A recent study has revealed alarming rates of bilharzia infection among children under two years of age, shedding light on a vulnerable group previously overlooked in disease control efforts. Bilharzia, also known as schistosomiasis, is a parasitic disease common in tropical regions and is one of the 20 Neglected Tropical Diseases (NTDs). The disease affects millions of people, particularly in areas with limited access to clean water and sanitation.
The study focused on young children in western Kenya, specifically in the Mbita region, and found that infants as young as eight months old were infected with Schistosoma mansoni, one of the main species responsible for the disease. Out of 361 children aged between six and 23 months enrolled in the research, a staggering 289 tested positive for the infection.
Bilharzia has two forms depending on the species involved. One causes blood in the stool by attacking the intestinal system, while the other leads to blood in the urine by affecting the urogenital system. These symptoms result from the parasites lodging in either the intestines or bladder, causing tissue damage that leads to bleeding.
The disease’s life cycle involves freshwater snails that act as intermediate hosts. Parasite eggs are released into water bodies through the urine or feces of infected individuals. These eggs hatch and infect the snails, where they develop into a stage that can infect humans. When people come into contact with contaminated water whether through swimming, washing clothes, fishing, or working in fields the parasite penetrates their skin and enters the bloodstream.
In Kenya, bilharzia is endemic mainly in coastal regions and around Lake Victoria, with significant infection rates in counties like Kisumu, Kakamega, Homa Bay, and others. Over 2.5 million people are at risk of infection nationwide. While school-aged children have been the primary target of control efforts, mainly through Mass Drug Administration (MDA) with praziquantel, younger children have often been excluded due to limited data on infection rates in this group.
This new evidence indicates that children under two years old are not only at risk but also bear a significant burden of the disease, underscoring the urgent need to expand treatment programs to include pre-school-aged children. The study authors emphasize that neglecting this group could lead to serious health consequences and perpetuate the cycle of infection.
Bilharzia is frequently called a “poor man’s disease” because it thrives in environments lacking clean water, proper sanitation, and healthcare services. Poverty is a major driver of the disease’s spread, as people living in affected regions often rely on unsafe water sources for daily activities. Improving access to clean water and sanitation infrastructure is critical for controlling transmission.
Preventive measures include avoiding contact with contaminated freshwater, treating or boiling water used for domestic purposes, and providing safe piped water in endemic areas. Health education plays a vital role in informing communities about the risks associated with contaminated water and encouraging hygienic practices.
Annual deworming with praziquantel remains the most effective treatment and control strategy. Given the findings, it is now clear that treatment programs must be adapted to cover younger children to reduce the infection reservoir and prevent long-term health complications.
Efforts to combat bilharzia also involve improving hygiene and sanitation and educating affected populations about the disease cycle. With coordinated public health interventions and adequate resources, the burden of bilharzia can be significantly reduced, offering hope for healthier futures for vulnerable children, including those still breastfeeding.
