Ultrasonography in Schistosomiasis in Africa

Abstract

Approximately 50 publications have become available in the international literature on ultrasonography in schistosomiasis in Africa. Geographically these cover Congo, Egypt, Kenya, Mali, Mauritius, Niger, Senegal, Sudan, Tanzania and East African Islands as well as Zimbabwe. Further studies are ongoing in many countries, such as Burundi, Ghana, Madagaskar and Uganda. It was shown that ultrasonography is useful in the detection of morbidity induced by schistosomiasis on an individual basis and on the community level. There is indication for varying morbidity patterns in different African foci. Post-treatment monitoring has provided evidence for reversibility of pathological lesions induced by Schistosoma (S.) haematobium and S. mansoni, even though evidence for reversibility of periportal fibrosis in adults is not yet satisfactorily substantiated. A standardized set of criteria for ultrasonographical observations has been worked out and is presently in the process of being refined. It is thus hoped that standardization will contribute to render studies in different endemic settings comparable on a global basis.

Morbidity associated with Schistosoma mansoni infection determined by ultrasound in an endemic area of Brazil, Caatinga do Moura.

“…Several studies using the classification scheme designed by Abdel-Wahab showed high prevalence of hepatic fibrosis in endemic areas. [19][20][21] The present study using this scheme detected degree I hepatic fibrosis in 65% of subjects and degree II in 25%. Moreover, splenomegaly (longitudinal diameter Ͼ 12 cm) was present in 9% of the subjects, and these patients had increased pathology of periportal tracts compared to persons without splenomegaly.…”

“…Others have also demonstrated regression of hepatic lesions after schistosomicidal drug treatment. 2,21,22 Sleigh and others in a three year follow-up without treatment described progression of hepatomegaly by clinical examination in 83% of patients and development of splenomegaly in 10% of patients with Ͼ 100 eggs/g stool. 23 No previous publication has assessed progression of hepatic lesions by ultrasonography without treatment.…”

Quantitative assessment of eosinophiluria in Schistosoma haematobium infections: a new marker of infection and bladder morbidity.

“…Ultrasound examination of the urinary tract provides visible evidence of pathology and since its introduction in assessment of S. haematobium-related morbidity it has been applied both at hospitals as well as in studies at the community and school levels involving a large number of individuals. 7,12,13,16,25,28,29 These studies have shown that ultrasound-detectable pathology correlates with other measures of morbidity including urinary egg counts, hematuria, proteinuria, and leukocyturia. However, ultrasound does not detect the early inflammatory reactions or early pathologic changes of the bladder wall, 17 and despite that the intensity of infection is a major factor responsible for development of pathology, disease sequelae between individuals with the same intensities may vary.…”

“…It is field applicable, rapid, and provides visible evidence of pathology. 15,16 However, ultrasound does not detect the early pathologic changes, i.e., the inflammatory reactions of the bladder. 17 Eosinophils make up a high proportion of the leukocyte infiltrate of the egg granuloma in Schistosoma sp.…”

Hepatosplenic morbidity in schistosomiasis japonica: evaluation with Doppler sonography.

“…17,18 Ultrasonographic features have been shown to correlate with histology, the presence and grade of esophageal varices, and with the risk of upper gastrointestinal hemorrhage. [19][20][21][22][23] Available literature on the ultrasonography of schistosomiasis japonica is scarce.…”