Hepatosplenic morbidity due to Schistosoma mansoni in schoolchildren on Ukerewe Island, Tanzania
Hepatosplenic morbidity due to Schistosoma mansoni in schoolchildren on Ukerewe Island, Tanzania
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DOI：
10.1007/s00436-011-2793-6
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发表时间：
2012-06-01
影响因子：
2
通讯作者：
Richter, J.
中科院分区：
文献类型：
--
作者：
El Scheich, Tarik;Hofer, L.;Richter, J.
这项研究是为了评估东非维多利亚湖Ukerewe岛上的学童中曼氏血吸虫的感染强度和发病率。360名以前从未接受过治疗的学生(男180人，女180人，年龄6-17岁[中位数10岁])在岛上三所不同的学校就读。从每名学生身上采集双份粪便样本，并根据世卫组织的建议对鸡蛋排泄物进行分类。超声检查是根据世卫组织尼亚美-贝洛奥里藏特方案进行的。男(112/180，62.2%)和女(104/180，57.7%)小学生感染，差异无统计学意义(N.S.)。在216例阳性病例中，虫卵排泄量从1个/克大便(EPG)到2440个/克粪便(EPG)[中位数165个EPG]。轻度感染69例(31.9%)，中度感染105例(53.2%)，重度感染42例(14.8%)。男性和女性之间以及年龄组之间没有显著差异。360例儿童中有354例接受超声检查，其中脾肿大321例(90.7%)，左叶316例(89.3%)，右叶109例(30.9%)。19例(5.4%)有明显的门静脉纤维化征象，其中11例表现为周围门脉回声增厚，8例表现为中央门脉分支增厚。非特异性门静脉壁改变6例(1.7%)。未发现PF与定量排卵之间的关联(PF组的中位数为172 EPG，非PF组的中位数为168 EPG；差异，N.S.)。门静脉扩张101例(28.5%)。在乌克雷韦，曼氏葡萄球菌在儿童中的感染率和感染强度很高，但与其他地方性疫源地相比，明显的肝脏发病率较低。非特异性超声异常包括肝脾肿大和门静脉扩张是常见的，但血吸虫病的部分难以评估。
The study was conducted to assess infection intensity and morbidity due to Schistosoma mansoni in schoolchildren on Ukerewe Island in Lake Victoria, Tanzania, East Africa. Three hundred and sixty pupils who have never been treated previously were enrolled (180 males/180 females, age 6-17 years [median 10 years]) in three different schools of the island. Double stool samples were collected from each pupil and egg excretion was classified according to WHO recommendations. Ultrasound investigations were performed in accordance with the WHO Niamey-Belo-Horizonte protocol. Male (112/180, 62.2%) and female (104/180; 57.7%) pupils were infected (difference, not significant [n.s.]). In the positive 216 cases, egg excretion varied from 1 to 2,440 eggs per gramme stool (epg) [median 165 epg]. There were 69/216 (31.9%) who had a low grade, 105/216 (53.2%) had a moderate and 42/216 (14.8%) had a heavy infection. There was no significant difference between male and female sex nor with regard to age groups. There were 354/360 children who underwent sonography: 321 (90.7%) had splenomegaly, 316 (89.3%) showed a left lobe and 109 (30.9%) had a right lobe hepatomegaly. Overt signs of portal fibrosis (PF) were present in 19 children (5.4%) out of whom 11 presented with echogenic thickening of peripheral portal and 8 with thickening of central portal branches. Non-specific portal wall changes were seen in 6 children (1.7%). Association of PF to quantitative egg excretion was not seen (median in PF, 172 epg vs. median in non PF, 168 epg; difference, n.s.). Portal vein dilatation was seen in 101/354 (28.5%) cases. In Ukerewe, the prevalence of S. mansoni infection and infection intensity in children is high, yet overt hepatic morbidity is low as compared to other endemic foci. Non-specific ultrasonographic abnormalities including hepatosplenomegaly and portal vein dilatation were seen frequently but the fraction attributable to schistosomiasis is difficult to assess.