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Schistosomiasis Mansoni in Low Transmission Areas. Abdominal Ultrasound
R Ruiz; P Candia; M Garassini; C Tombazzi; G Certad; AC Bruces; O Noya & B Alarcón de Noya
Abstract
In endemic areas with low prevalence and low intensity of
infection, the diagnosis of hepatic pathology due to the Schistosoma mansoni
infection is very difficult. In order to establish the hepatic morbidity,
a double-blind study was achieved in Venezuelan endemic areas, with one
group of patients with schistosomiasis and the other one of non-infected
people, that were evaluated clinically and by abdominal ultrasound using
the Cairo classification. Schistosomiasis diagnosis was established based
on parasitologic and serological tests. The increase of the hepatic size
at midclavicular and midsternal lines (in hepatometry) and the hard liver
consistency were the clinical parameters able to differentiate infected
persons from non infected ones, as well as the presence of left lobe hepatomegaly
detected by abdominal ultrasound. The periportal thickening, especially
the mild form, was frequent in all age groups in both infected and uninfected
patients. There was not correlation between the intensity of infection and
ultrasound under the current circumstances. Our data suggest that in Venezuela,
a low endemic area of transmission of schistosomiasis, the hepatic morbidity
is mild and uncommon. The Cairo classification seems to overestimate the
prevalence of periportal pathology. The specificity of the method must be
improved, especially for the recognition of precocious pathology. Other
causes of hepatopathies must be investigated.
Keywords
ultrasound - schistosomiasis - low transmission - Venezuela
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