Pulmonary paragonimiasis in Cameroon.

Paragonimus africanus has been known to be endemic in the Bakossi area of Meme Division of Cameroon since it was first described in 1952. After a lapse of 25 years, exploratory work was undertaken in the area (but not in the same villages) to study the prevalence of the disease, to record the common presenting symptoms, to make a number of paraclinical examinations, to assess the beliefs and attitudes of the people towards the disease and the possible reasons for its persistent endemicity in that area and to carry out a therapeutic trial with Niclofolan (Bilevon). The disease was found to have a prevalence of 5% with a higher prevalence among those less than 20 years old. Boys were more affected than girls. The population did not appear to recognize the disease which they confused with tuberculosis. The disease was contracted by eating improperly cooked crabs, the intermediate host. The therapeutic trial with Bilevon given orally as a single dose was completely successful. This study showed that paragonimiasis must be considered seriously in the differential diagnosis of tuberculosis in this area and that a study on a much wider scale is required to establish the real extent of the disease.