Schistosoma mansoni associated mortaiity in Gezira: Determined by clinical and ultrasound examination

Schistosomiasis is the most common problem in Gezira area. The prevalence among school children could reach up to 90% in some villages. This study was conducted in a small village in the Gezira area in central Sudan. This part of the Gezira is well known for its high endemicity of Bilharzia. A total of 428 individuals were included in the study. All were examined clinically and by Ultrasoungraphy for spleen and liver. Stoll specimens were also taken from all the subjects and were examined for Schistosoma mansoni ova. The prevalence of schistosomasis was found to be 72% in males and 68 3% in females. It was also observed that the overall prevalence of splenomegaly on the examined subjects was 35.8%. Males recorded higher prevalence of splenomegaly [38.8%] compared to females [32.7%] [p =/< 0.05]. The observed prevalence of hepatomegaly was 12.6%., with high prevalence among males [13.1%] compared to females [11.2%]. Out of the 406 subjects examined by ultrasound, 266 [63.1%] were found to have evidence of periportal fibrosis. The hepatomegaly in the different grades1.2 and 3 are 12.6%, 3.8% and 0% respectively. It is clear from the above data that the size of the spleen increases while the size of the liver decreases with the severity of periportal fibrosis

Regression of liver fibrosis in Schistosoma mansoni infected Sudanese subjects after praziquantel treatment

1-To evaluate the effect of Praziquantel [PZQ] therapy on the regression of liver fibrosis in an endemic population. 2-To determine the factors controlling the regression of hepatic fibrosis [e.g. gender, age and grade of fibrosis]. An association study of a cohort of one hundred seventy seven Sudanese patients infected with Schistosoma mansoni [82 males 46%, 95 females 54%] was conducted to evaluate the factors controlling the regression of liver fibrosis 39 months after treatment with PZQ using ultrasound evaluation. SPSS [Statistical Package for Social Science] software was used for statistical analysis. Chi- Square was used to compare the two phenotypes [regression and progression] in the study subjects. PPF was regressed in 63 patients [36%] from higher grades of fibrosis to lower ones. While in 24 patients [13%] the disease progressed to higher grades. In addition, the grade of PPF did not change in 90 patients [51%]. The mean values of portal vein diameter [PVD], splenic vein diameter [SVD], and index liver size [ILS] in subjects in whom PPF regressed after treatment were significantly lower than in subjects in whom the disease was progressed [P <.0001, P =.031, and P =.003 respectively].The progression of hepatic fibrosis in males [n = 15.18%] was greater than that of females [n = 9.9%]. Patients who showed regression of PPF or progression of the disease tend to cluster in certain families. Our study indicated that regression and stabilization of PPF after PZQ therapy is controlled by gender, age, grade of fibrosis, and possibly inherited factors