By Gatonye Gathura
Kenya’s first test-tube babies turned 12 years last month with scientists in Nairobi and US blaming growing cases of childlessness to bilharzia. The two girls from different mothers and now adolescents were born on 8th May 2006, at Avenue Hospital in Nairobi.
They were born of mothers, aged 30 and 35, through Caesarian section with their identities and those of the parents still remaining a secret. Since then, the two have been joined by an estimated 2,000 other test-tube babies from about nine fertility centers in the country.
A 2011 study by the Aga Khan University Hospital shows that there are at least two million couples, mainly from poor status requiring assisted reproductive technology in Kenya. Kenya falls within the African infertility belt which stretches across central Africa from Tanzania to the East to Gabon to the West.
In a larger study: Schistosomiasis and Infertility in East Africa, appearing in the January issue of the American Journal of Tropical Medicine and Hygiene, Patricia Woodall and Michael Kramer of Emory University, US reported a link between untreated bilharzia to female infertility in Kenya, Tanzania and Ethiopia.
In countries within the belt infertility rates of up to 30 per cent, have been recorded which is much higher than the worldwide average of 8–12 per cent.
This is mainly blamed on sexually transmitted infections (STIs) but recently scientists have argued that this does not fully explain the geographic variations. Even within Kenya, rates of infertility have been found to follow some geographic patterns with the highest at the Coast, Nyanza and pockets of Central Kenya such as Mwea in Kirinyaga County.
“We now believe we have finally pinned down the main cause of female infertility in Africa and its prevention,” says Charles H. King of Case Western Reserve University, US. King and others including at Kenya’s Ministry of Health have now linked high regional infertility rates to the presence of water bodies and high rates of bilharzia.
In a series of studies, the latest published in the current American Journal of Tropical Medicine and Hygiene, the team say women who have had bilharzia infections were at a high risk of becoming infertile.
They describe the two types of bilharzia flukes: S. mansoni and S. haematobium and blame the latter which causes female genital bilharzia for the high rates of infertility in girls and women in the region. In their extensive studies in Kenya, Ethiopia, Tanzania, and Uganda the Kramer team found women living in areas of high S. haematobium were at highest risk of infertility compared to women residing elsewhere.
“By the age of 10–12 years, school-age girls are known to already manifest symptoms of genital bilharzia which later turns into infertility,” says the latest study. The researchers want current school-based deworming programmes at the Coast, Mwea in Central and western Kenya to be intensified and to specifically target girls to prevent infertility later in life.
The scientists want mass drug administration for all girls aged 9-10 in bilharzia prone areas to reduce the incidence of adult infertility. For deworming against bilharzia, the World Health Organization recommends the drug praziquantel with a once off annual dose costing about US$ 0.02 per girl. “In this region, aggressive control of bilharzia can help limit childlessness and attendant stress,” says Kramer