Association of Tumor Necrosis Factor-α (-G308A) Polymorphism with risk of Upper Gastrointestinal Bleeding from Schistosomiasis in Pernambuco

ABSTRACT Background: We evaluated the association between polymorphisms in the tumor necrosis factor alpha (TNF-α) (-G308A) gene and upper gastrointestinal bleeding (UGIB) in schistosomiasis. Methods: This was a transverse study involving 294 Brazilian patients infected with Schistosoma mansoni. Results: The homozygous A/A genotype in TNF-α (-G308A) showed a risk association (prevalence ratio = 1.90, p = 0.008) with UGIB. There was no statistically significant difference in serum TNF-α levels between the clinical groups. Conclusions: The polymorphic TNF-α (-G308A) can be a risk factor for UGIB, in addition to being a potentially predictive factor for the severity of UGIB in schistosomiasis.

Association of the polymorphism Exon 1 (A/O) region of the mannose-binding lectin gene and periportal fibrosis regression in schistosomiasis after specific treatment

Abstract INTRODUCTION: We evaluated the association between genetic polymorphisms in exon 1 (A/O alleles) and promoter regions at positions -550 (H/L variant, rs11003125) and -221 (X/Y variant, rs7096206) MBL2 and periportal fibrosis regression. METHODS: This was a retrospective cohort study involving 114 Brazilians infected with Schistosoma mansoni, who were subjected to follow-up for three years after specific treatment for schistosomiasis to estimate the probability of periportal fibrosis regression. RESULTS: A risk association was observed between polymorphism at the exon 1 MBL2 and periportal fibrosis regression. CONCLUSIONS: This study suggests that the polymorphism of exon 1 MBL2 may potentially be used to predict periportal fibrosis regression in this population.

There is no evident correlation between interleukin-10 gene polymorphisms and periportal fibrosis regression after specific treatment

Abstract INTRODUCTION: We evaluated the associations between interleukin-10 (IL-10) gene polymorphisms -G1082A/-C819T/-C592A and periportal fibrosis regression after specific treatment for schistosomiasis. METHODS: This retrospective cohort study involved 125 Brazilian patients infected with Schistosomiasis mansoni, who were followed up for 2 years after specific treatment to estimate the probability of periportal fibrosis regression. RESULTS: There was no evidence of associations between IL-10 polymorphisms and periportal fibrosis regression after treatment. CONCLUSIONS: There was no evidence of associations between gene promoter polymorphisms of IL-10 and the regression of periportal fibrosis in this Brazilian population.

Treatment and education reduce the severity of schistosomiasis periportal fibrosis

Introduction This study evaluates the factors associated with the development of severe periportal fibrosis in patients with Schistosoma mansoni. Methods A cross-sectional study was conducted from April to December 2012 involving 178 patients infected with S. mansoni who were treated in the Hospital das Clínicas of Pernambuco, Brazil. Information regarding risk factors was obtained using a questionnaire. Based on the patients' epidemiological history, clinical examination, and upper abdomen ultrasound evaluation, patients were divided into 2 groups: 137 with evidence of severe periportal fibrosis and 41 patients without fibrosis or with mild or moderate periportal fibrosis. Univariate and multivariate analyses were conducted using EpiInfo software version 3.5.5. Results Illiterate individuals (30.1%) and patients who had more frequent contact with contaminated water in towns in the Zona da Mata of Pernambuco (33.2%) were at greater risk for severe periportal fibrosis. Based on multivariate analysis, it was determined that an education level of up to 11 years of study and specific prior treatment for schistosomiasis were preventive factors for severe periportal fibrosis. Conclusions The prevailing sites of the severe forms of periportal fibrosis are still within the Zona da Mata of Pernambuco, although there has been an expansion to urban areas and the state coast. Specific treatment and an increased level of education were identified as protective factors, indicating the need for implementing social, sanitary, and health education interventions aimed at schistosomiasis to combat the risk factors for this major public health problem. .

Aspectos epidemiológicos da esquistossomose hepatoesplênica no estado de Pernambuco, Brasil / Epidemiologic aspects of hepatosplenic schistosomiasis in the State of Pernambuco, Brazil

Objetivo: identificar os principais aspectos sociodemográficos e clínicos de portadores da forma hepatoesplênica da esquistossomose em pacientes atendidos em Hospital Universitário de Recife, capital do Estado de Pernambuco, Brasil, no período de setembro de 2008 a março de 2009. Metodologia: estudo descritivo do tipo ‘série de casos’; os casos foram diagnosticados por ultrassonografia de abdome, confirmando fibrose periportal e esplenomegalia. Resultados: comprovou-se faixa etária de maior ocorrência da doença entre 51 e 60 anos, sendo 61 por cento no sexo feminino; sugere-se um aumento do número de casos oriundos de Recife (20,1 por cento) – comparando-se com estudos anteriores – em que cinco desses casos eram nascidos na cidade, além de casos procedentes de Jaboatão dos Guararapes (11,9 por cento); hemorragia digestiva alta (HDA) foi encontrada em 61,6 por cento dos casos e 16 pacientes não foram tratados previamente para esquistossomose. Conclusão: o estudo demonstrou o aparecimento da forma grave da doença no litoral e Região Metropolitana de Recife, bem como a gravidade desses casos pela alta frequência de episódios de HDA, mostrando a necessidade de vigilância contínua dos programas de controle.

Objetive: identify the main clinical and social demographic aspects of the hepatosplenic form of schistosomiasis inpatients attended at the University Hospital in Recife, capital of the State of Pernambuco, Brazil, between september 2008 and march 2009. Methodology: a cross sectional study; the cases were diagnosed by abdominal ultrasound, confirming periportal fibrosis and splenomegaly. Results: the occurrence of the disease proved to be high in the age group from 51 to 60years, presenting 61 per cent of female gender; implies an increase in the number of serious cases arising from Recife (20.1 per cent) in comparison with previous studies, of which 5 been born in the city and more cases coming from Jaboatão dos Guararapes(11.9 per cent); upper digestive bleeding (UDB) was confirmed in 61.6 per cent of the cases, and 16 patients were not treated for schistosomiasis previously. Conclusion: this study demonstrates the appearance of this disease in the coast and in the Metropolitan Area of Recife, as well as the seriousness of these cases due to the high frequency of UDB episodes, indicating the need for efficient control programs and continuous vigilance.