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An unprecedented pocket of intestinal schistosomiasis was discovered in the Republic of Djibouti in 1997. The first cases were diagnosed in French and Djiboutian tourists who presented initial symptoms of bilharzian infection after bathing in the fresh-water basin under Hassan Gari Bira Falls, near Randa. Seventeen cases were subsequently confirmed by detection of anti-schistosome antibodies using indirect hemagglutination (IH) and indirect immunofluorescence (IIF) and/or detection of Schistosoma mansoni eggs in the stool.

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