Female genital schistosomiasis: prevalence disease associated morbidity and intensity of infection as detected by soluble egg antigen in urine

This study was done to assess the prevalence and morbidity pattern of S. haematobium infection in women of reproductive age [15 - 45 years] in schistosomiasis endemic area. One hundered and eighty women involved in this study and grouped as follows: group I: women with proven femal genital schistosomiasis [FGS] [n = 80], group II: endemic referents [n = 80] and group III: women living in schistosomiasis-free area [n= 20] serve as controls. Full history, general gynaecological and parasitological examinations were done to every women, a s and wich ELISA was carried to detect soluble egg antigen [SEA] in urine of all cases.Evaluation of the applicability of this assay as a diagnostic and morbidity indicator was done. revealed that significantly more FGS reported a history of spontaneous abortion [P < 0.01], complaints of irregular menstruation [P < 0.001], pelvic pain [P < 0.01] vaginal discharge [P < 0.0001], dysuria [P < 0.01] and haematuria [P < 0.0001] than in the referents. Biopsies were taken from the cervix of 80 women with macroscopical lesions and from them 24 cases, S. haematobium eggs were found by histological sectioning [30%]. In the control group [referents] no eggs were detected in the cervical biopsies of 10 of them [50%]. Infections with C and ida albicans, Trichomonas vaginalis were found in similar frequencies in all groups. Ecographic abnormalities of the urinary tract were present in 24% and 0% of the infected women and referents respectively. These findings were accompanied by an elevated frequency of haematuria [55.6% versus 10%] and proteinuria [70% versus 20%] in the FGS and referent groups. Our study indicates that S. haematobium infection in women may not only cause symptoms in the urinary tract but also frequently in the lower reproductive tract [LRT]. SEA levels in urine of S haematobium infected women significantly correlated with egg counts and with clinical findings [P < 0.001]. In addition lower genital tract pathology as determined by cervical smear and biopsy significantly correlated with the SEA levels in urine

Lymphocytic immuno-phenotype and expression of epidermal growth factor receptor in intestinal schistosomiasis

Schistosomiasis is an endemic disease in Egypt performing major health and subsequently economic problems. Schistosomiasis generates a range of host immune responses that may contribute to the pathogenesis of this disease. In this study immunologic response and reparative potentiality of intestinal mucosa following infection have been evaluated Fortey patients with manifestations of active intestinal schistosomiasis were selected by positive rectal snip for this study and compared to 10 negative control patients. sigmoidoscopic biopsies were obtained and conducted for histopathologic examination, immunohistochemistry study of CD4+, CD8+ and epidermal growth factor receptor [EGFr], and feulgen stain to evaluate DNA content of glandular epithelium, using CAS200 image analyzer system. All bilharzial biopsies demonstrated lymphocytic infiltration intermixed with eosinophils and bilharzial ovae were detected in 12 biopsies. Positive CD4+ lymphocytes were observed in 35 cases [88.2%] with focal or diffuse distribution [25 and 10 cases respectively]. Seven cases were CD8+ positive [17.5%]. In 18 biopsies [47%], epidermal growth factor receptor was expressed by glandular and brush border epithelium. These cases demonstrated proliferative diploid histogram represented S-phase pattern of DNA distribution. The EGFr expression was conelated well with presence of bilharzial ovae, ulcerated epithehum and positive CD4+ lymphocytes. In conclusion, the expression of EGEr is stimulated by antigenisity released from ovae and cytokines of the activated T cells, to participate in mucosal healing process through DNA synthesis and adaptation to the presence of infection