SCHISTOSOMIASIS IN AUSTRALIAN TRAVELERS TO AFRICA

Objective: To determine the proportion of Australian travellers to Afr ica at risk of Schistosoma infection, and the proportion of those infe cted. Design and Participants: Retrospective postal survey of 360 pati ents who had attended Fairfield Hospital travel clinic in 1994 and sta ted an intention to travel to Malawi, Zimbabwe or Botswana. Main Outco me Measures: Self-reported risk status for Schistosoma infection. For those at risk, results of an indirect haemagglutination assay (IHA). F or those with IHA titres greater than or equal to 1:32, results of enz yme-linked immunosorbent assay, urine microscopy and eosinophil count. Results: 360 letters were sent; 35 were returned to sender. Of the 32 5 remaining, 250 (77%) either responded or had an IHA test; 19 of thes e were still overseas or did not travel. 117/231 (51%) returned travel lers considered themselves at risk of infection. Significantly fewer o lder patients reported exposure (chi(2) = 66.6; P < 0.001). 109/117 (9 3%) of those at risk had IHA tests and 18 had titres greater than or e qual to 1:32. Subsequent testing indicated infection in 10/117 travell ers (8.5%; 95% CI, 4.2%-15.2%). Conclusion: Our findings indicate that a considerable number of Australian travellers to Africa are at risk of schistosomiasis, and some are infected. As complications can be ser ious, screening is recommended for individuals with any risk of infect ion, and treatment should be offered to those infected.