[Schistosoma intercalatum bilharziasis: clinical and epidemiological considerations].
Schistosoma intercalatum bilharziasis continues to raise numerous questions regarding pathogenicity and gravity. The parasite was identified recently and the last fully described outbreak occurred 10 years ago in the city of Bata, Equatorial Guinea. Geographically Schistosoma intercalatum biharziasis is limited to one part of the African continent but has shown a tendency to spread. Hybridization of Schistosoma intercalatum and Schistosoma haematobium has been observed. The main clinical manifestation of Schistosoma intercalatum is rectal bleeding. The endoscopic appearance of lesions is variable and non-specific ranging from granulomas or polyps to ulcerations. Complications include severe rectitis or genital involvement such as salpingitis with secondary sterility. Spontaneous abortion has also been reported. Association with salmonella and klebsiella infection has been confirmed and can lead to life-threatening situations. Few studies have been performed to assess the value of diagnostic tests. The sensitivity of stool smears and urinary sedimentation testing is 81.7% and 56.3% respectively using the two examinations as references for one another. The sensitivity of immunological tests is generally good but varies depending on the reference technique used. Specificity can be affected by cross-reaction with other schistosomas or trematodes and even with nematodes and hematozoons. Treatment with a single dose of Biltricide has proven to be effective. Prevention requires education of the population at risk and use of molluscacides. The control strategy must be adapted in function of the epidemiology of the disease, diagnostic data, cost and effectiveness of screening and treatment.
Jusot
J F
JF
Service d'Epidémiologie, Institut de Médecine Tropicale Prince Léopold, Anvers, Belgique.
Simarro
P P
PP
De Muynck
A
A
D000022:Abortion, Spontaneous / Q000469:parasitology; D017954:Africa South of the Sahara / Q000453:epidemiology; D000818:Animals; D000980:Antiplatyhelmintic Agents / Q000627:therapeutic use; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000469:parasitology; D006801:Humans; D007178:Inbreeding; D011159:Population Surveillance; D011223:Praziquantel / Q000627:therapeutic use; D011247:Pregnancy; D012007:Rectum; D012547:Schistosoma / Q000145:classification* / Q000254:growth & development; D012552:Schistosomiasis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000469:parasitology*; D012680:Sensitivity and Specificity
D000980:Antiplatyhelmintic Agents; D011223:Praziquantel
La bilharziose à Schistosoma intercalatum: considèrations cliniques et èpidèmiologiques.