Schistosomiasis in expatriates in the Arusha region of Tanzania.

BACKGROUND: In 1996 the seroprevalence of schistosomiasis in expatriates and travelers who had contact with Lake Malawi, a fresh water source thought to be schistosomiasis-free, was measured at 32%. Clinicians in Arusha, Tanzania, questioned the prevalence of Schistosoma infection in expatriates living in the Arusha region, and how schistosomiasis might relate to symptoms of chronic fatigue in Arusha expatriates. METHOD: We performed a cross-sectional survey of 80 expatriates living in the Arusha region of Tanzania to determine the seroprevalence of schistosome infection. Whole blood was analyzed by the Falcon assay screening test-enzyme-linked immunosorbent assay (FAST-ELISA) for the presence of species-specific Schistosoma mansoni and Schistosoma haematobium antibodies to microsomal antigens of adult Schistosoma worms, followed by confirmatory enzyme-linked immunoelectrotransfer blot (Western blot). Volunteers answered a questionnaire which included length of residence in Arusha, risk factors, symptoms, and previous diagnosis of schistosomiasis. RESULTS: Of the 80 expatriates sampled, 8 (10%) were positive for schistosomiasis (6 to S. mansoni only, 1 to S. haematobium, 1 to both species). Significant risk factors, elicited by questionnaire, included longer residence in the Arusha region (p =.020), history of fatigue (p =.010) and myalgias (p =.047), and previous diagnosis of schistosomiasis by stool or urine ova (p =.0007). CONCLUSION: The lower seroprevalence of schistosomiasis in Arusha expatriates, compared with expatriates and travelers to Lake Malawi, suggests a regional variation of rate of schistosomiasis infection. Although a history of fatigue and myalgias was related to seropositivity, there is no strong evidence that schistosomiasis infection is the cause of chronic fatigue in Arusha expatriates.