The use of a molluscicide, in conjunction with chemotherapy, to control Schistosoma haematobium at the Barombi Lake foci in Cameroon. I. The attack on the snail hosts, using N-tritylmorpholine, and the effect on transmission from snail to man.

The background and strategy of a campaign to control the transmission of Schistosoma haematobium at the isolated crater-lake villages of Barombi Mbo and Barombi Kotto are outlined. A two-pronged attack was envisaged, using N-tritylmorpholine (Frescon) to control the snail host, and niridazole (Ambilhar) to control the parasite in man. The lake villages and their environs are described. Observations, relevant to control, are recorded on the biology of Bulinus rohlfsi and B. camerunensis. Snail populations were sampled by hand picking, and by the use of basket traps baited with dead leaves. Some experiments on the susceptibility of both snails to S. haematobium are described, together with observations on the strains of schistosome developing in monkeys exposed to cercariae from naturally-infected snails from the lakes. Frescon was applied through a tube to the bottom layers at the edge of the lakes, where the snails lived. Concentrations of 2 ppm down to 0.5 ppm N-tritylmorpholine proved necessary for adequate kills. Intervals of 6 weeks between treatments sufficed to control B. rohlfsi, but applications every 2 weeks were needed for B. camerunensis. The numbers of egg-masses, of snails, and of infective snails of both species were recorded before, during and after Frescon/Ambilhar control; and snail transmission rates and indices have been calculated. Control operations reduced transmission by R. rohlfsi to 2.4% of the pre-control level, or to below the detectable threshold. They were most effective at Mbo, where B. rohlfsi was the only intermediate host. At Kotto, despite excellent B. rohlfsi control, transmission of the residual infections in the human population by B. camerunensis persisted during control operations, until the intervals between Frescon applications were cut to 2 weeks.