• Iron deficiency anaemia

• Problems in pregnancy

• Growth and stunting in childhood

• Poor cognitive development in childhood

Iron deficiency anaemia and schistosomiasis.

Schistosomiasis is thought to cause iron deficiency anaemia through intestinal blood loss and blood loss in the faeces and urine. During infection, eggs of the schistomes pass through the intestinal wall and into the gut causing damage and inflammation. This causes the blood and iron loss resulting in iron deficiency anaemia.
A study carried out to investigate the relationship between schistosomiasis infection and iron status in 174 school children found that there was a significant connection between the two issues. Iron deficiency anaemia was found in 57.7% of the subjects and the prevalence of anaemia increased with the number of eggs found in the samples analysed.
This demonstrates a need for levels of iron to be increased in the diet in areas where schistosomiasis is endemic. As mentioned previously, iron levels can be improved by increasing the amount of iron in the diet. Consuming foods such as meat, fish, green leafy vegetables, legumes and fortified grains will provide good sources of iron.

(Friedman et al., 2005; Prual et al., 1992)

Schistosomiasis in pregnancy.

Schistosomiasis can have detrimental effects on pregnant women because of the nutritional deficiencies it can cause. Blood loss through the stools or urine of a sufferer can encourage iron loss in the body. This can then create iron deficiency anaemia, which may create problems in pregnancy and the overall health outcome of the foetus.
As in malaria, anaemia caused by schistosomiasis can cause low birth weights in children which increases risk of child mortality.
A study conducted in Tanzania assessed 972 pregnant women and the connection between schistosomiasis infection and anaemia. 63.5% of women were infected with schistosomiasis and 66.4% of women were found to be anaemic. Connections were made in this study that highlighted heavy schistosomiasis infection and the increased risk of anaemia.
Treatment of schistosomiasis is considered relatively safe for pregnant women, yet once treated reinfection can occur. It is advised that pregnant women increase levels of iron within their diet to decrease the risk of developing anaemia if they become infected again with schistosomiasis. When supplementation is not available, available foods that are rich in iron can be recommended such as meat like beef or goat, green leafy vegetables such as spinach or fortified grains and pulses. It is also recommended that tea is not consumed, as it is a known inhibitor of iron absorption.

(Friedman et al., 2005; Ajanga et al., 2005; Tatala et al., 1998)

Childhood stunting and schistosomiasis

Childhood stunting can occur when a child is severely malnourished and underweight. Due to the nutritional deficiencies schistosomiasis creates in an infected individual and the immune response that the body has to the infection it can affect bone formation and growth.

A study carried out by Assis et al (2004) investigated the relationship between stunting, schistosomiasis infection and dietary intakes of school age children. Out of 461 children analysed, 55.1% were infected with schistosomiasis with 22.1% suffering from growth stunting. The study also found that lipid (fat) levels were much lower in those of the infected children than children with adequate diets. This demonstrates that inadequate diets without satisfactory levels of nutrients increase the risk of childhood stunting in schistosomiasis infection.

(Assis et al.,2004)

Schistosomiasis and cognitive function.

There have been connections made between heavy schistosomiasis infection and poor cognitive function in children because of the development of IDA and malnourishment associated with this infection.

A study conducted in Tanzania analysed 160 children that were heavily or moderately infected with schistosomiasis. After conducting memory and reaction tests, it was found that the children heavily infected with schistosomiasis had significantly lower scores on short term memory tests and reaction tasks. This study concluded that the children with heavy schistosomiasis were most likely to have poor nutritional status and suffer from poor cognitive development and function.
This again highlights the importance to increase overall levels of nutrition in children at risk of schistosomiasis.

(Jukes, 2002)