Liver ultrasound findings in a low prevalence area of S. japonicum in China: Comparison with history, physical examination, parasitological and serological results

Mott, K. E.; Chen, Minggang; Abdel-Wahab, F; Burki, A.; Dixon, H.; Fu-niu, Xu; Yu, Shun

doi:10.1016/0001-706x(92)90021-o

Cited by 14 publications

(5 citation statements)

References 4 publications

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“…The morbidity prevented by effective control has been studied clinically, but subclinical forms detectable by ultrasound are poorly understood and remain widespread in many endemic areas, even when infection prevalence is low (CAI et al. 1992: MOTT et al. 1992.…”

Section: Introductionmentioning

confidence: 99%

Two-year impact of praziquantel treatment for Schistosoma japonicum infection in China: re-infection, subclinical disease and fibrosis marker measurements

Sleigh

Ross

et al. 2000

Transactions of the Royal Society of Tropical Medicine and Hygi

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We studied a community cohort of 193 individuals exposed to endemic Schistosoma japonicum infection in the Dongting Lake region of China to assess subclinical morbidity and the 2-year benefit of curative therapy (praziquantel) administered in 1996. Prevalence and intensity of S. juponicum infection before treatment were 28% and 192 eggs per gram faeces (epg), respectively. Two years after cure, 22% of the cohort were reinfected, but with a lighter intensity (67 epg). Sixty-four subjects (37%) showed significant improvement in ultrasound parenchyma images after treatment and 5 1 subjects (54%) showed significant improvement of periportal fibrosis, Left-lobe enlargement also reversed (P < 0.05) and splenomegaly reversed in 6 of 8 cases and developed in only I. Two years post-treatment a dilated portal vein became less frequent, but the decline was not significant (16% vs 1 1 %, P > 0.05). The serum levels of laminin and collagen IV associated with reinfection and intensity and hyaluronic acid levels correlated with ultrasound findings (P < 0.01). Overall, treatment induced a marked decrease in subclinical hepatosplenic morbidity attributable to S. japonicum although low-intensity re-infection after treatment remained relatively frequent. Stratified analysis and logistic models evaluated potential confounding factors for assessment of treatment effects on hepatic fibrosis. S. juponicum infection and moderate-heavy alcohol intake interacted: improvement in parenchymal morbidity was impeded among drinkers (P < 0.05). Chemotherapy focused on at-risk residents controls prevalent subclinical hepatic fibrosis but re-infection indicates the need for complementary control strategies.

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Section: Introductionmentioning

confidence: 99%

Two-year impact of praziquantel treatment for Schistosoma japonicum infection in China: re-infection, subclinical disease and fibrosis marker measurements

Sleigh

Ross

et al. 2000

Transactions of the Royal Society of Tropical Medicine and Hygi

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“…This is also suggested by pathological studies done in West African subjects infected with S. mansoni [19]. One of the observations made in China has also suggested that prior parenteral treatment with antischistosomal drugs may be a major risk factor for acquisition of concomitant HBV infections [20]. Treatment of schistosomiasis is now based on oral drugs.…”

Section: Discussionmentioning

confidence: 85%

Absence of relationship between Schistosoma japonicum and hepatitis B virus infection in the Dongting lake region, China

Fu²,

Anderson

et al. 1998

Epidemiol. Infect.

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In order to determine whether infection with Schistosoma japonicum is related to a higher rate of infection with hepatitis B virus and/or to a higher probability of HBsAg chronic carriage, a population based survey was carried out in China in which HBV markers were studied in 112 subjects with long-lasting S. japonicum infection, and 93 subjects with no S. japonicum infection 37.5% of the cases and 40.9% of controls showed no markers of HBV infection. The prevalence rate of HBsAg was 12.5% in the cases and 12.9% in the controls. For anti-HBc and anti-HBs the figures were 59.8% and 59.8%, and 27.9% and 35.0%, respectively. These data do not support the hypothesis of an interaction between infection with hepatitis B virus and S. japonicum.

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“…31,32 However, there was poor agreement in identifying patients with a rounded caudal liver edge, a nonspecific finding associated with hepatomegaly. 33,34 Given the associations found between this outcome and both infection intensity and frequency of lake visits, more research should explore its clinical relevance in children living in endemic areas.…”

Section: Discussionmentioning

confidence: 99%

Baseline Liver Ultrasound Findings in Preschool Children From the Praziquantel in Preschoolers Trial in Lake Albert, Uganda

Pach,

Webb,

Edielu

et al. 2023

Pediatric Infectious Disease Journal

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Background: Periportal fibrosis is a late-stage manifestation of chronic infection with Schistosoma mansoni. Praziquantel (PZQ), the only drug available for the treatment of schistosomiasis, has limited effect in treating established morbidity. Preschool-aged children (PSAC) are not considered to be an at-risk population for severe morbidity. However, the prevalence of periportal fibrosis in PSAC in S. mansoni endemic settings is unknown. Methods: As part of a phase II clinical trial comparing different dosing regimens of PZQ in children age 12–47 months infected with S. mansoni in Uganda (“praziquantel in preschoolers” trial), we present baseline results assessing liver ultrasound (US) findings as per the WHO Niamey Protocol. Results: A total of 7/347 (2%) PSAC had Image Pattern C with pipe stems and echogenic rings suggestive of periportal fibrosis, 29/347 (8%) had Image Pattern B and 58 (17%) had evidence of periportal thickening There were higher adjusted odds of periportal thickening with older age [odds ratio (OR): 1.04; 95% confidence interval (CI): 1.00–1.07], primary maternal education (OR: 1.04; 95% CI: 1.00–1.07) and being taken to the lake weekly (OR: 3.02; 95% CI: 1.19–7.63). A further 44/347 children (13%) had a rounded caudal liver edge which was associated with high S. mansoni infection intensity (adjusted OR: 3.31; 95% CI: 1.46–7.51). Conclusions: Incipient schistosomiasis-related liver morbidity was detected in young children enrolled in the praziquantel in preschoolers trial. Adequate age-adjusted reference measurements for liver ultrasound findings in very small children are lacking but urgently needed. Schistosomiasis-related fibrosis may be delayed or averted with early and repeated PZQ treatment.

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Liver ultrasound findings in a low prevalence area of S. japonicum in China: Comparison with history, physical examination, parasitological and serological results

Cited by 14 publications

References 4 publications

Two-year impact of praziquantel treatment for Schistosoma japonicum infection in China: re-infection, subclinical disease and fibrosis marker measurements

Two-year impact of praziquantel treatment for Schistosoma japonicum infection in China: re-infection, subclinical disease and fibrosis marker measurements

Absence of relationship between Schistosoma japonicum and hepatitis B virus infection in the Dongting lake region, China

Baseline Liver Ultrasound Findings in Preschool Children From the Praziquantel in Preschoolers Trial in Lake Albert, Uganda

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