Patients with severe schistosomiasis mansoni in Ituri Province, Democratic Republic of the Congo
| Autor: | Peter Odermatt, Manuel Battegay, David Wully Nigo, Maurice M. Nigo, Patrick Hunziker, Georgette B. Salieb-Beugelaar |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Abdominal pain
Case Report Praziquantel Feces Intestinal schistosomiasis Ascites Prevalence Schistosomiasis Medicine Severe case Ultrasonography medicine.diagnostic_test biology lcsh:Public aspects of medicine Hematemesis Schistosoma mansoni General Medicine Middle Aged Diarrhea Infectious Diseases Abdominal ultrasonography Democratic Republic of the Congo Female medicine.symptom Hepatomegaly medicine.drug Adult medicine.medical_specialty Physical examination lcsh:Infectious and parasitic diseases Young Adult Internal medicine parasitic diseases Animals Humans lcsh:RC109-216 Mortality business.industry Public Health Environmental and Occupational Health lcsh:RA1-1270 biology.organism_classification medicine.disease Schistosomiasis mansoni Splenomegaly Morbidity business |
| Zdroj: | Infectious Diseases of Poverty Infectious Diseases of Poverty, Vol 10, Iss 1, Pp 1-14 (2021) |
| ISSN: | 2049-9957 |
| DOI: | 10.1186/s40249-021-00815-6 |
| Popis: | Background Severe hepatosplenic complications arise in patients with chronic Schistosoma mansoni infection after heavy exposure to disease agents in endemic areas. These complications are rarely reported and, hence, underestimated. Case presentation We report on eight patients with severe morbidity associated with S. mansoni infection in Ituri Province, northeastern Democratic Republic of Congo (DRC). The patients were identified during a community-based survey in 2017; one patient was seen at the district hospital. After taking the patients’ history, a clinical examination and an abdominal ultrasonographical examination were performed. S. mansoni infection was diagnosed in fecal (Kato-Katz technique) and urine (point-of-case circulating cathodic antigen test) samples. These eight patients with severe intestinal and hepatosplenic complications were identified from four villages with high S. mansoni infection prevalence and related morbidity. The patients’ ages ranged from 19 to 57 years; four patients were women. Three patients reported hematemesis. Two patients were severely anemic. All patients reported non-specific abdominal symptoms, such as diarrhea (six patients), abdominal pain (seven patients), and blood in the stool (five patients), as well as weight loss (two patients). Abdominal ultrasonography revealed ascites in four patients. All patients had portal hypertension with hepatomegaly (seven patients) or splenomegaly (five patients). Of the six patients with a discernable liver parenchyma pattern, five displayed pattern F and three patient displayed pattern E. Liver parenchyma was not visible for two patients with severe ascites. An S. mansoni infection was confirmed in six patients, with infection intensity ranging from light to heavy. All S. mansoni positive patients were treated with praziquantel (40 mg/kg body weight) and referred to the district hospital for follow-up. One patient with severe ascites died two weeks after we saw her. Due to security and accessibility reasons, the villages could not be visited again and the patients were lost to follow-up. Conclusions Our observations of patients with severe schistosomiasis document the severe degree of endemicity of S. mansoni in the province and suggest an urgent need for adequate schistosomiasis control measures that target vulnerable population groups and address severe complications. |
| Databáze: | OpenAIRE |
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