Prevalence of schistosome antibodies with hepatosplenic signs and symptoms among patients from Kaoma, Western Province, Zambia

BMC Research Notes

Paul Kelly²  Akwi W Asombang⁴  Mable Mutengo³  Eleanor Turner-Moss²  Lara Payne¹ 

[1]Faculty of Medicine, Imperial College London, South Kensington Campus, SW7 2AZ London, UK

[2]Barts and The London School of Medicine and Dentistry, Turner Street, E1 2AD London, UK

[3]University of Zambia, Lusaka University Teaching Hospital, P.O Box 50001, Lusaka, Zambia

[4]Washington University School of Medicine in St. Louis, 660 South Euclid, St Louis 63110, MO, USA

关键词: Hepatosplenic;    ELISA;    Seroepidemiology;    Zambia;    Schistosoma mansoni;    Schistosomiasis;   

Others  :  1141796
DOI  :  10.1186/1756-0500-6-344

 received in 2013-03-14, accepted in 2013-08-28,  发布年份 2013

【 摘 要 】

Background

Schistosomiasis is a major cause of morbidity and mortality, with over 200 million people infected worldwide. Eighty-five percent of cases are in Africa. The hepatosplenic form develops over time by an immune reaction to trapped Schistosoma mansoni eggs in the portal system leading to liver fibrosis, portal hypertension and oesophageal varices. Most patients presenting to the University Teaching Hospital in Lusaka with oesophageal varices, come from Western province, but no formal studies have been carried out in this area assessing the burden of hepatosplenic pathology. We aimed to define the extent of the problem in Kaoma district, western Zambia, and to correlate signs and symptoms with serology.

Findings

A symptom questionnaire, demographic survey and physical examination was conducted amongst patients presenting to Kaoma district outpatient clinics. To assess the prevalence of Schistosoma mansoni infections, blood was collected and screened for the presence of Schistosoma antibodies using Enzyme linked immunosorbent assay (ELISA). Of the 110 patients screened, 97 (88%) were ELISA positive. Forty-six percent (51/110) reported haematochezia and 7% experienced haematemesis (8/110). On physical examination 27% (30/110) hepatomegaly and 17% (30/110) splenomegaly was observed amongst participants but there were few correlations between serology and signs/symptoms. On questioning 68% (75/110) of participants knew nothing about schistosomiasis transmission.

Conclusions

Our serological and clinical data indicate a very heavy burden of schistosomiasis-related portal hypertension. Our evidence highlights a need for mass treatment in Kaoma to address and prevent extensive pathology of hepatosplenic schistosomiasis. Safe water and health education throughout Western Province are clearly also important.

【 授权许可】

   
2013 Payne et al.; licensee BioMed Central Ltd.

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