Stephen A Spencer was graduated with Honors from the University of Manchester Medical School in 2014. In 2013 he founded MADEX: Madagascar Medical Expeditions. By running yearly medical expeditions to the Marolambo, Madagascar, the aims of MADEX are to research schistosomiasis in this population and to reduce the burden of schistosomiasis infection on public health by controlling the disease through regular treatment and education.


Schistosomiasis carries a substantial burden on public health in Madagascar. A prevalence study in 1987 found that more than 50% of the population in Madagascar was infected with schistosomiasis. Due to poor infrastructure in the country, many treatment campaigns are unable to reach rural and remote regions of Madagascar. The aims of this research expedition were to determine the prevalence of schistosomiasis in the Marolambo district of Eastern Madagascar (one of Madagascar’s most remote regions) to provide treatment for schistosomiasis and initiate a health education program. We screened 399 school aged children (five to fourteen years of age) for schistosomiasis from six schools along the Nosivolo River in Marolambo, using circulating cathodic antigen (CCA) testing and Kato-Katz procedures. This study revealed a prevalence of 94% across six schools attributed to Schistosoma mansoni infection. A mean of 482 schistosome eggs per gram of stool was found with increasing parasite loads and increasing prevalence associated with age. The preliminary results from this study have revealed an extremely high prevalence of S. mansoni infection in Marolambo. Furthermore, children were found to be infected with severe parasite loads indicating that schistosomiasis is likely to have had a significant impact on their health. This study has highlighted the crucial importance of carrying out such epidemiological surveys in remote regions in order to identify communities that are in need of appropriate medical interventions.