Ultrasound organometry: the importance of body height adjusted normal ranges in assessing liver and spleen parameters among Chinese subjects with Schistosoma japonicum infection

Li, Y.S.; Kardorff, R.; Richter, J. E.; Sun, Kaidi; Zhou, Hui; McManus, Donald P.; Hatz, Christoph

doi:10.1016/j.actatropica.2004.06.009

Cited by 34 publications

(38 citation statements)

References 5 publications

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“…Multivariate logistic regressions were used to compare clinical outcomes of noninfected individuals with categories of infected individuals. Left liver lobe size was classified into normal (size ≤2 SD) and enlarged (size >2 SD) using height-adjusted measures from a Chinese reference population [9]. A P value of <.05 was considered statistically significant.…”

Section: Discussionmentioning

confidence: 99%

Severe Morbidity Due to Opisthorchis viverrini and Schistosoma mekongi Infection in Lao People's Democratic Republic

Sayasone¹,

Rasphone²,

Vanmany³

et al. 2012

Clinical Infectious Diseases

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Section: Discussionmentioning

confidence: 99%

Severe Morbidity Due to Opisthorchis viverrini and Schistosoma mekongi Infection in Lao People's Democratic Republic

Sayasone¹,

Rasphone²,

Vanmany³

et al. 2012

Clinical Infectious Diseases

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“…Hyperbilirubinemia was defined as an indirect (unconjugated) bilirubin level of Ͼ1 mg/dl. Splenomegaly was defined as a spleen size of Ͼ2 standard deviations (SD) above the reference mean for a healthy Chinese population (13).…”

Section: Methodsmentioning

confidence: 99%

Schistosoma japonicum Reinfection after Praziquantel Treatment Causes Anemia Associated with Inflammation

et al. 2006

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There is a relationship between schistosomiasis and anemia, although the magnitude and exact mechanisms involved are unclear. In a cohort of 580 Schistosoma japonicum-infected 7-to 30-year-old patients from Leyte, The Philippines, we evaluated the impact of reinfection with S. japonicum after treatment with praziquantel on the mean hemoglobin level, iron-deficiency (IDA) and non-iron-deficiency anemia (NIDA), and inflammatory markers. All participants were treated at baseline and followed up every 3 months for a total of 18 months. At each follow-up, participants provided stools to quantify reinfection and venous blood samples for hemograms and measures of iron status and inflammation. After 18 months, reinfection with S. japonicum was associated with a lower mean hemoglobin level (؊0.39 g/dl; 95% confidence interval [95% CI], ؊0.63 to ؊0.16) and 1.70 (95% CI, 1.10 to 2.61) times higher odds of all-cause anemia than those without reinfection. Reinfection was associated with IDA for high reinfection intensities only. Conversely, reinfection was associated with NIDA for all infection intensities. Reinfection was associated with serum interleukin-6 responses (P < 0.01), and these responses were associated with NIDA (P ‫؍‬ 0.019) but not with IDA (P ‫؍‬ 0.29). Our results provide strong evidence for the causal relationship between S. japonicum infection and anemia. Rapidly reinfected individuals did not have the positive treatment effect on hemoglobin seen in nonreinfected individuals. The principle mechanism involved in S. japonicum-associated anemia is that of proinflammatory cytokine-mediated anemia, with iron deficiency playing a role in high-intensity infections. Based on the proposed mechanism, anemia is unlikely to be ameliorated by iron therapy alone.

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“…To identify abnormal measures, height-adjusted standards were published by Li and others 22 in 2004. These references have been used in research studies, 34 but they are not routinely used in Chinese hospitals and in the field where ultrasonographers use standard adult cutoffs for children.…”

Section: Discussionmentioning

confidence: 99%

“…Other measures were evaluated as height-adjusted SD scores (SDS; z -score) if reference data from a healthy Chinese reference population was available. 22 Measurements were classified as abnormal if they were greater than two SDs above the mean measurement for the appropriate 0.2-m height bracket. For two measurements, spleen-vein diameter and portal-vein branch average diameter, reference data were not available, and morbidity was defined with standard cutoffs used widely in China.…”

Section: Methodsmentioning

confidence: 99%

Use of Ultrasonography to Evaluate Schistosoma japonicum-Related Morbidity in Children, Sichuan Province, China, 2000–2007

Hsiang

Carlton²,

Zhong³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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Abstract. Liver ultrasonography is a convenient way to evaluate Schistosoma japonicum -related morbidity; however, no consensus standards exist, and data on use in Chinese children are scant. We describe 7 years of ultrasound findings in a prospective cohort of 151 children from an endemic area in Sichuan Province, China and evaluate technical aspects of the ultrasound methodology. Although prevalence of infection decreased over time, prevalence of hepatomegaly increased, which was likely caused by re-infections. The prevalence of late findings such as parenchymal fibrosis and splenomegaly were rare and did not increase over time; however, when present, they were associated with stunting. The use of adult thresholds versus height-adjusted standards underestimated pathology in children. Reliability of all measures except parenchymal grade was poor to fair. Our findings highlight the importance of early intervention and screening. We also suggest methodological refinements to improve reliability of ultrasonography for large-scale assessment of S. japonicumrelated subclinical morbidity in children.

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Ultrasound organometry: the importance of body height adjusted normal ranges in assessing liver and spleen parameters among Chinese subjects with Schistosoma japonicum infection

Cited by 34 publications

References 5 publications

Severe Morbidity Due to Opisthorchis viverrini and Schistosoma mekongi Infection in Lao People's Democratic Republic

Severe Morbidity Due to Opisthorchis viverrini and Schistosoma mekongi Infection in Lao People's Democratic Republic

Schistosoma japonicum Reinfection after Praziquantel Treatment Causes Anemia Associated with Inflammation

Use of Ultrasonography to Evaluate Schistosoma japonicum-Related Morbidity in Children, Sichuan Province, China, 2000–2007

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