Regression of hepatosplenomegaly in Kenyan school-aged children after praziquantel treatment and three years of greatly reduced exposure to Schistosoma mansoni
| Autor: | Hilda Kadzo, H. Curtis Kariuki, Gachuhi Kimani, LeeCarol Kenty, John H. Ouma, Edmund Ireri, Joseph K. Mwatha, Birgitte J. Vennervald, Anthony E. Butterworth, Mark Booth, David W. Dunne, Clifford Amaganga |
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| Rok vydání: | 2005 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Adolescent Population Hepatosplenomegaly Schistosomiasis Praziquantel Organomegaly Cohort Studies Age Distribution parasitic diseases Prevalence medicine Humans Child education Parasite Egg Count Ultrasonography Anthelmintics education.field_of_study biology business.industry Public Health Environmental and Occupational Health General Medicine medicine.disease biology.organism_classification Kenya Schistosomiasis mansoni Treatment Outcome Infectious Diseases Liver Splenomegaly Immunology Cohort Female Parasitology Schistosoma mansoni medicine.symptom business Spleen Malaria Hepatomegaly medicine.drug |
| Zdroj: | Transactions of the Royal Society of Tropical Medicine and Hygiene. 99:150-160 |
| ISSN: | 0035-9203 |
| DOI: | 10.1016/j.trstmh.2004.06.009 |
| Popis: | Evaluating regression of morbidity associated with parasitic infections is an important component of community-based control programmes. We performed an intervention against Schistosoma mansoni infection, focusing on hepatosplenomegaly in the absence of periportal fibrosis, in a cohort of 67 Kenyan children aged 7-18 years from Makueni District, selected on the basis of hepatosplenomegaly detected by ultrasonography. Clinical and ultrasound examinations were conducted annually for three years after treatment, and the source of infection (a river) was regularly treated with molluscicide, thereby severely reducing exposure to schistosomiasis. Malaria transmission was uninterrupted. The prevalence of hard spleens, and the magnitude of clinically assessed splenomegaly along the mid-axillary and mid-clavicular lines decreased monotonically over time, independently of age, whereas clinically measured hepatomegaly along the mid-sternal line and the prevalence of firm livers decreased in an age-specific manner, being more pronounced amongst children aged 14 years or older at enrolment. Ultrasound data were less informative, and did not concur with clinical observations. These results demonstrate that praziquantel treatment reduces hepatosplenomegaly in the absence of exposure to S. mansoni, even with continuing exposure to malaria. The lack of complete resolution of hepatosplenomegaly in most children suggests, among other things, a residual organomegaly attributable to malaria. |
| Databáze: | OpenAIRE |
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