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Schistosoma Mansoni Proctocolitis with Polyposis

Fridah Bosire, Ian Orwa, Michael Mwachiro, Robert Parker, Russell White Tenwek Hospital

Correspondence to: Dr. Fridah Bosire, P.O. Box 39 Bomet, Kenya.

Email: fridahbosire@gmail.com

Summary

Schistosoma proctocolitis is a rare disease entity, with limited literature on its occurrence. We report the case of a 17 year old male from an endemic area around Lake Victoria, Western Kenya, where detailed disease mapping of Schistosomiasis has been carried out. The patient presented with a seven year history of a protruding rectal mass and occasional hematochezia. Colonoscopy revealed multiple polyps involving the entire colon to the anus, and pathology showed inflammatory polyps secondary to Schistosoma mansoni. He was successfully managed with medical therapy.

Key words: Schistosomiasis, Helminthiasis, Neglected Diseases, Colonoscopy, Colonic Polyps Ann Afr Surg. 2018; 15(2):81-85

DOI: http://dx.doi.org/10.4314/aas.v15i2.11

© 2018 Author. This work is licensed under the Creative Commons Attribution 4.0 International License.

Conflicts of Interest: None

Funding: None

Introduction

Schistosomiasis or Bilharziasis is a chronic infection caused by blood flukes. This parasitic disease constitutes significant public health challenges, and is associated with great morbidity and mortality with millions of people being affected worldwide. Globally, at least 230 million people are infected (1, 2, 14). According to a World Health Organization (WHO) report in 2014, the disease is prevalent in 74 countries, with at least 52 endemic countries including Kenya where preventative strategies have been set in place. Over 258 million people required preventive treatment and 62 million were treated for schistosomiasis (14). Ninety percent of these cases were in Africa (2, 5).

In Kenya, the annual mortality rate from schistosomiasis has decreased by 61.3% since 1990 (10,11), majorly due to public health strategies put in place that target chemotherapy given to school going children. The disease is endemic throughout the entire region. Estimates for the proportion of the population infected in Kenya have remained at 23% since the first estimation in1986 [11]. According to WHO, 12 million people in Kenya req