Mortality due to schistosomiasis mansoni: a field study in Sudan.

Kheir, Musa M.; Eltoum, Isam A.; Saad, Ahmed; Ali, Muslim; Baraka, Omer Z.; Homeida, M

doi:10.4269/ajtmh.1999.60.307

Cited by 37 publications

(25 citation statements)

References 11 publications

(15 reference statements)

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“…Unlike in Ukerewe, studies carried out in other highly endemic African countries such as Egypt, the region of Gezira in Central Sudan and Albert Lake in Uganda showed significant changes of the liver and serious complications in adolescents (Doehring-Schwerdtfeger et al 1989;Kheir et al 1999;Kabatereine 2000). Various factors such as more frequently repeated re-infections, a higher cumulative worm load and genetic factors have been discussed to underly to these differences between endemic areas (Dessein et al 1999;Blanton et al 2005;Eboumbou et al 2005).…”

Section: Discussionmentioning

confidence: 88%

Hepatosplenic morbidity due to Schistosoma mansoni in schoolchildren on Ukerewe Island, Tanzania

et al. 2012

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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.

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Section: Discussionmentioning

confidence: 88%

Hepatosplenic morbidity due to Schistosoma mansoni in schoolchildren on Ukerewe Island, Tanzania

et al. 2012

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“…In Sudan, a country endemic with schistosomiasis, AVH in the majority of cases is caused by portal hypertension due to schistosomal periportal fibrosis (PPF), while cirrhosis is less common[4]. Published data from Sudan showed that the crude mortality rate of schistosomiasis in a village in the Gezira state; an area endemic for schistosomiasis was 51/100000 per year with a case fatality per year of 1/1000 in those secreting eggs and 11/100 in those with bleeding varices[5]. Significant risk factors for variceal bleeding in patients with schistosomal portal hypertension, after at least one episode of bleeding compared to patients with schistosomal PPF without bleeding were splenic longitudinal dimension of more than 11 cm and PPF of ≥ grade III[6].…”

Section: Introductionmentioning

confidence: 99%

Mortality and rebleeding following variceal haemorrhage in liver cirrhosis and periportal fibrosis

Mohammed

Abdo

Mudawi

2016

WJH

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AIMTo investigate mortality and rebleeding rate and identify associated risk factors at 6 wk and 5 d following acute variceal haemorrhage in patients with liver cirrhosis and schistosomal periportal fibrosis.METHODSThis is a prospective study conducted during the period from March to December 2014. Patients with portal hypertension presenting with acute variceal haemorrhage secondary to either liver cirrhosis (group A) or schistosomal periportal fibroses (group B) presenting within 24 h of the onset of the bleeding were enrolled in the study and followed for a period of 6 wk. Analysis of data was done by Microsoft Excel and comparison between groups was done by Statistical Package of Social Sciences version 20 to calculate means and find the levels of statistical differences and define the mortality rates, the P value of < 0.05 was considered to be significant.RESULTSA total of 94 patients were enrolled in the study. Thirty-two patients (34%) had liver cirrhosis (group A) and 62 (66%) patients had periportal fibrosis (group B). Mortality: The 6-wk and 5-d mortality were 53% and 16% respectively in group A compared to 10% and 0% in group B (P value < 0.000 and < 0.004). In group A; a Child-Turcotte-Pugh class C and rebleeding within 5 d were significantly associated with 5-d mortality (P value < 0.029 and < 0.049 respectively) and Child- Turcotte-Pugh class C was also a significant risk factor for 6-wk mortality (P value < 0.018). In group B; mortality was significantly associated with rebleeding within the 6-wk follow-up period and requirement for blood transfusion on admission (P value < 0.005 and < 0.049). Rebleeding: The 6-wk and 5-d rebleeding rate in group A were 56% and 25% respectively compared to 32% and 3% in group B (P value < 0.015 and < 0.002). Clinical presentation with encephalopathy was a significant risk factor for 5 d rebleeding in group A (P value < 0.005) while grade III periportal fibrosis and requirement for blood transfusion on admission were significant risk factors for 6-wk rebleeding in group B (P value < 0.004 and < 0.02).CONCLUSIONThe 6-wk and 5-d mortality and rebleeding rate were significantly higher in patients with liver cirrhosis compared to patients with schistosomal periportal fibrosis.

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“…The mortality rate of schistosomiasis in published data from a village endemic with schistosomiasis in the Gezira state located in Sudan was 51/100,000 per year. The fatality rate per year is 1/1000 in patients secreting eggs and 11/100 in variceal bleeding patients [5] . Schistosoma mansoni (S.mansoni) complicated by portal hypertension has a major impact on morbidity and mortality because of esophagogastric variceal bleeding possibility [6] .…”

Section: Introductionmentioning

confidence: 99%

Surgical outcomes of distal splenorenal shunt or liver transplantation in treatment of schistosomal refractory variceal bleeding

Doush¹,

Elzein²

2018

JUMD

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Schistosomiasis is one of the most prevalent neglected tropical diseases, remains a serious public health problem in many developing countries in the tropics and subtropics and its pathogenesis depends on the parasite-host interaction. Periportal fibrosis of schistosomiasis complicated by portal hypertension results from increased intrahepatic vascular resistance and blood flow through the portal venous system. This leads to portosystemic collateral variceal veins formation which dilates until they finally rupture and bleed due to progressive rising in the portal venous pressure. The clinical impact of esophagogastric varices is critical due to the rebleeding rate of esophageal varices remains high within two years after cessation of acute bleeding from medium or large varices. In the present review, we will discuss hepatosplenic schistosomiasis and oesophagogastric varices pathophysiology and review the current surgical outcomes of distal splenorenal shunt or liver transplantation in schistosomal refractory variceal bleeding.

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Mortality due to schistosomiasis mansoni: a field study in Sudan.

Cited by 37 publications

References 11 publications

Hepatosplenic morbidity due to Schistosoma mansoni in schoolchildren on Ukerewe Island, Tanzania

Hepatosplenic morbidity due to Schistosoma mansoni in schoolchildren on Ukerewe Island, Tanzania

Mortality and rebleeding following variceal haemorrhage in liver cirrhosis and periportal fibrosis

Surgical outcomes of distal splenorenal shunt or liver transplantation in treatment of schistosomal refractory variceal bleeding

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