In series A, 2 children were examined wiith
urine and stool examination, Eosinophil. Counts, and
Cercarial Skin Test Antigen.
15 cases with ova demonstrable, gave raised
Eosinophil Counts and + positive Skin Tests.
In series B, 30 adult male Railway employees were
similarly investigated. 8 cases has ova
demonstrable in either urine or stool. All gave a
+ positive skin test, but Eosinophil :Dounts did not
snow a consistent rise. Cases Nos. 11, 12 and 19
alone had percentage counts above normal limits.
In -series C, 33 adult male private patients were
similarly investigated. Only one case was found to
nave demonstrable ova, the case gave a positive skin
test and the Eosinophil count was normal.
In series D 18 adult private patients were similarly
investigated. None showed demonstrable ova in urine
or stool. One case (No. 18) with a previous history
of S. mansoni infestation was found to have a very
high Eosinophilia and a doubtful skin test reaction.
This case was further investigated by crystoscopy and
sigmoidoscopy with negative findings and a diagnosis
of Tropical Eosinophilia was finally mace.
In the cases where ova were present in urine and stool: -
In series A, three children gave positive skin test,
Eosinophilia and history of risk of infestation.
Two children gave doubtful skin test, normal
Eosinophilia Counts and risk of infestation, and
nine children gave negative skin test, normal
Eosinophil Counts and possible risk.
In series B, seven cases of Railwaymen gave positive
skin test, and normal Eosinophil Counts, except in
2 cases where Eosinophilia was present. Three
cases of Railwaymen gave doubtful skin test - one only
had an Eosinophilia, and eleven cases of Railwaymen
gave negative skin test - two only had an Eosinophilia.
All these cases ran an occupational risk of infestation.
In series C, two cases gave a positive skin test,
normal Eosinophil Counts and risk of infestation. Five
cases gave a doubtful skin test, normal Eosinophil
Counts and risk of Infestation, and twenty-five cases
gave a negative skin test, Eosinophilia was present in
4 cases only, and risk of infestation was doubtful.
In series D, two cases gave a positive skin test, both
had Eosinophilia and risk of infestation was unlikely.
One case gave a doubtful skin test, a very high
Eosinophilia, and a history of old S. mansoni
infestation of 4 years duration, and fourteen cases
gave a negative skin test, five of whom has an
Eosinophilia. The risk of infestation in all these
cases was very improbable.
In a review of the cases in the series
A, B, C, and D, it is apparent that: -
1. The demonstration of ova in urine and stool is
positive evidence of the disease; that in such cases
the Cercarial Skin Test Antigen gives a positive
reaction in every case, and that the Eosinophil
Percentage Count is not a completely reliable test
in such cases. •
2. Absence of ova in urine and stool in a case does
not necessarily imply freedom from the disease as
such cases do not. always give a negative Cercarial
Skin Test Antigen Reaction, nor is the Eosinophil
Percentage Count always within normal limits. Should,
however, the Cercarial Skin Test Reaction be a negative
one, and the Eosinophil Count is normal, then it is
practically certain the case is not one suffering
from Schistosomiasis. •
3. Absence of ova in urine and stool in a case
giving a positive Cercarial Skin Test Antigen may or
may not mean the presence of Schistosomiasis, even
with an Eosinophilia. •
4. The absence of ova in urine and stool in a case
giving a doubtful Cercarial Skin Test Antigen Reaction
may or may not mean the presence of Schistosomiasis,
and that, with or without an Eosinophilia.
In cases complying with categories 3 and 4, further
intensive investigations are called for by
cystoscopic and sigmoidoscopic examinations as well
as further examinations of urine and stool specimens,
etc. From this examination and analysis the author
concludes that; -
The children in S. Rhodesia are very liable
to infestation by Schistosomiasis.
The employees on the Rhodesian Railways in
tn.e course of their occupation run a very grave
risk of becoming infested, and
The men and women engaged in their ordinary
pursuits of life in cities of S. Rhodesia are the
least likely subjects to fall victim to the disease.