Detection of Early Liver Fibrosis in Patients with Intestinal Schistosomiasis: Sonographic and Histologic Findings in Schistosoma mansoni Infection

Chiavaroli, Roberto; Grima, Pierfrancesco

doi:10.1007/s15010-008-7202-4

Cited by 24 publications

(17 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus an infected child could therefore wait up to 3–4 years before receiving first treatment, and with this may have already entered a more ‘chronic’ stage of disease [40], [41], [42], [43]. For example, earlier clinical and ultrasound studies in Uganda in children aged 6 and above, have shown significant hepatosplenomegaly (i.e.…”

Section: Discussionmentioning

confidence: 99%

Schistosoma mansoni Infections in Young Children: When Are Schistosome Antigens in Urine, Eggs in Stool and Antibodies to Eggs First Detectable?

et al. 2011

View full text Add to dashboard Cite

BackgroundIn Uganda, control of intestinal schistosomiasis with preventive chemotherapy is typically focused towards treatment of school-aged children; the needs of younger children are presently being investigated as in lakeshore communities very young children can be infected. In the context of future epidemiological monitoring, we sought to compare the detection thresholds of available diagnostic tools for Schistosoma mansoni and estimate a likely age of first infection for these children.Methods and FindingsA total of 242 infants and preschool children (134 boys and 108 girls, mean age 2.9 years, minimum 5 months and maximum 5 years) were examined from Bugoigo, a well-known disease endemic village on Lake Albert. Schistosome antigens in urine, eggs in stool and host antibodies to eggs were inspected to reveal a general prevalence of 47.5% (CI95 41.1–54.0%), as ascertained by a positive criterion from at least one diagnostic method. Although children as young as 6 months old could be found infected, the average age of infected children was between 3¼–3¾ years, when diagnostic techniques became broadly congruent.ConclusionWhilst different assays have particular (dis)advantages, direct detection of eggs in stool was least sensitive having a temporal lag behind antigen and antibody methods. Setting precisely a general age of first infection is problematic but if present Ugandan policies continue, a large proportion of infected children could wait up to 3–4 years before receiving first medication. To better tailor treatment needs for this younger ageclass, we suggest that the circulating cathodic antigen urine dipstick method to be used as an epidemiological indicator.

show abstract

Section: Discussionmentioning

confidence: 99%

Schistosoma mansoni Infections in Young Children: When Are Schistosome Antigens in Urine, Eggs in Stool and Antibodies to Eggs First Detectable?

et al. 2011

View full text Add to dashboard Cite

show abstract

“…It has, however, to be taken into account that early fibrotic liver changes are likely to be underestimated when only the characteristic macroscopically evident ultrasonographic features are taken into account (Kabatereine et al 1999;Richter 2000;Chiavaroli et al 2008). Non-specific abnormalities such as increase in predominantly left liver lobe size have been discussed as constituting an early sign of incipient hepatic involvement (DoehringSchwerdtfeger et al 1989).…”

Section: Discussionmentioning

confidence: 99%

Hepatosplenic morbidity due to Schistosoma mansoni in schoolchildren on Ukerewe Island, Tanzania

et al. 2012

View full text Add to dashboard Cite

The study was conducted to assess infection intensity and morbidity due to Schistosoma mansoni in schoolchildren on Ukerewe Island in Lake Victoria, Tanzania, East Africa. Three hundred and sixty pupils who have never been treated previously were enrolled (180 males/180 females, age 6-17 years [median 10 years]) in three different schools of the island. Double stool samples were collected from each pupil and egg excretion was classified according to WHO recommendations. Ultrasound investigations were performed in accordance with the WHO Niamey-Belo-Horizonte protocol. Male (112/180, 62.2%) and female (104/180; 57.7%) pupils were infected (difference, not significant [n.s.]). In the positive 216 cases, egg excretion varied from 1 to 2,440 eggs per gramme stool (epg) [median 165 epg]. There were 69/216 (31.9%) who had a low grade, 105/216 (53.2%) had a moderate and 42/216 (14.8%) had a heavy infection. There was no significant difference between male and female sex nor with regard to age groups. There were 354/360 children who underwent sonography: 321 (90.7%) had splenomegaly, 316 (89.3%) showed a left lobe and 109 (30.9%) had a right lobe hepatomegaly. Overt signs of portal fibrosis (PF) were present in 19 children (5.4%) out of whom 11 presented with echogenic thickening of peripheral portal and 8 with thickening of central portal branches. Non-specific portal wall changes were seen in 6 children (1.7%). Association of PF to quantitative egg excretion was not seen (median in PF, 172 epg vs. median in non PF, 168 epg; difference, n.s.). Portal vein dilatation was seen in 101/354 (28.5%) cases. In Ukerewe, the prevalence of S. mansoni infection and infection intensity in children is high, yet overt hepatic morbidity is low as compared to other endemic foci. Non-specific ultrasonographic abnormalities including hepatosplenomegaly and portal vein dilatation were seen frequently but the fraction attributable to schistosomiasis is difficult to assess.

show abstract

“…In the clinical setting, liver fibrosis is generally evaluated by ultrasonography, which is a safe, rapid, noninvasive, and relatively inexpensive technique for assessing schistosomiasis-related lesions in individual patients and in community surveys [10,11], although histopathologic assessment of liver biopsy is generally regarded as being the "gold standard" of fibrosis evaluation [29]. There have been no previous studies that have made a direct comparison of S japonicum-induced fibrosis by ultrasound and liver biopsy pathology; and to our knowledge, this study is the largest study comparing the two methods of fibrosis assessment in advanced schistosomiasis.…”

Section: Discussionmentioning

confidence: 99%

Severe hepatosplenic schistosomiasis: clinicopathologic study of 102 cases undergoing splenectomy

Chen²,

Ross

et al. 2011

Human Pathology

View full text Add to dashboard Cite

Detection of Early Liver Fibrosis in Patients with Intestinal Schistosomiasis: Sonographic and Histologic Findings in Schistosoma mansoni Infection

Cited by 24 publications

References 46 publications

Schistosoma mansoni Infections in Young Children: When Are Schistosome Antigens in Urine, Eggs in Stool and Antibodies to Eggs First Detectable?

Schistosoma mansoni Infections in Young Children: When Are Schistosome Antigens in Urine, Eggs in Stool and Antibodies to Eggs First Detectable?

Hepatosplenic morbidity due to Schistosoma mansoni in schoolchildren on Ukerewe Island, Tanzania

Severe hepatosplenic schistosomiasis: clinicopathologic study of 102 cases undergoing splenectomy

Contact Info

Product

Resources

About