Clinical-epidemiologic profile of the schistosomal myeloradiculopathy in Pernambuco, Brazil

ABSTRACT

This was a retrospective descriptive study on a series of cases of schistosomal myeloradiculopathy (SMR) and the aim was to investigate the incidence of this disease and its clinical and epidemiological characteristics in cases diagnosed at three healthcare units in Pernambuco, Brazil between 1994-2006. The data were collected by reviewing the medical records from both the neurological and paediatric outpatient clinics and wards of the Hospital Clinics, Hospital of the Restoration and Pernambuco Mother and Child Institute. To gather the data, a spinal cord schistosomiasis evaluation protocol was used. The diagnoses were based on positive epidemiological evidence of schistosomiasis, clinical findings and laboratory tests (stool parasitological examination or rectal biopsies, magnetic resonance imaging findings and cerebrospinal fluid investigations). A total of 139 cases aged between 2-83 years were found. The most important determinants of SMR were male sex (66.2 percent), contact with fresh water (91 percent), origin in endemic regions (39.5 percent), lower-limb muscle weakness (100 percent), sensory level at the lower thoracic medulla (40.3 percent), myeloradicular form (76 percent) and presence of eggs in the stool parasitological examination (48 percent). This sample indicates the need for intervention policies guided by diagnostic standardization, thereby avoiding disease under-notification.