title: Schistosoma haematobium infection in western Madagascar: morbidity determined by ultrasonography.
abstract: To assess the morbidity related to Schistosoma haematobium infection in western Madagascar, an ultrasonographic examination was performed of 574 inhabitants > 5 years old in a village in an old-established endemic area where no prior systematic antischistosomal treatment had been given. The overall prevalence of infection was 75.9% and the geometric mean egg count of positive individuals was 36 eggs/10 mL of urine. Recent haematuria had been experienced by 31.8% of individuals. Echographic abnormalities of the urinary tract were present in 50.5% of individuals: they were more frequent in males. Bladder wall lesions were observed in 93.1% of individuals with ultrasonographic changes, irregularities of the inner surface being the most common finding. Congestive changes were noted in 8.4% of kidneys, but we observed only 4 severe congestions. Bladder lesions and congestive changes in kidneys predominated in youth; their presence and severity were significantly correlated with egg excretion. In 12 inhabitants, grade 1 periportal fibrosis was observed, but no significant association was found with S. haematobium infection. In a control village, where the prevalence of S. haematobium infection was 7%, moderate congestion of kidneys was observed in 2% of examined inhabitants, and bladder changes in 6%, with a significant relationship with S. haematobium infection.
authors.affiliation: Service de Radiologie, Centre Hospitalier Soavinandriana, Antananarivo, Madagascar.
authors.forename: J
authors.initials: J
authors.lastname: Serieye
authors.forename: P
authors.initials: P
authors.lastname: Boisier
authors.forename: V E
authors.initials: VE
authors.lastname: Ravaoalimalala
authors.forename: C E
authors.initials: CE
authors.lastname: Ramarokoto
authors.forename: P
authors.initials: P
authors.lastname: Leutscher
authors.forename: P
authors.initials: P
authors.lastname: Esterre
authors.forename: J
authors.initials: J
authors.lastname: Roux
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000000981:diagnostic imaging; D008109:Liver Diseases, Parasitic / Q000000981:diagnostic imaging; D008270:Madagascar / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010270:Parasite Egg Count; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic; D015995:Prevalence; D012553:Schistosomiasis haematobia / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D012555:Schistosomiasis mansoni / Q000150:complications; D017678:Sex Distribution; D014463:Ultrasonography; D001745:Urinary Bladder Diseases / Q000000981:diagnostic imaging; D014552:Urinary Tract Infections / Q000000981:diagnostic imaging; D014556:Urine / Q000469:parasitology