Prevalence and familial aggregation of schistosomal liver morbidity in Kenya: evaluation by new ultrasound criteria.
Severe periportal fibrosis is not an inevitable consequence of infection with Schistosoma mansoni. Genetic predisposition may be a deciding factor in the development of disease. To assess the contribution of genetic factors in the severity of hepatic fibrosis, the degree of familial aggregation was determined in a Kenyan population. Schistosomal fibrosis was identified with hepatic ultrasound and newly proposed World Health Organization criteria, which include both qualitative and quantitative observations. These 2 aspects of the criteria correlated well with one another. The peak prevalence of ultrasound proven fibrosis trailed 5-10 years behind peak prevalence of infection and declined sharply after age 50 years. This pattern was consistent with either resolution of severe fibrosis over 10-20 years or early death of those severely affected. Genetic predisposition appears to be a weak factor in the development of severe disease in this population, since no household or familial aggregation could be identified.
Division of Vector Borne Diseases and Office of Radiologic Services, Kenya Ministry of Health, Nairobi, Kenya.
H C
HC
Kariuki
G
G
Mbugua
P
P
Magak
J A
JA
Bailey
E M
EM
Muchiri
F W
FW
Thiongo
C H
CH
King
A E
AE
Butterworth
J H
JH
Ouma
R E
RE
Blanton
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000818:Animals; D001700:Biomphalaria / Q000469:parasitology; D002648:Child; D002675:Child, Preschool; D004199:Disease Vectors; D005192:Family Health; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007630:Kenya; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging; D015995:Prevalence; D012555:Schistosomiasis mansoni / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology; D014463:Ultrasonography