Morbidity due to Schistosoma mansoni among Sugar-Cane Cutters in Zimbabwe

Abstract

Quantitative determination of Schistosoma mansoni infection was carried out on 1995 cane cutters of the Hippo Valley and Triangle Sugar Estates. A total of 315 cutters were chosen for the study on the basis of S. mansoni infection and lack of anti-schistosomal chemotherapy during the previous three years. Stool consistency and blood and mucus in stool were determined for all the infected cutters. Overt and occult blood in stool was detected in a significantly high number of infected people compared to the control subjects (chi 2 p less than 0.001). However, the blood loss was found to have no anaemia-producing effect as determined by haemoglobin and red blood cell counts. Watery stool was prevalent among people with egg output exceeding 500 eggs per gram of stool. Mucus in stool was found to be more prevalent among infected people compared to the control subjects but the difference was not significant (p greater than 0.05). Symmer's periportal fibrosis (PPF) of various degrees of severity was detected in 47% of the infected people and grade one liver fibrosis was found in 7.5% of the control subjects (p less than 0.0001). Some 54.5% of those infected complained of abdominal pains compared to 35% of uninfected controls (p less than 0.01). There was a significant difference in the rate of absenteeism from work due to abdominal pains and diarrhoea among the infected and uninfected cane cutters (p less than 0.02).

Intestinal Schistosomiasis in Mothers and Young Children in Uganda: Investigation of Field-Applicable Markers of Bowel Morbidity

“…In China, no relationship was observed between FOB and the presence or intensity of S. japonicum infection 45. In contrast, studies in Brazil and Zimbabwe showed a positive correlation between intensity of S. mansoni infection and percentage of FOB-positive stools 27,46. Similarly, in the Philippines, persons with heavy S. japonicum infections were 3.5 times more likely to be FOB positive than those with no or light to moderate infections 28.…”

Relationship Between Schistosoma Japonicum and Nutritional Status Among Children and Young Adults in Leyte, the Philippines

“…28 In cross-sectional and case-control studies in the context of Schistosoma mansoni, investigators have found strong evidence for a relationship between fecal occult blood and intensity of schistosomiasis infection. [29][30][31] In one such study, individuals with moderateor high-intensity S. mansoni had increased prevalence of occult blood; however, uninfected individuals had a 23.1% prevalence of occult positivity, and no adjustment was made for the presence of hookworm infection, which was endemic. 30 In another study, high-versus low-intensity infection with S. mansoni increased the risk for occult positivity by approximately 4-fold.…”

“…30 In another study, high-versus low-intensity infection with S. mansoni increased the risk for occult positivity by approximately 4-fold. 31 Given the lack of control for hookworm and trichuris infections, which have been associated with occult blood loss at high intensities, 16,32 it is difficult to interpret the studies in S. mansoni. This study suggests that occult blood loss may be relevant only at high-intensity infection in S. japonicum.…”

Fecal Occult Blood and Fecal Calprotectin as Point-of-Care Markers of Intestinal Morbidity in Ugandan Children with Schistosoma mansoni Infection

“…Across community-based surveys worldwide, detection of intestinal blood loss in schistosomiasis-endemic areas has revealed a positive association between egg-patent infection and presence of blood in stools [7] – [9] . However, the majority of these studies used guaiac-based fecal occult blood (FOB) tests that are known to be less sensitive than the FOB immunochemical assays now widely used for colorectal cancer detection [10] , [11] .…”