A cross-sectional study of periportal fibrosis and Schistosoma mansoni infection among school-aged children in a hard-to-reach area of Madagascar.

Autor:	Russell HJ; University of Manchester Medical School, Manchester, M13 9PL, UK.; Red House, Guilsfield, Powys, Wales, SY21 9NH., Penney JMS; University of Manchester Medical School, Manchester, M13 9PL, UK.; University Hospital Monklands, NHS Lanarkshire, Glasgow, Scotland, ML6 0JS., Linder C; University of Manchester Medical School, Manchester, M13 9PL, UK.; Maidstone and Tunbridge Wells Hospital, Maidstone and Tunbridge Wells NHS Trust, Kent, England, TN2 4QJ., Joekes EC; Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK., Bustinduy AL; Clinical Research Department, London School of Tropical Medicine and Hygiene and Tropical Medicine, London, WC1E 7HT, UK., Stothard JR; Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK., Rakotomampianina DAL; Faculté de Médecine, Université d'Antananarivo, Antananarivo, Madagascar., Andriamasy EH; Faculté de Médecine, Université d'Antananarivo, Antananarivo, Madagascar., Mahary LR; Faculté de Médecine, Université d'Antananarivo, Antananarivo, Madagascar.; Department of Immunology, Joseph Ravoahangy University Hospital Centre, Antananarivo, Madagascar., Ranjanoro EP; Faculté de Médecine, Université d'Antananarivo, Antananarivo, Madagascar.; Compassion Madagascar University Hospital, Antananarivo, Madagascar., Rahetilahy AM; Ministère de la Santé Publique, Antananarivo, Madagascar., Spencer SA; University of Manchester Medical School, Manchester, M13 9PL, UK.; Infectious Diseases, North Bristol NHS Trust, Bristol, BS10 5NB, UK.
Jazyk:	angličtina
Zdroj:	Transactions of the Royal Society of Tropical Medicine and Hygiene [Trans R Soc Trop Med Hyg] 2020 Apr 08; Vol. 114 (4), pp. 315-322.
DOI:	10.1093/trstmh/traa009
Abstrakt:	Background: A cross-sectional survey was performed to estimate the prevalence of periportal fibrosis in children based on ultrasound examination in the Marolambo district of the Atsinanana region of Madagascar. This is a remote area known to have a high prevalence of intestinal schistosomiasis. Methods: School-aged children (5-14 y) were selected from six villages for parasitological and sonographic examination. Circulating cathodic antigen (CCA) tests and Kato Katz (KK) stool microscopy were performed. Video-clips of liver views were recorded with a SonoSite iViz and interpreted in the UK by comparison with standardised images (WHO protocol). Results: The prevalence of schistosomiasis according to CCA testing was 97.8% (269/275) and 73.8% (203/275) by KK. Sonographic evidence of periportal fibrosis was observed in 11.3% (31/275). The youngest children with fibrosis were aged 6 y. Fibrosis was more common in older children (p=0.03) but was not associated with either infection intensity category (p=0.07) or gender (p=0.67). Conclusions: Findings of periportal fibrosis among children in these hard-to-reach villages suggests chronic Schistosoma mansoni infection from a very young age. This may reflect other similarly remote schistosomiasis-endemic areas and reinforces the need to investigate morbidity in neglected communities to understand the true extent of disease burden in endemic countries. (© The Author(s) 2020. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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