Schistosomiasis in Lake Malawi: Relationship of Fish and Intermediate Host Density to Prevalence of Human Infection

Prior to 1985, the open waters of Lake Malawi were free from schistosome transmission. Over the past decades, however, the prevalence of urinary schistosomiasis has increased dramatically in the southern part of the lake. We found the prevalence of human schistosomiasis in school-aged children to be negatively correlated with the density of molluscivorous fishes. Specifically, the increased infection rate in southern Lake Malawi between 1978 and 1991 is coincident with the reduction in numbers of snail-eating fishes. During 2003, we determined the relative abundance of molluscivorous fishes and snail density at 18 sites throughout the lake and schistosome infection in school-aged children living in selected lakeshore communities of Lake Malawi. At the 18 sites sampled in 2003, we found that snail abundance decreased with an increase in abundance of snail-eating fishes. Furthermore, the 2003 samples showed that the abundance of snail-eating fishes increased and there was a reduction in schistosomiasis in school-aged children in Chembe Village. We believe that we will not observe a return to the 1978 infection rates until these fishes continue to increase and inhabit shallower waters.