Dr Lisa Chapman, Stafford
Known also as The Pearl of Africa, it is a country of spectacular natural beauty. Not only does it have the largest lake in Africa (Lake Victoria), the world’s longest river (Nile River), the tallest mountain range in Africa (Rwenzori Mountains), and one of the world’s most powerful waterfalls (Murchison Falls). Uganda also lies on the equator, has open savannah, dense rainforest, deep crater lakes, lush green hills, intensely red earth, abundant birdlife, diverse wildlife, and is home to half of the world’s remaining mountain gorillas.
I recently travelled to Uganda as a participant in a tropical medicine expedition course (www.tropmedex.com). There are many significant health issues faced by the people of Uganda, including HIV/AIDS, tuberculosis, malaria, leprosy, sleeping sickness, river blindness and schistosomiasis.
Schistosomiasis, also known as bilharzia, is transmitted via skin contact with affected fresh water. Even brief exposure can result in infection. It is estimated that over 200 million people worldwide are infected with this parasite, mostly in sub-Saharan Africa. The parasite can infect the bladder, intestines, spinal cord and brain, with serious complications.
In Uganda, Jinja is a popular travel destination for white-water rafting on the mighty Nile River. An estimated 12 000 people raft in Uganda each year. It is often thought that fast moving white-water presents a low risk for infection, however a study has shown that after recreational exposure to river white-water in Uganda, 17% of participants subsequently had evidence of schistosomiasis infection.
It is recommended to avoid swimming, wading and rafting in fresh water lakes, rivers, and white-water in schistosomiasis endemic countries. Importantly, see your travel medicine doctor if you think you may have been at risk of infection during your travels, as there is a simple test and treatment available which will prevent long term damage from this worm.