title: Ultrasound versus clinical examination as indication for Schistosoma mansoni associated morbidity in children.
abstract: In order to compare clinical versus ultrasound based diagnosis of Schistosoma mansoni induced periportal fibrosis (pF) 536 infected Sudanese schoolchildren underwent clinical and sonographical examination. A liver exceeding 3 cm in sternal line and a palpable spleen were considered pathological. Ultrasound criteria for age dependent organometry of a Central European cohort were used as reference. Based on clinical criteria 190 children (35.4%) had hepatomegaly, whereas according to ultrasound results the rate was only 11.4%. Splenomegaly was detected in 77 cases (14.4%) by clinical means, but in 196 by ultrasound (36.6%). The sensitivity of clinical parameters as indication of pF was around 50%. Results for ultrasound detected organomegaly were only slightly better. It was concluded that assessment of liver and spleen sizes was of limited value as an indication for pF and that a considerable discrepancy existed between clinical and ultrasound based assessment of hepato- and splenomegaly.
authors.affiliation: Institute for Medical Parasitology, University of Bonn, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Doehring-Schwerdtfeger
authors.forename: C
authors.initials: C
authors.lastname: Kaiser
authors.forename: J
authors.initials: J
authors.lastname: Schlake
authors.forename: I M
authors.initials: IM
authors.lastname: Abdel-Rahim
authors.forename: Q
authors.initials: Q
authors.lastname: Mohamed-Ali
authors.forename: J
authors.initials: J
authors.lastname: Richter
authors.forename: D
authors.initials: D
authors.lastname: Franke
authors.forename: R
authors.initials: R
authors.lastname: Kardorff
authors.forename: M
authors.initials: M
authors.lastname: Elsheikh
authors.forename: J H
authors.initials: JH
authors.lastname: Ehrich
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D006529:Hepatomegaly; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D009017:Morbidity; D015995:Prevalence; D012555:Schistosomiasis mansoni / Q000150:complications*; D013163:Splenomegaly; D013397:Sudan / Q000453:epidemiology; D014463:Ultrasonography