If the serology is positive, we presume infestation and treat it. They are contacted by the Peace Corps and told to go to a local physician for treatment. I got a panic call from a family doctor in a rural town in Colorado who had an anxious volunteer in his office with a positive serology to S. haematobium . I guess they don't see a lot of this parasite in rural Colorado. For sheer numbers, the most common class of health problem in the region is skin disorders.
Cellulitis is much more common here than in the States.
I don't know whether it's the virulence of the bacteria, the difficulty of hygiene without running water in your house, or both. Minor bites or scrapes frequently evolve into cellulitis, requiring drainage and antibiotics. The fungi seem to love our volunteers also. Tinea something seems to show up in almost every volunteer at one time. In the usual scenario, a volunteer slaps a bug on his neck with a subsequent large area of second degree burn from the caustic substance secreted by the beetle.