Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019209 (hepatomegaly)
 5,798 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A cross-sectional survey of schistosomiasis was carried out in five villages around the Elziedab irrigation scheme, in the north, and three villages in the Gezira-Managil area in central Sudan. Stools and urine from 53% (2832 individuals) and 72% (3684 individuals) of the population of these villages, respectively, were examined using the modified Kato thick smear for stools and sedimentation for urine. Clinical history and examination were done on 2832 subjects (53%) in Elziedab and on 893 (18%) randomly selected samples in Gezira-Managil. Prevalence of Schistosoma mansoni was 36% in Elziedab and the mean egg count was 150 eggs per gram of faeces (e.p.g.). Prevalence of bloody diarrhoea was 6%, hepatomegaly 6% and splenomegaly 10%. There was a significant association between these parameters and infection in the age group 10-24 years. Prevalence and intensity in Gezira-Managil area were significantly higher than in Elziedab, 52% and 234 e.p.g. Prevalences of bloody stool 29%, hepatomegaly 17% and splenomegaly 15% were also significantly higher than in Elziedab. These parameters were unrelated to the presence of eggs in the stool. Advanced hepatosplenic schistosomiasis is less than 1% in both areas. While S. haematobium was not found in Elziedab, its prevalence varied from 10 to 15% in Gezira-Managil area. In conclusion, S. mansoni is much less prevalent in Elziedab than Gezira, signs and symptoms are much less prominent in Elziedab, and most of the symptoms are unrelated to the presence of eggs in the stool.
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PMID:Infection with Schistosoma mansoni in two different endemic areas: a comparative population-based study in Elziedab and Gezira-Managil irrigation schemes, Sudan. 845 82

A community-based, double-blind, randomized trial of praziquantel was carried out in an area of Zambia endemic for schistosomiasis. The aim of the study was to assess the impact of the treatment on Schistosoma mansoni morbidity. A total of 377 infected children, aged seven to 19 years, was randomized into two groups: one of 190 (group A) and one of 187 (group B). All children were treated with 40 mg praziquantel/kg at the start of the study. Six months later, the children in group A were re-treated with the same dose of praziquantel, while the children in group B were given placebos. All children were followed up three, six and 12 months after the initial treatment, morbidity being clinically evaluated at the six- and 12-month follow-ups. The results show that, in both groups of children, there were significant reductions in splenomegaly, hepatomegaly, and subjective symptoms of morbidity six and 12 months after initial treatment. However, there were no significant differences, between the two groups, in the prevalences of these symptoms of morbidity. It therefore appears that once-yearly treatment of children, in this and similar endemic areas, is sufficient to reduce schistosomiasis morbidity to, and maintain it at, a tolerable level.
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PMID:A community-based randomized trial of praziquantel to control schistosomiasis morbidity in schoolchildren in Zambia. 856 26

Following the introduction of large-scale irrigation, an exceptional epidemic of intestinal schistosomiasis occurred in northern Senegal when a non-immune population was exposed to massive infection. Subjects infected with Schistosoma mansoni were followed up parasitologically and clinically from the onset of the epidemic. After the initial evaluation, patients received a health education session and were treated with praziquantel in a dose of 30 mg/kg. One year after this treatment, S. mansoni eggs were found in the stools of 227/301 subjects (75%). Twenty-three per cent of subjects excreted > 400 eggs per gram (e.p.g.) and 11% excreted > 1000 e.p.g. of faeces. Overall, the geometric mean was 191 e.p.g. of faeces in infected individuals. The prevalence of diarrhoea was reduced from 55 to 29%, the prevalence of bloody diarrhoea from 44 to 11% and the prevalence of abdominal discomfort from 66 to 41%. No hepatomegaly was found in these patients either before or one year after treatment. Splenomegaly was reduced from 30% (measured by ultrasound) to 3% (on clinical examination). Morbidity associated with S. mansoni infection was considerably reduced one year after treatment with praziquantel (30 mg/kg).
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PMID:Clinical investigation of a population recently infected with Schistosoma mansoni (Richard-Toll, Senegal). 866 83

Previous attempts to assess the health impact of schistosomiasis control programs on community morbidity have been limited by a lack of a theoretical framework that describes the dynamic relationships between infection and morbidity. In this paper, a model of schistosomal morbidity is developed and parameterized. Morbidity is divided into that due to current heavy infection, and early and late stages of chronic disease. The model was parameterized using data showing resolution of disease after treatment, correlations between prevalence of disease and intensity of infection and using age-morbidity profiles. The fitted parameters suggest that early manifestations of disease such as hepatomegaly in Schistosoma mansoni and S. japonicum infections would resolve relatively quickly following treatment whereas later forms of disease such as liver fibrosis resolve very slowly or not at all. Similar general conclusions were obtained with data on early and late forms of urinary tract morbidity in S. haematobium.
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PMID:Dynamic models of schistosomiasis morbidity. 870 23

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

The Cuando River area of eastern Caprivi, Namibia, is highly endemic for Schistosoma mansoni whereas S. haematobium transmission, due to the scarcity of its intermediate host snail, Bulinus africanus, does not occur. Chemotherapy (6-monthly blanket treatments with praziquantel) combined with focal mollusciciding (monthly application of niclosamide) was used in a project in the area to control the disease. Although as many adults and pre-school children as possible were tested and treated, the project concentrated largely on school-age children. It took 3 years for prevalence to decline from > 80% to 20% because of a lack of proper sanitary facilities and piped water supplies and high rates of absenteeism and re-infection. However, intensity of infection decreased more rapidly, from an arithmetic mean of > 200 to < 5 eggs/g faeces. Hepatomegaly was common among school children when the project started but could be seen in only a small percentage of them after 3 years of control. Neither the bovine schistosome, S. mattheei, nor the lechwe schistosomes, S. margrebowiei and S. leiperi, were observed in the excreta of humans living in the area.
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PMID:Epidemiology and control of schistosomiasis mansoni in communities living on the Cuando River floodplain of East Caprivi, Namibia. 874 38

During 1991-1992 in the Gorduras district of Belo Horizonte, the capital of Minas Gerais State in Brazil, data on 451 persons over 2 years old who carried Schistosoma mansoni eggs, as detected on at least 1 of 4 slides, were compared with data on 465 same-age persons who were free of such eggs to describe the epidemiology of schistosomiasis in this urban area. The schistosome host, Biomphalaria glabrata, was present at all 11 monitored points along streams. Snails infected with S. mansoni were found at 6 points. Sewerage was entering the streams at 2 points. 92.7% of households had a piped water supply. 89.4% had a sewerage system. 20% of the 3049 sampled peoples had schistosomiasis. The geometric mean of S. mansoni eggs stood at 70.8 eggs/gram. Only 4.7% of persons infected with S. mansoni eggs had bloody stools. Less than 3% had a hardened enlarged liver. No one had splenomegaly or splenectomy. Signs and symptoms independently associated with S. mansoni infection included bloody stools (odds ratio [OR] = 8), palpable hardened liver at the middle clavicular line (OR = 5.5), and palpable hardened liver at the middle sternal line (OR = 8). Sociodemographic variables and reasons for water contact independently associated with S. mansoni infection were age (OR = 7.1 for 10-19 years; OR = 3.3 for =or + 20 years), being male (OR = 3.1), swimming and/or playing in water (OR = 2.2 for =or- 2 times/month; OR = 3 for 2 times/month), and living in Belo Horizonte (OR = 2.5). There was no association between infection and water supply. These findings suggest a need for schistosomiasis control measures centering on water contacts for leisure in this area.
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PMID:Urban schistosomiasis: morbidity, sociodemographic characteristics and water contact patterns predictive of infection. 902 38

This paper uses a mathematical framework to predict the long-term consequences of chemotherapy for the age distribution of schistosomiasis morbidity. The framework incorporates a previously validated transmission model, which is here extended to capture effects on 2 forms of Schistosoma mansoni morbidity: early disease exemplified by hepatomegaly and late disease exemplified by Symmer's fibrosis. The main aim of this analysis is to show how such an approach could be used to explore the probable public health consequences of decades of control. It is suggested that this procedure could usefully inform current approaches to the design of long-term control programmes.
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PMID:Modelling the dynamic effects of community chemotherapy on patterns of morbidity due to Schistosoma mansoni. 919 75

Inflammatory pseudotumor of the liver is uncommon in children. Only 14 cases have been reported in the literature. The underlying etiology is unclear but traumatic and infectious factors may be implicated. This report describes an inflammatory pseudotumor that was observed in a 9-year-old child from the Ivory Coast one year after traumatic injury of the right hypochondrium. Clinical findings were limited to non-febrile but painful hepatomegaly with weight loss. Laboratory tests were consistent with an inflammatory process. Ultrasonography revealed a poorly delimited, heterogeneous area approximately 5 cm in diameter at the level of the VI segment which had been resected. Histology documented the presence of fibro-inflammatory tissue with granulomatous inclusions. At the center of the lesion was a foreign body corresponding to a Schistosoma mansoni egg. In this case the mechanism underlying inflammatory pseudotumor could have involved either bilharziasis or trauma. A review of the literature allows the authors to enumerate the main features of this uncommon benign tumor of the liver in children.
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PMID:[Inflammatory pseudo-tumor of the liver in a child: case report]. 951 56

A population dynamic model of schistosome transmission was used to investigate the interaction between drug efficacy and drug price of different brands of praziquantel in determining the cost-effectiveness of school-targeted treatment for Schistosoma mansoni. In this analysis, costs were affected by coverage, drug price and distance travelled, and effectiveness by coverage and drug efficacy. Four effectiveness measures were assessed: the number of infection case-years prevented, heavy infection case-years prevented, hepatomegaly case-years prevented and fibrosis case-years prevented. The interactions between drug efficacy and drug price were complex. In particular, there was a highly nonlinear relationship between drug efficacy and cost-effectiveness, with drugs of low efficacy producing high and variable cost-effectiveness ratios, particularly when other programme costs related to distance travelled were high. The results suggest that given the current price range of praziquantel, a drug with less than a 50% chance of killing the worms is not to be recommended. This has important practical implications for the widespread use of praziquantel, since most international agencies procure praziquantel purely on the basis of price. There is clearly a need for studies which evaluate the efficacy of new brands of praziquantel, and more credence should be given to the use of high efficacy brands, not only in terms of maximizing the cost-effectiveness of the intervention programme, but also in delaying the onset of drug resistance.
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PMID:An investigation into the interaction between drug efficacy and drug price of praziquantel in determining the cost-effectiveness of school-targeted treatment for Schistosoma mansoni using a population dynamic model. 965 4


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