Schistosomiasis in the Senegal River Basin: before and after the construction of the dams at Diama, Senegal and Manantali, Mali and future prospects.

Ecological changes in the Senegal River Basin (SRB) resulting from the construction of a barrage at Diama, Senegal on the Senegal River to prevent the intrusion of sea water into the river, and a dam at Manantali, Mali on the Bafing River to control the flow of water and to generate electricity, have been responsible for changes in the epidemiology of human schistosomiasis. The introduction of Schistosoma mansoni into the Lower and Middle Valleys of the SRB and subsequent spread of the parasite in the human population is recorded with regard to prevalence and intensity. New foci of S. haematobium are described. The reduction in salinity and change from an acidic to an alkaline environment in the water are beneficial to both the fecundity and growth of freshwater snails and transmission of the parasite. The creation of new irrigation canals and expansion of the rice fields have provided new habitats for intermediate hosts to colonize. The evidence for praziquantel resistance/tolerance by populations of S. mansoni and the possibilities of the development, production and testing of a vaccine against human schistosomiasis are discussed. Future studies will monitor the spread of human urinary and mesenteric schistosomiasis in the SRB, will evaluate further the presence of praziquantel resistance/tolerance in S. mansoni, will examine the heavily infected human population for pathological symptoms and determine the most appropriate methods to control this severe outbreak of human schistosomiasis.