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 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Clinical gastro-intestinal manifestations were studied in 34 patients in the initial phase of schistosomiasis mansoni. The patients, all men, were of similar age and in similar nutritional condition and had been infected simultaneously at the same transmission site. Most (85%) showed some gastro-intestinal sign or symptom, generally of light or moderate intensity; 56% had liquid or pasty diarrhoea, 41% abdominal pain, 29% hepatomegaly, 21% dysentery, 15% anorexia, 12% pain on colon palpation and 9% nausea and/or vomiting. High worm burden was associated with blood in faeces but apparently not with any other clinical manifestation. There was no apparent association between any clinical manifestation and peripheral-blood eosinophil counts or titres of IgE specific for Schistosoma mansoni (evaluated by the area of immediate intradermal reaction to injected adult worm antigen). The absence of association between worm burden and nearly all the clinical gastro-intestinal manifestations strengthens the concept that factors other than worm burden, such as host reactivity, constitute important pathogenetic elements in the initial phase of schistosomiasis mansoni.
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PMID:Gastro-intestinal manifestations of the initial phase of schistosomiasis mansoni. 766 18

The impact of repeated chemotherapy on morbidity due to schistosomiasis mansoni was evaluated in Gihungwe (initial prevalence 58%) and Buhandagaza/Kizina (33%), two village clusters in Burundi. Surveys were carried out with reference to the first treatment (month 0) at months -6, -3, 0, 3, 6, 9, 12, 24, and 36. Praziquantel (40 mg/kg) was given at months 0, 12, 24, and 36 to those showing eggs in the feces with a single 28-mg Kato slide. At each survey, duplicate Kato smears were examined, and all participants responded to a standardized medical history interview and underwent a clinical examination. In the three preintervention surveys, spleen and liver rates remained stable at the community and the individual level. The frequencies of diarrhea and abdominal pain varied to some extent, but they were consistently higher in the most heavily infected villages and age groups and remained relatively stable at the individual level. At the final survey, the prevalence of infection had decreased to 25%, and the frequency of diarrhea from 19-26% to 10% in both village clusters. This impact was strongest in the younger age groups. The frequency of abdominal pain was reduced only at the short term and in selected age groups. Organomegaly decreased only to a limited extent in those treated, and increased in those not treated, possibly due to the impact of malaria. The net result was that no measurable impact of the treatments on organomegaly at the community level could be demonstrated. In the light of these results, the relevance of community-based chemotherapy in moderate foci is questioned.
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PMID:Impact of repeated community-based selective chemotherapy on morbidity due to schistosomiasis mansoni. 798 56

We retrospectively studied 343 consecutive patients treated between 1979 and 1992. Ninety patients whose stool was not examined were excluded. Fifty-three patients with strongyloidiasis were compared with 200 controls with regard to outcomes and the following characteristics: age, sex, underlying disease, use of corticosteroids, abdominal pain, diarrhea, fever, pulmonary symptoms, and eosinophilia. Patients with strongyloidiasis more commonly had eosinophilia (P = .01) and fever (P = .03). There was a single but fatal case of the disseminated disease syndrome (1.9% of patients with strongyloidiasis). In multiple logistic regression analysis, the factors predictive for strongyloidiasis were schistosomiasis (odds ratio [OR], 6.58), ascariasis (OR, 2.78), and the use of steroids (OR, 2.29). Strongyloidiasis was highly prevalent among patients with hematologic malignancies in Brazil. Occurrence of the disseminated disease syndrome seems to be unusual.
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PMID:Strongyloidiasis in patients with hematologic malignancies. 852 67

A cohort analysis was performed in Ndombo, Senegal, a community of about 4000, in the epicenter of the schistosomiasis outbreak. Four randomly selected cohorts of +or- 400 subjects were surveyed. Each cohort was examined parasitologically, clinically, and serologically (circulating antigen and antibody profiles); treated with praziquantel 40 mg/kg; and followed up at 6-12 weeks and at 1 and 2 years after treatment. The first cohort numbered 422 individuals, of which 91% had positive egg counts, with a mean egg count of 663 eggs per gram feces (epg). Quantitative egg counts in those aged 10-14 were 1409 epg and then declined to 632 epg in the age group 20-29 and to 266 epg in the age group over 40. In cohorts 2 and 3, examined in the spring and autumn, egg counts were substantially lower, particularly in adults, as compared with cohorts 1 and 4, which were both examined in the summer season. 94% of the subjects were positive in the serum circulating anodic antigen (CAA) ELISA, 83% in the serum CAA ELISA, and 95% in the urine circulating cathodic antigen (CCA) ELISA; CAA in urine was less sensitive, and was negative in half of the urine samples. Positivity rates for all assays increased with rising egg counts, and circulating antigen concentrations in both serum and urine correlated well with egg counts. IgE showed a significant increase with age, while IgG4 peaked in the age groups 10-15 and/or 15-19 years. A strong correlation between IgG, IgGl, and IgG4 against both crude antigens with pretreatment egg load was observed. Of the subjects in the first cohort, 61% reported abdominal pain, 33% diarrhea; only 16% showed mild hepatomegaly and only a few children had mild splenomegaly. In the first cohort, 82% of 298 reexamined subjects were still positive for S. mansoni 12 weeks after treatment with praziquantel 40 mg/kg. One year after treatment, cohort 1 showed mean egg counts in children (5-19 years) at 358 epg as compared with 1188 epg pretreatment.
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PMID:Immuno-epidemiology of Schistosoma mansoni infections in a recently exposed community in Senegal. 853 70

The effect of the colour group on the morbidity due to Schistosoma mansoni was examined in two endemic areas situated in the State of Minas Gerais, Brazil. Of the 2773 eligible inhabitants, 1971 (71.1%) participated in the study: 545 (27.6%) were classified as white, 719 (36.5%) as intermediate and 707 (35.9%) as black. For each colour group, signs and symptoms of individuals who eliminated S.mansoni eggs (cases) were compared to those who did not present eggs in the faeces (controls). The odds ratios were adjusted by age, gender, previous treatment for schistosomiasis, endemic area and quality of the household. There was no evidence of a modifier effect of colour on diarrhea, bloody faeces or abdominal pain. A modifier effect of colour on hepatomegaly was evident among those heaviest infected (> or = 400 epg): the adjusted odds ratios for palpable liver at the middle clavicular and the middle sternal lines were smaller among blacks (5.4 and 6.5, respectively) and higher among whites (10.6 and 12.9) and intermediates (10.4 and 10.1, respectively). These results point out the existence of some degree of protection against hepatomegaly among blacks heaviest infected in the studied areas.
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PMID:Effect of skin colour and selected physical characteristics on Schistosoma mansoni dependent morbidity. 873 Dec 61

During October 1990 to December 1993, in Ife-Central Local Government Area of Osun State, Nigeria, interviews with and physical and laboratory examinations of 106 grade 4-6 pupils aged 8-16 were conducted in Ogbagba village so the researchers could determine their knowledge, attitudes, practices, and beliefs about urinary schistosomiasis as well as the factors that offer opportunities for morbidity control of urinary schistosomiasis in an endemic area. There was no health facility in Ogbagba. 89.5% of the children had urinary schistosomiasis. 75.5% of all pupils knew the local name for urinary schistosomiasis. 66% had previously passed blood in their urine. 85.7% of these pupils believed hematuria was serious. 70.8% gave a positive history of current episode of hematuria. 62.7% of these pupils did not seek any treatment. Symptoms associated with past hematuria included abdominal pain, weakness, weight loss, and fever. 65.7% of all pupils did not know what causes urinary schistosomiasis. 67.1% believed that urinary schistosomiasis was acquired via some form of contact with water, especially swimming (57.1%). The leading types of water contact included washing clothes (95.3%), fetching water (94.3%), bathing (87.7%), and swimming (74.5%). 74.5% of all pupils urinated deliberately in the river. The sensitivity, specificity, predictive values, and efficiency of alternative methods of detecting urinary schistosomiasis revealed that subjective hematuria was comparable to gross/microscopic hematuria. These findings will be used to design information, education, and communication materials for a health education program on urinary schistosomiasis using the primary health control approach. The researchers propose that both subjective and gross hematuria be used as the basis for treating children aged 4-19 living in areas endemic for urinary schistosomiasis. Praziquantel should be used as the only drug for treating urinary schistosomiasis. Health education in the schools' curriculum and information, education, and communication developed by health authorities should promote better water contact practices. Teachers need to regularly ask their pupils about hematuria and encourage them to seek medical treatment.
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PMID:Urinary schistosomiasis: options for control within endemic rural communities: a case study in south-west Nigeria. 875 3

The consequence of an acute mesenteric venous thrombosis following porta-azygos disconnection for the treatment of bleeding esophageal varices due to mansonian schistosomiasis has not been well defined in the literature. The clinical manifestations reported were fever, spasmodic abdominal pain associated with food intake. We treated three patients with thrombosis of the portal-mesenteric trunk following porta-azygos disconnection and adopted a conservative clinical approach in two patients while one had to have a surgical small bowel ressection.
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PMID:[Mesenteric venous thrombosis after azygos-portal disconnection with splenectomy for the treatment of bleeding esophageal varices in mansonian schistosomiasis. Three cases reports]. 900 35

Female genital schistosomiasis (FGS) is a neglected disease entity which may give rise to considerable suffering among women of child-bearing age in areas where schistosomiasis (especially due to Schistosoma haematobium) is prevalent. The close relation between the vessels in genital organs and the urinary bladder enables the parasite to easily change location to virtually any organs in the female pelvic area. Symptoms concur with the anatomical location of worm pairs and their ova. Lesions of the lower female genital tract can easily be investigated by cytology, histology or direct demonstration of eggs in scrapings or biopsies whereas schistosomiasis of the upper genital tract is clinically indecipherable and less accessible for examination. In the literature there are references to FGS as a cause of infertility, complications of pregnancy, menstrual disorders, problems related to sexual intercourse, diagnostic similarities to STDs and cancer, unspecified complaints related to blood loss, chronic abdominal pain, social segregation and related psychological problems. The diagnosis of female upper genital schistosomiasis is difficult and the authors point out possible diagnostic procedures which might be helpful for further understanding of this complex entity.
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PMID:Schistosomiasis in women: manifestations in the upper reproductive tract. 902 8

In this study we examined 1,909 individuals (53% males and 47% females) to determine the current status of Schistosoma japonicum among the people in five fishing villages situated on two islands (large, Qingshan island; small, Niangashan island) in the Dongting Lake region in Hunan Province, the People's Republic of China. The results of this study indicate that the overall prevalence for schistosomiasis on the two islands is 16%. Two distinct peaks in prevalence (29%) were observed at 25-35 years of age and again at 45-55 years of age for both the large and small islands. On the small island the overall prevalence (24%) varied significantly (P < 0.01) from the large island (15%). Fishermen had the highest prevalence (22.4%) among all the occupational groups examined but students produced the highest worm intensity (geometric mean = 69 eggs per gram [epg] of feces). There was a significant difference (P < 0.01) in the prevalence of schistosomiasis between males and females. In general, males had a much higher prevalence (22%) than females (8.9%). When the study populations were classified as uninfected, lightly infected (10-100 epg), moderately infected (101-400 epg), and heavily infected (> 401 epg) with S. japonicum, the distribution pattern was similar for each of the five villages. The majority (76-88%) of the population remains uninfected. Lightly infected individuals had the highest prevalence (7-12%) followed by moderately infected individuals (1-9%). Only a very small percentage of the population was heavily infected (0-2%). Hepatomegaly along the midsternal line (MSL > or = 3) was commonly seen in both uninfected (21%) and infected individuals (1939%). Subjects heavily infected with S. japonicum reported significantly higher (P < 0.05) cases of liver enlargement when compared with those uninfected. The reported cases of abdominal pain for both uninfected (9%) and infected individuals (4-19%) was relatively high. Lightly and moderately infected individuals reported significantly (P < 0.05 and P < 0.01, respectively) more episodes of abdominal pain than those uninfected. The occurrence of diarrhea was low (5%) for uninfected individuals but this clinical feature was significantly (P < 0.01) more prevalent in both the lightly and heavily infected categories (8-17%).
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PMID:Epidemiologic features of Schistosoma japonicum among fishermen and other occupational groups in the Dongting Lake region (Hunan Province) of China. 931 40

During the summer of 1980, acute Manson's Schistosomiasis occurred in 28 pediatric patients, swimming in two ponds with no watershed connections between them, in the rural area of Juncos and Cidra, Puerto Rico. Clinical and immunological events were studied and Oxamniquine (Vansil, Pfizer) was administered to all of them and followed closely for 3 years. Fever and general malaise recorded in 93% of the patients, diarrhea and abdominal pain in 68% and urticaria or facial edema in 64%. Hepato and/or splenomegaly was recorded in 71% of them. Twenty seven of the patients had evidence of immunoserological activity against adult schistosomal antigens (GASP and PSAP). Two patients had intense immunologic activity, even before the recovering of fresh Schistosoma mansoni eggs in their stool. This was a response to GASP and PSAP antigens. When they started passing fresh eggs of schistosoma and COP (Circumoval Precipitation Test) turned positive, their clinical status worsened and antibodies to GASP antigen increased two fold. The oviposition phase elicited a strong antibody and immunological reaction with significant eosinophilia and cross reaction was observed between adult schistosomal and egg shell antigens. Severe clinical manifestations were seen in spite of low egg excretion. Oxamniquine was effective in obtaining a coprological cure and in altering the immunologic response as compared with other untreated groups in literature.
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PMID:The efficacy of oxamniquine in acute schistosomiasis: a clinical analysis of 28 treated patients. 943 87


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