title: Ultrasonographical investigation of periportal fibrosis in children with Schistosoma mansoni infection: reversibility of morbidity seven months after treatment with praziquantel.
abstract: Five hundred thirty six Sudanese schoolchildren with Schistosoma mansoni infection were treated at random with either 20 mg or 40 mg/kg praziquantel. Seven months later 420 children could be reinvestigated by ultrasonography. Reduction of egg excretion and reversibility of sonographically-proven periportal fibrosis (PF) was not significantly different in the two groups. Schistosoma mansoni-induced PF grade II decreased from 22.9% to 6.7% and grade III from 5.2% to 1.6%. An increased prevalence of PF grade I, from 10% to 29.8% of the investigated patients, was observed. This increase was caused partly by a downshifting of patients who had PF II (n = 45) and PF III (n = 8) before therapy, but also by patients who developed PF I in the seven months after therapy (n = 56). The overall percentage of patients with PF before and after treatment was 38.1%. Of 420 children, 17.4% increased in their PF grade, 55% remained at the same level and 27.6% improved. Children younger than 11 years of age had a higher rate of complete reversibility than older ones. The percentage of patients with hepatomegaly decreased significantly (11.6% to 6.9%; p = 0.001). The rate of splenomegaly remained unchanged. It was concluded that within seven months therapy with praziquantel resulted in a considerable qualitative improvement of PF in Sudanese schoolchildren with S. mansoni infection.
authors.affiliation: Sultan Qaboos University, Al-Khod Muscat, Oman.
authors.forename: Q
authors.initials: Q
authors.lastname: Mohamed-Ali
authors.forename: E
authors.initials: E
authors.lastname: Doehring-Schwerdtfeger
authors.forename: I M
authors.initials: IM
authors.lastname: Abdel-Rahim
authors.forename: J
authors.initials: J
authors.lastname: Schlake
authors.forename: R
authors.initials: R
authors.lastname: Kardorff
authors.forename: D
authors.initials: D
authors.lastname: Franke
authors.forename: C
authors.initials: C
authors.lastname: Kaiser
authors.forename: M
authors.initials: M
authors.lastname: Elsheikh
authors.forename: M
authors.initials: M
authors.lastname: Abdalla
authors.forename: P
authors.initials: P
authors.lastname: Schafer
mesh_terms: D002648:Child; D006529:Hepatomegaly; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D010270:Parasite Egg Count; D011223:Praziquantel / Q000627:therapeutic use*; D011897:Random Allocation; D012555:Schistosomiasis mansoni / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D013163:Splenomegaly; D013997:Time Factors; D014463:Ultrasonography
chemical_list: D011223:Praziquantel