Transmission of schistosomiasis in Kariba, Zimbabwe, and a cross-sectional comparison of schistosomiasis prevalences and intensities in the town with those in Siavonga in Zambia.

Given that the two communities lie only 10 km apart, on the northern shore of Lake Kariba, it is surprising that human schistosomiasis now appears to be a much less important health problem in Kariba town (Zimbabwe) than in Siavonga town (Zambia). In an attempt to explain this difference, the level and sites of Schistosoma haematobium and S. mansoni transmission in Kariba, and the prevalences and intensities of human infection with these parasites in both communities, have now been investigated. In a longitudinal study, a cohort of 378 schoolchildren, 150 subsistence fishermen and 42 commercial fishermen from Kariba town was screened three times for schistosome infection, at 6-month intervals. Sixteen human-water contact sites in or near the town were surveyed for intermediate host snails every month for 1 year. Finally, the results of screening 660 Kariba schoolchildren (in January 2001) and 527 Siavonga schoolchildren (in July 2002) were compared. In the longitudinal study, 9.0% of the schoolchildren, 7.3% of the subsistence fishermen and 0% of the commercial fishermen were each found positive for S. haematobium at least once. The corresponding values for S. mansoni were 2.5%, 12.5% and 26.3%, respectively. The results indicated that, each year in Kariba, 2.4% and 2.0% of schoolchildren and 18.2% and 5.2% of fishermen were infected with S. haematobium and S. mansoni, respectively. Although both Bulinus globosus and Biomphalaria pfeifferi were found at 14 of the 16 water-contact sites, snails infected with schistosomes that could infect mammals were only found at three of the sites. The problem of schistosomiasis in Kariba town appears to be greater among fishermen than schoolchildren, all transmission probably occurring in Lake Kariba. As expected, the overall prevalences of S. haematobium and S. mansoni infection among Siavonga schoolchildren (19.4% and 33.5%, respectively) were far higher than the corresponding values for Kariba schoolchildren (7.1% and 2.1%, respectively). The marked differences in the prevalence of human schistosomiasis between Kariba and Siavonga appear to be attributable to the better water and sanitation facilities and a history of schistosomiasis-control activities in Kariba town.