The situation of hepatosplenic schistosomiasis in Brazil today

Andrade, Zilton de Araújo

doi:10.1590/s0074-02761998000700062

Cited by 24 publications

(18 citation statements)

References 12 publications

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“…In 4, a diagnosis of type I membranoproliferative glomerulonephritis was confirmed. These findings are similar to those previously described and do not support a decrease in the frequency of renal disease in hepatosplenic schistosomiasis reported by others 17 .…”

Section: Discussionsupporting

confidence: 86%

Glomerulonephritis in schistosomiasis mansoni: a time to reappraise

Rodrigues

Otoni

Voieta

et al. 2010

Rev. Soc. Bras. Med. Trop.

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Introduction:The current prevalence of glomerulonephritis in patients with hepatosplenic schistosomiasis mansoni in Brazil was evaluated. Methods: Sixty three patients (mean age 45.5±11 years) attending the outpatient infectious disease clinic of a University Hospital in Belo Horizonte, Brazil, from 2007 to 2009, were consecutively examined and enrolled in the present investigation. Diagnosis of hepatosplenic schistosomiasis was based on epidemiological, clinical and parasitological data and imaging techniques. Eight patients, who presented >30mg/day albuminuria, were submitted to percutaneous ultrasound guided renal biopsy. Kidney tissue fragments were examined under light, direct immunofluorescence and electron microscopy. Results: All patients showed mesangial enlargement. In five, mesangial hypercellularity was observed and four presented duplication of the glomerular basement membrane. Areas of glomerular sclerosis were diagnosed in four. Deposits of immunoglobulin M and C3 were present in six samples; deposits of IgG in four, IgA in three and C1q in two samples. In all patients, immunoglobulin A was reported in the lumen of renal tubules. Deposits of kappa and lambda were observed in six samples. Electron microscopy revealed dense deposits in the glomerular tissue of three patients. Arterial hypertension, small esophageal varices, slight increases in serum creatinine and decreases in serum albumin were associated with glomerular disease. Conclusions: Renal disease associated with hepatosplenic schistosomiasis was verified in 12.7% of patients and type I membranoproliferative glomerulonephritis was observed in 50% of them. Schistosomal glomerulopathy still is an important problem in patients with hepatosplenic schistosomiasis in Brazil.

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Section: Discussionsupporting

confidence: 86%

Glomerulonephritis in schistosomiasis mansoni: a time to reappraise

Rodrigues

Otoni

Voieta

et al. 2010

Rev. Soc. Bras. Med. Trop.

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“…However, the benefits of these initiatives are not equally distributed because of regional and country-specific differences in available resources and/or political commitment. For example, the health burden caused by schistosomiasis has been reduced significantly over the past several decades in China (9,10) and Brazil (11), whereas the disease remains a major public health problem in many parts of Africa, where large-scale control initiatives focused on reducing morbidity through the use of the antihelminthic drug praziquantel have been initiated. More recently, control efforts have been further fueled by funds from international foundations (7,12).…”

mentioning

confidence: 99%

Environmental effects on parasitic disease transmission exemplified by schistosomiasis in western China

Liang

Seto

Remais

et al. 2007

Proc. Natl. Acad. Sci. U.S.A.

105

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Environmental effects on the transmission of many parasitic diseases are well recognized, but the role of specific factors like climate and agricultural practices in modulating transmission is seldom characterized quantitatively. Based on studies of Schistosoma japonicum transmission in irrigated agricultural environments in western China, a mathematical model was used to quantify environmental impacts on transmission intensity. The model was calibrated by using field data from intervention studies in three villages and simulated to predict the effects of alternative control options. Both the results of these interventions and earlier epidemiological findings confirm the central role of environmental factors, particularly those relating to snail habitat and agricultural and sanitation practices. Moreover, the findings indicate the inadequacy of current niclosamide-praziquantel strategies alone to achieve sustainable interruption of transmission in some endemic areas. More generally, the analysis suggests a village-specific index of transmission potential and how this potential is modulated by time-varying factors, including climatological variables, seasonal water-contact patterns, and irrigation practices. These time-variable factors, a village's internal potential, and its connectedness to its neighbors provide a framework for evaluating the likelihood of sustained schistosomiasis transmission and suggest an approach to quantifying the role of environmental factors for other parasitic diseases.disease control ͉ environment

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“…Esta verdade foi confirmada após o tratamento em larga escala das populações nordestinas, o que veio a reduzir drasticamente a existência das formas avançadas da esquistossomose entre nós, embora sem igual impacto sobre a presença de esquistossomose-infecção 4 .…”

Section: Fibrose Hepáticaunclassified

Regressão da fibrose hepática

Andrade

2005

Rev. Soc. Bras. Med. Trop.

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RESUMODurante muito tempo, se acreditou que a fibrose hepática extensa e de longa duração fosse um processo irreversível. As investigações sobre o comportamento da fibrose hepática, nas formas avançadas da esquistossomose, vieram abalar este conceito e hoje em dia está se estabelecendo a noção de que qualquer fibrose é reversível, inclusive aquela associada à cirrose hepática. O problema é identificar sua causa e removê-la. Embora, a fibrose hepática tenha per se pouca significação fisiopatológica, sua gravidade está relacionada com as alterações vasculares que ela encerra. O que dá ao assunto primordial importância são os indícios até aqui obtidos de que, a regressão da fibrose costuma se acompanhar de uma remodelação das alterações vasculares no seu interior. Mas, há peculiaridades relativas ao tipo anatômico e ao papel fisiológico que certas fibroses exibem, e tais peculiaridades podem interferir com o processo regressivo da mesma, o que pode significar que por vezes a fibrose pode se tornar permanente. Esses assuntos, alguns deles controversos, são aqui apresentados e discutidos. Palavras-chaves: Fibrose hepática. Esquistossomose. Cirrose hepática. Capillaria hepatica. ABSTRACTExtensive and persistent hepatic fibrosis has for a long time been considered irreversible. However, recent studies on the behavior of hepatic fibrosis, especially those related to evolution and involution of advanced schistosomiasis in man, have challenged this concept, and nowadays it is becoming clear that any type of fibrosis is reversible, including that associated with hepatic cirrhosis. The problem consists in identifying and eliminating its cause. Although fibrosis in the liver has little functional significance by itself, its severity derives from associated vascular changes. However, new data on fibrosis regression indicate that disappearance of fibrosis is usually accompanied by remodeling of vascular changes. But, there are peculiarities related to the anatomic type of fibrosis and to its functional significance, which suggest that sometimes fibrosis may indeed be irreversible. These aspects, some of which in need of further studies, are presented and discussed herein. Key-words: Hepatic fibrosis. Schistosomiasis. Hepatic cirrhosis. Capillaria hepatica. GENERALIDADESOs conhecimentos sobre o tecido conjuntivo têm progredido muito nos anos recentes, especialmente no que diz respeito à composição e potencialidades da sua matriz extracelular. O tecido que preenche os espaços entre as células, conduzindo os vasos sanguíneos e linfáticos, tem funções óbvias de sustentação e de integração, mas a sua importância vai mais além. Os seus componentes incluem moléculas que são fundamentais para a ancoragem, estimulação e movimentação das células no seu interior e para as interações célula-matriz e célula-célula, pois na matriz extracelular se encontram fatores de crescimento, hormônios, ligandos e moléculas de adesão 11 . Na sua porção não-fibrilar predomina um material amorfo, gelatinóide, constituído predominantemente por glicose-amin...

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The situation of hepatosplenic schistosomiasis in Brazil today

Cited by 24 publications

References 12 publications

Glomerulonephritis in schistosomiasis mansoni: a time to reappraise

Glomerulonephritis in schistosomiasis mansoni: a time to reappraise

Environmental effects on parasitic disease transmission exemplified by schistosomiasis in western China

Regressão da fibrose hepática

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