending school at São Tomé. Women carrying out domestic activities are more at risk of contracting the infection because of longer periods of water contact than men. The morbidity produced by the infection is restricted to splenomegaly and blood in the stools. High prevalences have been found of Ascaris lumbricoides and Trichuris trichiura, and hookworm and Stronglyloides stercoralis were also observed. Praziquantel was well tolerated and appears to be a good tool for control purposes, although reinfection in the transmission area apparently occurs rapidly. Control strategies based on chemotherapy should take into account an older age group as well as the schoolchildren. Focal mollusciciding and the introduction of washing facilities may also have a role to play in control. The possible recent introduction of the infection to the island is discussed.
Variability of Schistosoma intercalatum eggs in shape and size, and their similarity to those of S. haematobium presented a problem of species identification when egg morphology was the diagnostic criterion used in a study of human schistosomiasis conducted on São Tomé and Principe. More than 2500 egg measurements were obtained by light micoscopy to gather data relating to size variability of S. intercalatum eggs, to evaluate whether factors such as age of host, sex of host and intensity of infection are correlated with variability, and the data were compared with previously published measurements on different isolates and strains of S. intercalatum: the range in length (104–203 μm) embraces most of the measurements reported in other studies of S. intercalatum eggs. There was no correlation either between age and sex of the host, or intensity of infection with variability of egg size. Comparison between measurements of the eggs of S. haematobium, S. intercalatum and S. bovis eggs are presented.
This paper reports the morphological and biochemical characterization of the species of Schistosoma infecting humans in the Republic of São Tomé and Principe. The eggs are typical in shape and size of S. intercalatum, measuring on average between 174.5 microns and 189.1 microns. The eggs are voided in the faeces and not the urine of infected people. The parasite experimentally develops in several different species of Bulinus belonging to the B. forskalii group, including B. forskalii, with a minimum prepatent period of 25 d, and also in snails of the B. reticulatus group (B. wrighti); it is incompatible with snails of the B. africanus and B. truncatus/B. tropicus complex. A survey of 5 different habitats at intervals of 2 weeks over a period of one year showed that populations of B. forskalii increased during the dry period of June, July and August in 1988, and in 3 of the habitats snails were present throughout the year. Hence transmission may take place in these habitats throughout the year. Preliminary evidence suggests that water velocity is a limiting factor confining Bulinus to the north-east of the island where the terrain is less mountainous. Development of schistosomes from São Tomé was followed in experimentally infected hamsters. The cross-over point (the point at which the paired male and female worms are of the same average length) occurred at about 49 d after infection: eggs were first seen in the uteri of the female worms 48 d after infection. The parasite from São Tomé developed in sheep and produced viable eggs.(ABSTRACT TRUNCATED AT 250 WORDS)
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