SCHISTOSOMA-MANSONI IN MIGRANTS ENTERING SOUTH-AFRICA FROM MOCAMBIQUE- A THREAT TO PUBLIC-HEALTH IN NORTH-EASTERN KWAZULU-NATAL

Objectives. To identify possible public health consequences of Schisto soma mansoni infections in migrants entering north-eastern KwaZulu-Nat al and Mpumalanga and Northern Province from southern Mocambique. Desi gn. (i) Intestinal parasite surveys, one sample per person, within a 4 -month period; (ii) temperature recordings and snail collections in an irrigation system. Setting. North-eastern KwaZulu-Natal and Kruger Na tional Park, Mpumalanga and Northern Province. Participants. Ninety-se ven migrants (1-68 years) from north-eastern KwaZulu-Natal and 47 from the Kruger Park (1-70 years). Main outcome measures. The relatively h igh S. mansoni prevalence may cause problems on the rice paddy scheme in north-eastern KwaZulu-Natal. Ranges and prevalence rates of other p arasites were recorded. Results. S. mansoni prevalence in Mocambicans entering north-eastern KwaZulu-Natal was 14.4%, seven times more than in local residents. S. mansoni is not endemic to this region because m ost bodies of water become too warm for either the parasite or its sna il host, Biomphalaria pfeifferi, to develop. Recordings in paddies sug gest, however, that the rice modifies the temperature pattern as it gr ows and provides a suitable habitat for transmission. Migrants enterin g the Transvaal lowveld where S. mansoni is endemic may become more se verely infected. Thirteen other parasite species were recorded from mi grants entering KwaZulu-Natal and 8 from those entering Mpumalanga and Northern Province. Conclusions. The relatively high S. mansoni preval ence among migrants entering north-eastern KwaZulu-Natal may have publ ic health implications as it could encourage transmission in a non-end emic area. The range of parasites carried by migrants entering KwaZulu -Natal, Mpumalanga and Northern Province was similar to that. harboure d by local people but prevalence rates were generally lower.