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Schistosoma mansoni-related morbidity on Ukerewe Island, Tanzania: clinical, ultrasonographical and biochemical parameters

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dc.contributor.author Kardorff, R.
dc.contributor.author Gabone, R. M.
dc.contributor.author Mugashe, C.
dc.contributor.author Obiga, D.
dc.contributor.author Ramarokoto, C. E.
dc.contributor.author Mahlert, C.
dc.contributor.author Spannbrucker, N.
dc.contributor.author Lang, A.
dc.contributor.author Günzler, V.
dc.contributor.author Gryseels, B.
dc.contributor.author Ehrich, J. H. H.
dc.contributor.author Doehring, E.
dc.date.accessioned 2010-05-20T09:27:44Z
dc.date.available 2010-05-20T09:27:44Z
dc.date.issued 1997
dc.identifier.issn 1360-2276
dc.identifier.other ITG-D10A
dc.identifier.other DIRECT
dc.identifier.other U-SCHISTO
dc.identifier.other JIF
dc.identifier.other ABSTRACT
dc.identifier.other FTB
dc.identifier.uri http://hdl.handle.net/10390/6152
dc.description.abstract One thousand six hundred and ninety-five inhabitants of 3 rural villages on Ukerewe Island, Lake Victoria, Tanzania, were examined by clinical, parasitological, ultrasonographic and--in part--serological means to evaluate Schistosoma (S.) mansoni-related morbidity on a community level. Villagers frequently complained of typical colitis symptoms (abdominal pain 80.1%, bloody stools 43.1%, diarrhoea 35.1%); haematemesis, on the other hand, was rare (and reports doubtful in most cases). 16.9% of the population had been given praziquantel previously. Overall S. mansoni prevalence was 86.3%, with a median egg output of 176 eggs per gram (e.p.g.) and maximum output of 17,984 e.p.g. Children and adolescents were infected more severely than adults, men more severely than women. Pretreated individuals excreted significantly fewer ova (median 124 vs 192e.p.g., P < 0.001). Hepatomegaly (determined by ultrasonography) was present in 35%, splenomegaly in 80%. Organomegaly was significantly related to egg output. Pretreated persons had lower rates of splenomegaly and left lobe hepatomegaly. Low-degree periportal fibrosis was common, while severe grades of fibrosis (MANAGIL score II and III) were present in about 6%. About 10% had other abnormalities on liver sonography (irregular parenchymal texture and/or shape); these person passed significantly more S. mansoni ova than others. Clear sonographic signs of portal hypertension were seen in 2.1%. Serum procollagen-IV-peptide and gamma-glutamyl-transferase levels were increased in persons with severe periportal fibrosis, irregular liver texture of portofugal collateral vessels. Thus, S. mansoni infection in the western part of Ukerewe Island is frequent and often severe, leading to a high prevalence of gastrointestinal symptoms. Hepatosplenic involvement does occur, although symptomatic cases of portal hypertension were not identified beyond doubt. The overall level of schistosomal morbidity is thus considered intermediate. Serum procollagen-IV-peptide may be a promising marker of schistosomal liver disease. Our data suggest that S. mansoni infection may also be related to diffuse liver parenchyma alterations in this area. en
dc.language English en
dc.publisher Blackwell Science
dc.subject Helminthic diseases en
dc.subject Schistosomiasis en
dc.subject Schistosoma mansoni en
dc.subject Morbidity en
dc.subject Ultrasonography en
dc.subject Biochemistry en
dc.subject Children en
dc.subject Tanzania en
dc.subject Africa, East en
dc.title Schistosoma mansoni-related morbidity on Ukerewe Island, Tanzania: clinical, ultrasonographical and biochemical parameters en
dc.type Article en
dc.citation.issue 3 en
dc.citation.jtitle Tropical Medicine and International Health en
dc.citation.volume 2 en
dc.citation.pages 230-239 en
dc.identifier.pmid http://www.ncbi.nlm.nih.gov/pubmed/9491101
dc.citation.jabbreviation Trop Med Int Health en


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