Intensity of Schistosoma mansoni, hepatitis B, age, and sex predict levels of hepatic periportal thickening/fibrosis (PPT/F): a large-scale community-based study in Ethiopia.
To elucidate determinants of morbidity in schistosomiasis mansoni, a community-based study was undertaken involving 2,451 subjects (mean age, 18.8 +/- 15.3 [SD] years) from four endemic sites in Ethiopia. Overall prevalence of infection was 65.9%, reported blood in stools was 35.8%, and schistosomal periportal thickening/fibrosis (PPT/F) was 4.6%. Similarly, 43.2% were positive for at least one marker of hepatitis B virus (HBV), 5.3% were HBsAg positive, and 1.3% were anti-hepatitis C virus (HCV) positive. Prevalence of PPT/F increased significantly with increasing community prevalence and intensity of S. mansoni infection. In a multiple logistic regression analysis, intensity of egg excretion, markers of HBV infection, age, and male sex were significantly associated with PPT/F, whereas co-infection with other intestinal helminths was associated with lower odds for PPT/F. HCV was not associated with S. mansoni infection or with schistosomal PPT/F. In conclusion, integrated helminth control targeting school-aged children, who have the highest burden infection, should be used to substantially reduce the risk of periportal fibrosis.
Berhe
Nega
N
Ullevål University Hospital, Department of Infectious Diseases, Centre for Imported and Tropical Diseases, Oslo, Norway. nega_berhe@yahoo.com <nega_berhe@yahoo.com>
Myrvang
Bjørn
B
Gundersen
Svein G
SG
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000818:Animals; D002648:Child; D002675:Child, Preschool; D005002:Ethiopia / Q000453:epidemiology; D005243:Feces / Q000469:parasitology; D005260:Female; D006509:Hepatitis B / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D006526:Hepatitis C / Q000097:blood / Q000150:complications / Q000453:epidemiology; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008103:Liver Cirrhosis / Q000209:etiology* / Q000469:parasitology / Q000473:pathology*; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D012550:Schistosoma mansoni; D012555:Schistosomiasis mansoni / Q000150:complications* / Q000453:epidemiology* / Q000473:pathology; D012737:Sex Factors; D014463:Ultrasonography