How can schistosomiasis (bilharzia) be prevented?

Updated: Jun 11, 2020
  • Author: Shadab Hussain Ahmed, MD, AAHIVS, FACP, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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Travelers to endemic areas should avoid contact with fresh water. Suspect acute schistosomiasis in a setting of recent contact with fresh water and treat early if diagnostic test results are positive or clinical suspicion is high. Early treatment after high-risk exposures should minimize morbidity.

People returning from endemic areas with history of exposure to fresh water should be screened by serologic testing for schistosomiasis. Many infections are silent and may remain asymptomatic. Urine and stool screening should be obtained in patients with positive serologies for species identification. [63] Rates of schistosomiasis seropositivity have been recorded as 44% and 23% in African refugees. [66]

Topical lipid formulations of N,N-diethyl-m-toluamide (DEET), such as LipoDEET, are effective in killing schistosome cercariae. Minimal absorption, low cost, and a range of activity against insects and schistosomes make this compound an excellent prophylactic agent against human and animal schistosomiasis, especially for travelers. [67]

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