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.
Kariuki
H C
HC
Division of Vector Borne Diseases and Office of Radiologic Services, Kenya Ministry of Health, Nairobi, Kenya.
Mbugua
G
G
Magak
P
P
Bailey
J A
JA
Muchiri
E M
EM
Thiongo
F W
FW
King
C H
CH
Butterworth
A E
AE
Ouma
J H
JH
Blanton
R E
RE
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