Endomyocardial Fibrosis (EMF) in a Ugandan Child with Advanced Hepatosplenic Schistosomiasis: Coincidence or Connection?

Bustinduy, Amaya L.; Luzinda, Kenneth; Mpoya, Simon; Gothard, Philip; Stone, Neil C.; Wright, Stephen; Stothard, J. Russell

doi:10.4269/ajtmh.14-0156

Cited by 9 publications

(5 citation statements)

References 12 publications

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“…Owing to high levels of re-infection 12 , an extensive burden of intestinal schistosomiasis remains and children with hepatosplenic and gastrointestinal disease can be found 13 .…”

Section: Introductionmentioning

confidence: 99%

An extensive burden of giardiasis associated with intestinal schistosomiasis and anaemia in school children on the shoreline of Lake Albert, Uganda

Al-Shehri

Stanton

LaCourse

et al. 2016

Trans R Soc Trop Med Hyg

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“…Owing to high levels of re-infection 12 , an extensive burden of intestinal schistosomiasis remains and children with hepatosplenic and gastrointestinal disease can be found 13 .…”

Section: Introductionmentioning

confidence: 99%

An extensive burden of giardiasis associated with intestinal schistosomiasis and anaemia in school children on the shoreline of Lake Albert, Uganda

Al-Shehri

Stanton

LaCourse

et al. 2016

Trans R Soc Trop Med Hyg

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“…An association with Schistosoma mansoni, haematobium and intercalatum has been reported 456. In the our case, Schistosoma infection may have been the trigger for clinical aggravation due to the superimposition of Loeffler’s syndrome on chronic fibrotic EMF.…”

Section: Discussionmentioning

confidence: 49%

Active schistosomiasis, severe hypereosinophilia and rapid progression of chronic endomyocardialendomyocardial fibrosis

Mocumbi

Gonçalves

Damasceno

et al. 2016

CVJA

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Endomyocardial fibrosis (EMF) is a neglected restrictive cardiomyopathy of unknown aetiology and unclear natural history, which causes premature deaths in endemic areas. We present the case of a 13-year-old boy from a highly endemic area, presenting with concurrent signs of chronic EMF and severe hypereosinophilia associated with active schistosomal cystitis. We discuss the possible role of this parasitic infection in determining the progression of EMF in endemic areas for both conditions.

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“…Most of the cases of EMF seen in the present study were clustered in districts bordering Lake Victoria, the Victorian and Albert Nile, suggesting a possible aetiologic link with hepatosplenic schistosomiasis that is common in areas near water bodies. The association between schistosomiasis and EMF has been previously suggested, (19,28,29), but these have not yet been proven. The biologic plausibility for such an association is considered sound since both advanced EMF and schistosomiasis share certain typical clinical features like cachexia, hepatosplenomegaly and gross ascites with minimal peripheral edema (19).…”

Section: Discussionmentioning

confidence: 94%

Trends in Annual Incidence Rates of Newly Diagnosed Endomyocardial Fibrosis Cases at the Uganda Heart Institute: A 14-Year Review

Aliku

Rwebembera

Lubega

et al. 2022

Front. Cardiovasc. Med.

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BackgroundFirst described in Uganda over seven decades ago, Endomyocardial fibrosis (EMF) is a rare form of restrictive cardiomyopathy found in the tropics. EMF occurs mainly in two phenotypes; biventricular involvement and right ventricular (RV) form. Previously endemic in several countries, there are reports suggesting that the disease is on the decline.ObjectivesTo describe trends in annual incidence rates of newly diagnosed EMF cases at the Uganda Heart Institute (UHI).MethodsThis was a retrospective chart review of all newly diagnosed EMF cases at UHI from January 2007 to December 2020. Cases were divided into two groups A (2007–2013) and B (2014–2020).ResultsA total of 155 cases were diagnosed during the period (Group A, n = 124; Group B, n = 31). There were no significant differences between the two groups A and B regarding median age at diagnosis (14 vs. 12 years, p = 0.0940), gender (48.4% female vs. 35.5%, p = 0.1987), and EMF type (66.9% RV EMF vs. 71.0%, p = 0.6634), respectively. The presence of complications such as intracardiac thrombus (5.6 vs. 32.2%, p = 0.0002) and pericardial effusion (57.3% vs. 80.6, p = 0.0172) were more frequent in group B than A, respectively. Pulmonary hypertension (PHT) was predominantly seen in cases with biventricular EMF compared to those with RV EMF (26 vs. 3.8%, p = 0.0001). The number of new cases diagnosed per year remained largely stable in the period 2007–2011, ranging 14–21 per year, peaked in 2012 (26 new cases), and thereafter declined from 10 cases seen in 2013 to 1–5 cases seen per year in the period 2017–2020. Similarly, the annual incidence rates of new EMF diagnosis remained relatively stable in the period 2007–2012, ranging between 22.7 and 29.7 per 10,000 patients seen in the echo labs, and then dramatically declined after 2012 to range between 1.0 and 4.5 new cases per 10,000 patients in the period between 2017 and 2020.ConclusionThere has been a steady decline in the number of new cases of EMF seen at the UHI. However, there were no significant differences in the gender, age at diagnosis and EMF subtype of cases during the period under review. Complication rates were more frequent in the later cohort.

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Endomyocardial Fibrosis (EMF) in a Ugandan Child with Advanced Hepatosplenic Schistosomiasis: Coincidence or Connection?

Cited by 9 publications

References 12 publications

An extensive burden of giardiasis associated with intestinal schistosomiasis and anaemia in school children on the shoreline of Lake Albert, Uganda

An extensive burden of giardiasis associated with intestinal schistosomiasis and anaemia in school children on the shoreline of Lake Albert, Uganda

Active schistosomiasis, severe hypereosinophilia and rapid progression of chronic endomyocardialendomyocardial fibrosis

Trends in Annual Incidence Rates of Newly Diagnosed Endomyocardial Fibrosis Cases at the Uganda Heart Institute: A 14-Year Review

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