Polluted lakes, rivers affect fertility

Lakes and rivers that used to be trusted sources of potable water in the country now pose danger to women's fertility.

Scientists have revealed that many rivers and lakes in the country are polluted with the eggs of the parasite that causes schistosomiasis, also referred to as bilharzia, posing the risk of infertility among women who use those water bodies.

The pollution of these water bodies has come about as a result of open defecation and open urination into them.

Bilharzia is a disease caused by a parasitic worm found in freshwater that can live inside people and cause discomfort or symptoms like blood in urine and stool.

For some women, it can also lead to other problems which can develop over a long period of time. These include genital bleeding, miscarriage or barrenness. This is known as female genital schistosomiasis (FGS).

Treatment

The Programme Manager of the Neglected Tropical Diseases (NTDs), Dr Joseph Larbi Opare, who disclosed this in an interview with the Daily Graphic, accordingly advised all eligible persons, especially those staying along water bodies, to participate in all mass drug administration exercises organised in their communities by the Ghana Health Service (GHS) to treat the condition.

He further advised against open defecation and urination, especially near water bodies, while advocating personal hygiene and the use of potable water.

Disease

Schistosomiasis is one of the 21 known NTDs.

People get infected when larval forms of the parasite — released by freshwater snails — penetrate the skin during contact with infested water.

This can be through contact with contaminated water when walking, swimming or playing in it.

Transmission occurs when people suffering from schistosomiasis contaminate freshwater sources with faeces or urine containing parasite eggs, which hatch in water.

Schistosomiasis is prevalent in tropical and subtropical areas, especially in poor communities without access to safe drinking water and adequate sanitation.

Female genital schistosomiasis (FGS) has been described as one of the most neglected sexual and reproductive health diseases in sub-Saharan Africa, with an estimated 56 million women and girls currently living with the disease.

Dr Opare said although genital schistosomiasis affected both male and female, prevalence of the condition among males in Ghana was just under one per cent, while females had between 10 and 17 per cent infection.

Infertility

Explaining how females could become infertile from FGS, Dr Opare said research had revealed that when some of the eggs from the schistosomes were retained in the body, especially in the urogenital tract, the bladder and where the reproductive organs were, they were able to cause immune reactions.

He said when that happened, it led to inflammation of the cervix, the vagina, the uterus and fallopian tubes, which might lead to a blockage.

So even when the eggs were released, the eggs could not be fertilised because the eggs would not be able to move through the tubes and the spermatozoa would also not be able to move to meet the egg.

“When it happens this way, one eventually becomes infertile or subfertile and the signs and symptoms of FGS are just like any sexually transmitted infection.

"There's pain after intercourse - lower abdominal pain - there's a vaginal discharge and all those symptoms depicting STIs.

So you may treat with the normal medicines that we have, but you may end up missing the fact that schistosomiasis can cause that as well,” he said.

He said that was not the case for many years when people talked about schistosomiasis mainly in terms of blood in urine.

Blood urine

Dr Opare consequently advised that when people living along water bodies, especially lakes, began to notice blood in their urine, it was an indication that they might have the parasite-causing schistosomiasis.

He, however, explained that people living along lakes were not to get the condition if they did not step in the water, swim or farm in it.

He explained that children between five and 14 years were the worst affected by schistosomiasis because they normally swam a lot, played and did many things in water bodies.

Fortunately, he said, both FGS and schistosomiasis could be treated with a drug which was normally administered during mass drug administration exercises organised by the Ghana Health Service (GHS).

He, therefore, asked all those living in schistosomiasis endermic areas to participate in such exercises in their communities, regardless of whether they were sick of the condition or not.

He said the exercise was normally organised once every year in the endermic areas of the country for school age children and adults.