title: Oesophagostomum bifurcum-induced nodular pathology in a highly endemic area of Northern Ghana.
abstract: Human infection with Oesophagostomum bifurcum is rare globally, but focally endemic and common in Ghana and Togo. Two clinical presentations are identified: uni-nodular disease, which may be recognized as a 'Dapaong Tumour', and multi-nodular disease. Here, we describe the prevalence of O. bifurcum infection and the association with nodular pathology in northern Ghana. The study was performed in October 2002. Out of a well-defined population of approximately 18000, 928 subjects of all ages were randomly selected for parasitological and ultrasound examination. In stool cultures, 44% had detectable third-stage O. bifurcum larvae present. Females were more often infected than males (P<0.05). In 34% of the samples, nodules were detected along the colon wall, with the ascending and the transverse colon being the most affected regions. Significant correlations existed between the intensity of infection and the presence of nodules, both at the village and the individual level (P<0.001 for both). Patients with multi-nodular pathology had significantly higher larval counts than patients with uni-nodular pathology. The present data suggest that nodular pathology, and probably the severity of the disease, are directly related to intensity of the infection.
authors.affiliation: Department of Parasitology, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands.
authors.forename: J B
authors.initials: JB
authors.lastname: Ziem
authors.forename: N
authors.initials: N
authors.lastname: Spannbrucker
authors.forename: P
authors.initials: P
authors.lastname: Magnussen
authors.forename: A
authors.initials: A
authors.lastname: Olsen
authors.forename: D Nii
authors.initials: DN
authors.lastname: Amon-Kotey
authors.forename: K
authors.initials: K
authors.lastname: Frenzel
authors.forename: A
authors.initials: A
authors.lastname: Nang-Beifubah
authors.forename: R G J
authors.initials: RG
authors.lastname: Westendorp
authors.forename: A M
authors.initials: AM
authors.lastname: Polderman
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003106:Colon / Q000473:pathology; D019353:Endemic Diseases / Q000706:statistics & numerical data*; D005243:Feces / Q000469:parasitology; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009814:Oesophagostomiasis / Q000453:epidemiology* / Q000473:pathology; D010270:Parasite Egg Count; D015995:Prevalence; D012423:Rural Health; D012720:Severity of Illness Index; D017678:Sex Distribution