title: Schistosoma mansoni: assessment of morbidity before and after control.
abstract: The literature on the assessment of morbidity due to Schistosoma mansoni infection is updated. Imaging techniques such as ultrasonography, echodoppler cardiography, computerized tomography (CT scan) and magnetic resonance imaging (MRI) introduced a new perspective, and expanded our knowledge on morbidity. Three well-defined syndromes caused by schistosomiasis mansoni have been described: the stage of invasion, acute schistosomiasis (Katayama fever), and chronic schistosomiasis. Complications of the acute and chronic syndromes have also been reported: pulmonary hypertension, neuroschistosomiasis, association with Salmonella, association with Staphylococci, viral hepatitis B, glomerulonephritis. In most individuals with hepatosplenic schistosomiasis the spleen is increased in size. Hepatosplenic schistosomiasis can, however, occur without splenomegaly. The definition of hepatosplenic schistosomiasis in endemic areas as the finding of S. mansoni eggs in the stools in an individual with hepatosplenomegaly is not satisfactory anymore. Many aspects of morbidity are expected to change after schistosomiasis control. Some are expected to change quickly (worm burden, Salmonella bacteremia, hepatosplenic schistosomiasis in children) whereas others shall remain for years (pulmonary hypertension, glomerulonephritis, neuroschistosomiasis). Intestinal schistosomiasis in individuals with low worm burdens is very difficult to diagnose and therefore laborious to control.
authors.affiliation: Faculty of Medicine, Federal University of Minas Gerais, Department of Internal Medicine (Infectious Disease Branch), 30.130-100, MG, Belo Horizonte, Brazil. lamber@net.em.com.br
authors.forename: J R
authors.initials: JR
authors.lastname: Lambertucci
authors.forename: J C
authors.initials: JC
authors.lastname: Serufo
authors.forename: R
authors.initials: R
authors.lastname: Gerspacher-Lara
authors.forename: A A
authors.initials: AA
authors.lastname: Rayes
authors.forename: R
authors.initials: R
authors.lastname: Teixeira
authors.forename: V
authors.initials: V
authors.lastname: Nobre
authors.forename: C M
authors.initials: CM
authors.lastname: Antunes
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002493:Central Nervous System Diseases / Q000175:diagnosis / Q000469:parasitology; D003140:Communicable Disease Control; D005921:Glomerulonephritis / Q000150:complications; D006509:Hepatitis B / Q000150:complications; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000175:diagnosis; D007410:Intestinal Diseases / Q000175:diagnosis / Q000469:parasitology; D008107:Liver Diseases / Q000175:diagnosis / Q000469:parasitology; D008279:Magnetic Resonance Imaging; D009017:Morbidity; D012480:Salmonella Infections / Q000150:complications; D012555:Schistosomiasis mansoni / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D013158:Splenic Diseases / Q000175:diagnosis / Q000469:parasitology; D013203:Staphylococcal Infections / Q000150:complications; D014054:Tomography; D014463:Ultrasonography