Morbidity associated with Schistosoma mansoni infection in north-eastern Democratic Republic of the Congo

Abstract

Background Controlling morbidity is the main target of schistosomiasis control. Yet, only rarely do we assess morbidity linked to Schistosoma sp. infection. In the Democratic Republic of Congo (DRC), and particularly in the northeastern Ituri province, morbidity associated with Schistosoma mansoni infection is unknown. For this reason, we aimed to assess intestinal and hepatosplenic morbidity associated with S. mansoni infection in Ituri province. Methods / Principal Findings In 2017, we conducted a cross sectional study in 13 villages in Ituri province, DRC. S. mansoni infection was assessed with a Kato-Katz stool test (2 smears) and a point-ofcare circulating cathodic antigen (POC CCA) test in urine. A questionnaire was used to obtain demographic data and information about experienced intestinal morbidity. Each participant underwent an abdominal ultrasonography examination to diagnose hepatosplenic morbidity. Of the 586 study participants, 76.6% tested positive for S. mansoni . Intestinal morbidity, such as abdominal pain (52.7%), diarrhoea (23.4%) and blood in the stool (21.5%) in the previous two weeks, was very frequent, as was hepatosplenic morbidity, such as splenomegaly (60.1%), hepatomegaly (23.2%) and abnormal liver parenchyma pattern (52.6%). Hepatomegaly (adjusted odds ratio [aOR] 2.04, 95% confidence interval [CI] 1.27 to 3.26, P =0.003) and splenomegaly (aOR 1.69, 95% CI 1.17 to 2.45, P =0.005) were positively associated with S. mansoni infection at the individual level. At the village level, S. mansoni prevalence was positively associated with the prevalence of hepatomegaly and splenomegaly. Higher S. mansoni infection intensities were associated with diarrhoea, blood in the stool, hepatomegaly, splenomegaly and with liver parenchyma, pathology pattern D-E. Four study participants were diagnosed with ascites and five reported hematemesis. Conclusions/Significance : Our study documents a high burden of intestinal and hepatosplenic morbidity associated with S. mansoni infection status in Ituri province. The results call for targeted interventions to address both S. mansoni infection and related morbidity.

A Self-Purifying Microfluidic System for Identifying Drugs Acting Against Adult Schistosomes

“…In contrast, studies on trematodes are scare and mostly focused on worm locomotion mechanistics 28. In parallel, progress has been made on the use of microfluidics for the detection of the parasites in human fluid either by microfluidic PCR, antigen identification or egg isolation47. The application of microfluidic technologies to the study of adult worm couple viability and fertility, or the evaluation of drug effects remains to be explored.…”

Patients with severe schistosomiasis mansoni in Ituri Province, Democratic Republic of the Congo

“…The four villages were part of a large in-depth study of morbidity due to S. mansoni infection. The complete results of the study are available elsewhere [ 6 ]. Table 1 is an excerpt from the study, describing the epidemiological context of the four villages in which the patients with severe cases resided.…”

“…Between 2015 and 2017, three large cross-sectional studies were conducted in Ituri Province, in northeastern DRC. Both the prevalence of S. mansoni infection and its associated morbidity were found to being high in the province [ 5 , 6 ].…”