Prevalence of schistosome antibodies with hepatosplenic signs and symptoms among patients from Kaoma, Western Province, Zambia.
Prevalence of schistosome antibodies with hepatosplenic signs and symptoms among patients from Kaoma, Western Province, Zambia.
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DOI：
10.1186/1756-0500-6-344
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发表时间：
2013-08-30
影响因子：
1.8
通讯作者：
Kelly, Paul
中科院分区：
文献类型：
--
作者：
Payne, Lara;Turner-Moss, Eleanor;Kelly, Paul
背景：血吸虫病是发病率和死亡率的主要原因，全世界有超过2亿人感染。85%的病例发生在非洲。hepatosplenic形式发展随着时间的推移,通过免疫反应被困曼氏裂体吸虫鸡蛋在门户系统中导致肝纤维化,门脉高压和食管静脉曲张。卢萨卡大学教学医院的大多数食管静脉曲张患者来自西部省，但在该地区尚未开展评估肝脾病理负担的正式研究。我们的目的是确定赞比亚西部科马地区问题的严重程度，并将体征和症状与血清学联系起来。结果：对在科马区门诊就诊的患者进行症状问卷调查、人口统计调查和体格检查。为了评估曼氏血吸虫感染的流行程度，采集血样并使用酶联免疫吸附试验（ELISA）筛查血吸虫抗体的存在。在筛选的110例患者中，97例（88%）ELISA阳性。46%（51/110）报告有赤足，7%经历呕血（8/110）。在体格检查中，参与者中有27%（30/110）肝肿大和17%（30/110）脾肿大，但血清学和体征/症状之间几乎没有相关性。在询问中，68%（75/110）的参与者对血吸虫病的传播一无所知。结论：我们的血清学和临床数据表明，血吸虫病相关的门静脉高压症负担非常重。我们的证据强调需要在科马进行大规模治疗，以解决和预防肝脾血吸虫病的广泛病理。整个西部省的安全饮水和卫生教育显然也很重要。
BACKGROUND: Schistosomiasis is a major cause of morbidity and mortality, with over 200 million people infected worldwide. Eighty-five percent of cases are in Africa. The hepatosplenic form develops over time by an immune reaction to trapped Schistosoma mansoni eggs in the portal system leading to liver fibrosis, portal hypertension and oesophageal varices. Most patients presenting to the University Teaching Hospital in Lusaka with oesophageal varices, come from Western province, but no formal studies have been carried out in this area assessing the burden of hepatosplenic pathology. We aimed to define the extent of the problem in Kaoma district, western Zambia, and to correlate signs and symptoms with serology.FINDINGS: A symptom questionnaire, demographic survey and physical examination was conducted amongst patients presenting to Kaoma district outpatient clinics. To assess the prevalence of Schistosoma mansoni infections, blood was collected and screened for the presence of Schistosoma antibodies using Enzyme linked immunosorbent assay (ELISA). Of the 110 patients screened, 97 (88%) were ELISA positive. Forty-six percent (51/110) reported haematochezia and 7% experienced haematemesis (8/110). On physical examination 27% (30/110) hepatomegaly and 17% (30/110) splenomegaly was observed amongst participants but there were few correlations between serology and signs/symptoms. On questioning 68% (75/110) of participants knew nothing about schistosomiasis transmission.CONCLUSIONS: Our serological and clinical data indicate a very heavy burden of schistosomiasis-related portal hypertension. Our evidence highlights a need for mass treatment in Kaoma to address and prevent extensive pathology of hepatosplenic schistosomiasis. Safe water and health education throughout Western Province are clearly also important.