Hunter's Tropical Medicine and emerging infectious diseases

Strickland, G. Thomas

doi:10.1590/s0036-46652001000200018

Cited by 31 publications

(44 citation statements)

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“…Therefore, many had a few Schistosoma ova in their stools in the absence of the complications of schistosomiasis. 3 However, many persons with enlarged livers and spleens, portal vein dilatation, and bright or coarse echo patterns compatible with chronic hepatitis and fibrosis were detected during ultrasound. 7 By that time many in these rural villages were known to have chronic HCV infections.…”

Section: The Switch: From Schistosomiasis To Hepatitis Cmentioning

confidence: 99%

“…26 Others also reported that HCV infection with genotype 4a was the main cause of chronic liver disease in 135 adult patients living in Alexandria 27 and in 801 residents of a Nile Delta community. 28 Case-control studies have shown that both HBV and HCV infection increase the risk of HCC (adjusted odds ratios of [3][4][5][6][7][8][9][10][11][12][13]. Because the prevalence of infections with HCV in the country is so much higher than the prevalence of HBV infections, the attributable fraction of HCV (60%-70%) and the anti-HCV rate (75%-90%) has become the greatest risk factor for HCC in Egypt.…”

Section: Magnitude Of Hcv-caused Chronic Liver Disease In Egyptmentioning

confidence: 99%

“…The association of chronic liver disease, characterized by hepatosplenomegaly and portal hypertension with schistosomiasis mansoni was first made by William St. Claire Symmers, also while working at Kasr El Aini Hospital in Cairo, when he described clay pipe stem fibrosis in 1904. 3 Urinary schistosomiasis due to S. haematobium was the predominant form in Egypt until 35 or 40 years ago. This species was found in ancient mummies, and 200 years ago Napoleonic documents mentioned "menstruating males of Egypt," attesting to the frequency of hematuria.…”

mentioning

confidence: 99%

“…This was the treatment of choice for American troops infected with S. japonicum during the re-invasion of the Philippines in 1944; tartar emetic remained the standard therapy for S. mansoni and S. japonicum for over 60 years. 3 The single-dose, safe and effective oral drug, praziquantel, did not become readily available in Egypt until the 1980s. 3,6 The Outbreak: Extensive Campaigns to Control Schistosomiasis Egypt has had strong academic tropical medicine programs.…”

mentioning

confidence: 99%

“…3 The single-dose, safe and effective oral drug, praziquantel, did not become readily available in Egypt until the 1980s. 3,6 The Outbreak: Extensive Campaigns to Control Schistosomiasis Egypt has had strong academic tropical medicine programs. Because many "tropical" medical problems confronting physicians were due to complications of hepatic fibrosis and cirrhosis due to schistosomiasis and chronic viral infections, some prominent Egyptian hepatologists established clinical liver centers.…”

mentioning

confidence: 99%

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Liver disease in Egypt: Hepatitis C superseded schistosomiasis as a result of iatrogenic and biological factors

2006

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In Egypt, schistosomiasis was traditionally the most important public health problem and infection with Schistosoma mansoni the major cause of liver disease. From the 1950s until the 1980s, the Egyptian Ministry of Health (MOH) undertook large control campaigns using intravenous tartar emetic, the standard treatment for schistosomiasis, as community-wide therapy. This commendable effort to control a major health problem unfortunately established a very large reservoir of hepatitis C virus (HCV) in the country. By the mid-1980s, the effective oral drug, praziquantel, replaced tartar emetic as treatment for schistosomiasis in the entire country. This both reduced schistosomal transmission and disease and interrupted the "occult" HCV epidemic. It was evident when diagnostic serology became available in the 1990s that HCV had replaced schistosomiasis as the predominant cause of chronic liver disease. Epidemiological studies reported a high prevalence and incidence of HCV, particularly within families in rural areas endemic for schistosomiasis. Clinical studies showed 70% to 90% of patients with chronic hepatitis, cirrhosis, or hepatocellular carcinoma had HCV infections. Co-infections with schistosomiasis caused more severe liver disease than infection with HCV alone. Schistosomiasis was reported to cause an imbalance in HCV-specific T-cell responses leading to increased viral load, a higher probability of HCV chronicity, and more rapid progression of complications in co-infected persons. As complications of HCV usually occur after 20 years of infection, the peak impact of the Egyptian outbreak has not yet occurred. Efforts have been initiated by the Egyptian MOH to prevent new infections and complications of HCV in the estimated 6 million infected persons. (HEPATOLOGY 2006;43:915-922.)

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Section: The Switch: From Schistosomiasis To Hepatitis Cmentioning

confidence: 99%