Prevalence and intensity of urinary schistosomiasis and soil-transmitted helminths among women of reproductive age in Mwaluphamba,Kwale

Objective:To assess the epidemiology of urinary schistosomiasis and soil-transmitted helminthiasis among women of reproductive age in Mwaluphamba,Kwale County,Kenya.Methods:A community-based cross-sectional study design was employed to randomly sample 422 women of reproductive age(15-<50 years)from four villages in Mwaluphamba location.Stool specimens were collected and examined using the Kato-Katz method,while filtration technique was used to analyze urine specimens.Participants’sociodemographic details were obtained using a standardized questionnaire.Results:Urinary schistosomiasis prevalence was at 4.7%(20/422,95%CI 2.8%-6.9%)while the prevalence of soil-transmitted helminthiasis infection was 4.5%(19/422,95%CI 2.6%-6.7%).The infection intensities of urinary schistosomiasis among the study participants ranged from 1 to 120 eggs/10 mL of urine with median egg count of 18.45 eggs/10 mL.The patients were diagnosed with light infection,of 56.16 egg/gram and 48.48 egg/gram for Trichuris trichiura and hookworms,respectively.Women without latrines had 15.7 times higher risk of having urinary schistosomiasis compared to those with a latrine.Similarly,use of surface water(aOR=1.0,95%CI 0.2-1.4,P=0.010)and crossing the river to go to a place(aOR=1.1,95%CI 0.3-1.6,P=0.009)were statistically significant risk factors for getting urinary schistosomiasis.In bivariable regression analysis,defecating around the water source(OR=4.3,95%CI 1.5-12.9)had a statistically significant association with the prevalence of soil-transmitted helminthiasis(P=0.008).Conclusions:This study has given an insight on the prevalence and intensity of urinary schistosomiasis and soil-transmitted helminthiasis in Mwaluphamba location that form a basis for strengthening the control and elimination programmes for these neglected tropical diseases.

Colonic schistosomiasis mimicking cancer,polyp,and inflammatory bowel disease:Five case reports and review of literature

BACKGROUND Schistosomiasis,officially named as a neglected tropical disease by The World Health Organization,is a serious parasitic disease caused by trematode flukes of the genus Schistosoma.It is a common infectious disease,endemic in more than 78 countries.The disease can involve various organs and poses far-reaching public health challenges.CASE SUMMARY Here,we present a series of five patients with variable presentations:an asymptomatic patient who was diagnosed with colonic schistosomiasis upon screening colonoscopy;2 patients with clinical suspicion of colonic cancer;and 2 patients with a clinical diagnosis of inflammatory bowel disease.All patients were subsequently confirmed to have colonic schistosomiasis after colonoscopy and histopathologic examination.The clinical manifestations,colonoscopy features and histologic findings of the patients are described.Most of the patients showed significant clinical improvement following administration of oral praziquantel.CONCLUSION Intestinal schistosomiasis can present with features mimicking other gastrointestinal conditions.This disease should be a diagnostic consideration in patients who live in or have traveled to endemic areas.

Epidemiological, Clinical and Therapeutic Aspects of Bladder Tumors in a Schistosomiasis-Endemic Country

Introduction: Bladder tumors are common in our country;Mali is a bilharzial endemic country. In our context, urinary bilharzia is common, and bladder tumors arouse particular interest in the field of urological oncology, because of their frequency, their diagnosis, their difficulty in management and their histological particularity. The objective of our work was to study the epidemiological, clinical and therapeutic aspects of bladder tumors. Materials and Methods: This is a cross-sectional, descriptive study with a retrospective and prospective collection that took place over 3 years from January 1, 2020 to December 31, 2022. Results: We identified 316 cases of bladder tumors during this period. Bladder tumors are a common pathology representing 35.95% of all hospitalized patients, and occupying the 1st rank of tumors in urology in the Urology Department of the Pr Bocar Sidy Sall University Hospital in Kati. Bladder tumors were more common in men with 56.33%. The average age of our patients was 50 years ± 25.8 years and the extreme ages were 20 and 87 years. Urinary schistosomiasis, considered a predisposing factor, was found in 66.78% of cases in our patients as a history. Transurethral resection of the bladder was performed in 100% of our patients, nephrostomy in 1.90% of cases, ureterostomy in 1.58% of cases, Bricker type urinary diversion in 1.27% of cases, and a neobladder in 0.32% of cases. Squamous cell carcinoma is the dominant histological type (88.29%). The postoperative outcome was 99% favorable after resection. Conclusion: Bladder tumors were mainly tumors infiltrating the bladder muscle. The main risk factor was urinary bilharzia. Squamous cell carcinoma is the most common histological type with a diagnostic delay, thus limiting radical treatment after resection of the bladder tumor.

Application of Solution-Focused Approach in Nursing Care of Advanced Schistosomiasis

Objective:To analyze the effect of solution-focused approach on advanced schistosomiasis(AS).Methods:10 cases of patients with AS that were treated with a solution-focused approach were included in our study.The indicators before and after the intervention were measured(knowledge mastery,prevention and treatment compliance,personal behavior,self-care ability,management satisfaction,complication rate).Results:After analyzing pre-and post-intervention indicators,statistical significance was found(P<0.05).The intervention received a satisfaction rate of 80.00%,with a complication rate of 10.00%.Conclusion:Using a solution-focused approach for ankylosing spondylitis(AS)patients can enhance their understanding and attitude toward disease prevention and treatment,improve their behaviors and self-care ability,resulting in high satisfaction and reduced complications.

Male genitourinary schistosomiasis-related symptoms among long-term Western African migrants in Spain:a prospective population-based screening study

Background Schistosomiasis is highly endemic in sub-Saharan Africa and frequently imported to Europe.Male urogenital manifestations are often neglected.We aimed to ascertain the prevalence of genitourinary clinical signs and symptoms among long-term African migrants in a non-endemic European country using a serology test.Methods We carried out a prospective,community-based cross-sectional study of adult male migrants from sub-Saharan Africa living in Spain.Schistosoma serology tests and microscopic urine examinations were carried out,and clinical data were obtained from an electronic medical record search and a structured questionnaire.Results We included 388 adult males,mean age 43.5 years[Standard Deviation(SD)=12.0,range:18-76].The median time since migration to the European Union was 17[Interquartile range(IQR):11-21]years.The most frequent country of origin was Senegal(N=179,46.1%).Of the 338,147(37.6%)tested positive for Schistosoma.Parasite eggs were present in the urine of only 1.3%.Nine genitourinary clinical items were significantly associated with positive Schistosoma serology results:pelvic pain(45.2%;OR=1.57,95%CI:1.0-2.4),pain on ejaculation(14.5%;OR=1.85,95%CI:1.0-3.5),dyspareunia(12.4%;OR=2.45,95%CI:1.2-5.2),erectile dysfunction(9.5%;OR=3.10,95%CI:1.3-7.6),self-reported episodes of infertility(32.1%;OR=1.69,95%CI:1.0-2.8),haematuria(55.2%;OR=2.37,95%CI:1.5-3.6),dysuria(52.1%;OR=2.01,95%CI:1.3-3.1),undiagnosed syndromic STIs(5.4%),and orchitis(20.7%;OR=1.81,95%CI:1.0-3.1).Clinical signs tended to cluster.Conclusions Urogenital clinical signs and symptoms are prevalent among male African long-term migrants with a positive Schistosoma serology results.Genital involvement can be frequent even among those with long periods of non-residence in their sub-Saharan African countries of origin.Further research is needed to develop diagnostic tools and validate therapeutic approaches to chronic schistosomiasis.

Spinal Cord Schistosomiasis: Report on Seven Adult Patients

Background: Spinal Cord Schistosomiasis (SCS) is the most disabling ectopic form of Schistosomal infection. It may or may not have clinical manifestations. They include low back pain and/or lower limb pain and weakness, and double incontinence. Early diagnosis and treatment provide a good outcome. Aim: To describe the clinical, radiologic, and therapeutic data of 7 patients with Spinal Schistosomiasis. Patients and Methods: In this retrospective clinical case study, the medical records of 7 patients with spinal cord pathologies admitted to Aswan University Hospital from May 2014 to May 2017 were reviewed. All were male aged from 17 to 30 years old (mean ± SD, 20 ± 9.5 yr.;median 21 yr.), with neurological deficit in the form of lower limb weakness and sphincter disturbance. All were treated by decompressive laminectomy and debulking of the intramedullary lesion followed by medical treatment. Results: The outcome of our patients was good as 4/7 patients (57%) presented a full recovery, 3/7 patients (43%) presented a partial recovery without functional limitations and none presented a partial recovery with limitations or no response. Conclusion: High index of suspicion should be raised in the differential diagnosis of patients with clinical or radiological evidence of Spinal Cord Schistosomiasis, as early diagnosis can guarantee a better prognosis and avoid the occurrence of serious sequels. The association of corticosteroids and antischistosomal drugs is related to the best outcome. The role of surgery is decompression, particularly in the granulomatous or pseudotumoral form, and to obtain material for definite histopathological diagnosis in doubtful cases.

Infection of Schistosomiasis japanicum is likely to enhance proliferation and migration of human breast cancer cells:mechanism of action of differential expression of MMP2 and MMP9

Objective:To study whether the infection of Schistosomiasis japanicum(S.japanicum) is related to enhanced proliferation and migration of cancer cells,and the molecular mechanism pertains to cancer cell metastasis in human host.Methods:The gene of S.japanicum glutathione transferase(sjGST) cloned from 5.japanicum was expressed,purified and applied in a series of assays to explore the effect of sjGST on proliferation and migration of MDA-MB-435S,and the expression of MMP2 and MMP9.Immunofluorescence assay for the binding of sjGST to MDA-MB-435S was also carried out.Results:Results showed that sjGST enhanced proliferation and migration in human breast cancer cell MDA-MB-435S signifycantly at 50-200 nM,but did not enhance them in human lung cancer cell A549.Immunofluorescence assay for the binding of sjGST to MDA-MB-435S and A549 showed that GST was readily hound to the breast cancer cells,but showed almost no binding to human lung cancer cells.The assays for gelatinase activity showed that both MMP2 and MMP9 activities were increased significantly in the presence of sjGST(50-200 nM) in MDA-MB-435S, but they were not significant in A549.Conclusions:Our current results show strongly that S. japanicum GST binds to MDA-MB-435S probably via its i'eceptor,and enhances proliferation and migration of the cancer cells by up-regulatory expression of MMP2 and MMP9.

Endoscopic findings and clinicopathologic characteristics of colonic schistosomiasis:A report of 46 cases

AIM:To make a retrospective analysis of endoscopy findings and clinicopathologic characteristics of colonic schistosomiasis in order to further improve our understanding of the disease and decrease its misdiagnosis. METHODS:Endoscopy findings and clinicopathologic characteristics of 46 intestinal schistosomiasis patients were retrospectively analyzed.All the patients underwent colonoscopy and all biopsy specimens stained with hematoxylin and eosin were observed under a light microscope. RESULTS:Of the 46 colonic schistosomiasis patients,1 was diagnosed as acute schistosomal colitis,16 as chronic schistosomal colitis and 29 as chronic active schistosomal colitis according to their endoscopic findings and pathology.Not all patients were suspected of or diagnosed as colonic schistosomiasis.Of the 12 misdiagnosed patients,4 were misdiagnosed as ulcerativecolitis,1 as Crohn's disease,and 7 as ischemic colitis.The segments of rectum and sigmoid colon were involved in 29 patients(63.0%) .Intact Schistosoma ova were deposited in colonic mucosa accompanying infiltration of eosinocytes,lymphocytes,and plasma cells in acute schistosomal colitis patients.Submucosal fibrosis was found in chronic schistosomal colitis patients.Among the 17 patients with a signal polyp,hyperplastic polyp,canalicular adenoma with a low-grade intraepithelial neoplastic change,tubulovillous adenoma with a highgrade intraepithelial neoplastic change were observed in 10,5,and 2 patients,respectively.Eight out of the 46 patients were diagnosed as colonic carcinoma. CONCLUSION:Endoscopy contributes to the diagnosis of colonic schistosomiasis although it is nonspecific. A correct diagnosis of colonic schistosomiasis can be established by endoscopy in combination with its clinicopathologic characteristics.

Effects of in vitro cultivated Calculus Bovis compound on pulmonary lesions in rabbits with schistosomiasis

AIM:To explore the interventional effects and mechanism of in vitro cultivated Calculus Bovis compound preparation(ICCBco) on pulmonary lesions in portal hypertensive rabbits with schistosomiasis. METHODS:The experimental group included 20 portal hypertensive rabbits with schistosomiasis treated by ICCBco.The control group included 20 portal hypertensive rabbits with schistosomiasis treated by praziquantel. The morphological changes of the pulmonary tissues were observed under light and electron microscopy.The expression of fibronectin(FN) and laminin(LN) in the lung tissues was analyzed by immunohistochemistry. RESULTS:Under light microscope,the alveolar exudation in the lung tissue was more frequently observed in the control group,while the alveolar space was fairly dry in the lung tissue of ICCBco group.Under electron microscope,more alveolar exudation in the lung tissue,and moremacrophages,alveolar angiotelectasis and the blurred three-tier structure of alveolar-capillary barrier could be seen in the control group.In ICCBco group,fibers within the alveolar interspace slightly increased in some lung regions,and the structure of typeⅠepithelium,basement membrane and endodermis was complete,and no obvious exudation from the alveolar space,and novascular congestion could be observed.There was a positive or strong positive expression of FN and LN in the lung tissue of the control group,while there was a negative or weak positive expression of FN and LN in ICCBco group. CONCLUSION:ICCBco can effectively prevent pulmonary complications in portal hypertensive rabbits with schistosomiasis by means of improving lung microcirculation and lowering the content of extracellular matrix.

CHARACTERISTIC MAGNETIC RESONANCE ENHANCEMENT PATTERN IN CEREBRAL SCHISTOSOMIASIS

Objective To describe the characteristic magnetic resonance imaging （MRI） appearance of cerebral schistosomiasis. Methods Twenty-five patients whose diagnosis of central nervous system （CNS） schistosomiasis had been pathologically （n = 8 ） and clinically （n = 17） confLrmed were randomly selected. MRI was performed on a Signal 1.5T MRI scanner before and after the intravenous administration of gadopentetate dimeghimine constrast medium. We reviewed the MRI studies obtained at the time of initial presentation, as well as follow-up studies obtained during and after medical treatment Results ImmunoLogicaL tests in L5 patients indicated schistosomiasis haematobium. Contrast-enhanced TL-weighted images in 22 cases showed central linear enhancement surrounded by multiple enhancing punctate nodules, which ap- peared “arborized”. Through operation and pathological examination, 8 cases had the granuloma formation of schistoso- mal eggs extensive surrounded by inflammation and venous congestion. And 17 cases were treated with praziquantel and corticosteroid therapy. And they were followed up for 2 months by taking MRI, which turned out to be complete resolution of the enhancing structure and edema. At follow-up, all the patients＇ initial symptoms also resolved. Conclnsion The specified MRI enhancement pattern of cerebral schistosomiasis is common in most cases of CNS schistosomiasis, so it should be taken account into the diagnosis of cerebral schistosomiasis.

Efficacy and side effects of praziquantel in the treatment of Schistosomiasis mansoni in schoolchildren in Shesha Kekele Elementary School,Wondo Genet,Southern Ethiopia

Objective:To evaluate the efficacy and side effects of praziquantel(PZQ) in the treatment of schistosomiasis in Ethiopia.Methods:In a cross-sectional study,stool specimens were collected from randomly selected 299 school children in Shesha Kekele Elementary School,Wondo Genet, Southern Ethiopia,in April 2010.Stool specimens were examined using a single Kato-Katz thick smear for Schistosoma mansoni(5.mansoni) ova.Children who were found positive for S.mansoni were treated with a single oral dose of PZQ at 40 mg/kg bw and interviewed for treatment-related symptoms 24 hours after drug administration.Four weeks post-treatment,stool specimens were collected from the same children and examined following the same procedure as in the pretreatment.Drug efficacy was determined based on cure and egg reduction rates.Results:Pretreatment prevalence of S.mansoni infection was 74.9%with geometric mean egg count of 268. The evaluated generic PZQ produced an overall cure rate of 73.6%(P<0.000 1,OR:8.33,CI:5.3-13.1) and egg reduction rate of 68.2%(P=0.03,F=0.64).The cure rate showed significant association with age(x^2=H,P=0.004),the highest rate being observed in the 15-22 age group.83%of S. mansoni infected children showed various treatment-related symptoms,the most frerjiient being headache,nausea,and abdominal pain.These symptoms were associated with age(P<0.001) and pre-treatment intensity of infection(P<0.05).Conclusions:The present observations revealed relatively lower cure and egg reduction rates of the PZQ evaluated as compared to previous reports for other PZQ brands in Ethiopia.Hence,in depth studies are recommended to clarify whether the present relatively lower cure rate is the actual cure rate of the praziquantel evaluated,treatment failure,or reduced susceptibility of the parasite.Treatment-related side effects observed were transient and tolerable.

Effects of propranolol or propranolol plus isosorbide-5-mononitrate on variceal pressure in schistosomiasis

AIM: To compare the effects of propranolol (PR) to that of PR plus isosorbide-5-mononitrate (ISMN) on variceal pressure in patients with schistosomiasis. METHODS: Forty-eight patients with schistosomiasis who had no previous variceal bleeding were treated with PR alone or PR plus ISMN. Seven patients refused variceal pressure manometry (3 receiving PR and 4 receiving PR plus ISMN). One patient withdrew from the trial due to headache after taking ISMN. At the time of termination, twenty patients were randomly assigned to treatment with PR plus ISMN or PR alone. The dose of PR was adjusted until the resting heart rate had been reduced by 25% or was less than 55 bpm. In the PR plus ISMN group, after PR was titrated to the same target, the dose of ISMN was increased up to 20 mg orally twice a day. Variceal pressure was measured using a noninvasive endoscopic balloon technique at the end of the 6-mo treatment period. RESULTS: In 40 patients (20 in the PR group and 20 in the PR plus ISMN group), variceal pressure was measured before treatment and at the end of the 6-mo treatment period. PR or PR plus ISMN treatment caused a significant reduction in variceal pressure (PR group: from 24.15 ± 6.05 mmHg to 22.68 ± 5.70 mmHg, P = 0.001; PR plus ISMN group: from 25.69 ± 5.26 mmHg to 20.48 ± 5.43 mmHg; P < 0.001). The percentage decrease in variceal pressure was significant after PR plus ISMN compared with that after PR alone (15.93% ± 8.37% vs 6.05% ± 3.67%, P = 0.01). One patient in the PR plus ISMN group and two patients in the PR group had variceal bleeding during follow-up. There were no significant differences between the two groups regarding the incidence of variceal bleeding. In the PR plus ISMN group, three patients had headache and hypotension. The headache was mild and transient and promptly disappeared after continuation of the relevant drug in two patients. Only one patient withdrew from the trial due to severe and lasting headache after taking ISMN. No side effects occurred in the PR group. CONCLUSION: PR plus ISMN therapy may be an alternative treatment for patients with schistosomiasis who have a high risk of bleeding.

Effect of Chinese herbal compound on liver fibrosis in rabbits with schistosomiasis by B-ultrasound

Objective: To explore the value of B-ultrasound on the evaluation of the effects of traditional Chinese medicine compound of Radix astragali , Salvia miltiorrhiza and Angelica sinensis , and TCM + praziquantel on liver fibrosis in rabbits with schistosomiasis. Methods: The hepatic fibrosis model in rabbits with schistosomiasis was established. The experimental animals (24 rabbits) were randomly divided into four groups (group A, B, C and D, n =6). Group A (control group) was only treated by praziquantel; Group B was treated by mixture of Radix astragali and Salvia miltiorrhiza + praziquantel; Group C was treated by mixture of Radix astragali and Angelica sinensis + praziquantel; Group D was treated by mixture of Radix astragali, Salvia miltiorrhiza and Angelica sinensis + praziquantel. Then B-ultrasonogram was used to evaluate the effects. Results: Each group showed certain curative effect on liver fibrosis in rabbits with schistosomiasis. The efficacy of group B, C and D was better than group A, and that of group D was the best. The differences in long diameter, thickness diameter, transverse diameter and portal vein inner diameter of liver before and after treatment were statistically significant ( P <0.05). The liver function indexes and liver fibrosis indexes were significantly improved after treatment ( P <0.05). Conclusions: The mixture of Radix astragali, Salvia miltiorrhiza and Angelica sinensis combined with Western medicine treatment can obviously improve the efficacy on liver fibrosis of schistosomiasis.

Prevalence,intensity of infection and risk factors of urinary schistosomiasis in preschool and school aged children in Guma Local Government Area,Nigeria

Objective:To determine the prevalence and intensity of infection and the risk factors associated with urinary schistosomiasis in pre—school and school aged children in Cuma Local Government Area of Benue State,Nigeria.Methods:Urine filtration technique using polycarbonate membrane filters was employed to process urine specimens and to determine presence of Schistosoma haematobium eggs in urine.Questionnaires were also administered to children to collect information on socio-demographic data and water-contact activities.Results:An overall prevalence of 55.0%(165/300)was recorded out of the 300 urine samples examined.Prevalence of infection varied between 36.0%-64.0%with a significant difference(X^2=11.59,P=0.041)between the different communities visited.Males were more infected(60.6%,103/170)than females(47.7%,62/130)with a significant difference(X^2=4.95,P=0.026).The age-related prevalence showed higher prevalence(70.5%,36/52)in the 11-15 year old children than that in the 1-5 year old ones(44.9%,53/118).A significant difference was observed in the prevalence between the age groups(X^2=10.56,P=0.014).The prevalence of light intensity of infection(1-49 eggs/10 mL of urine)(86.6%)was significantly higher than that of heavy intensity of infection(5=50 eggs/10 mL of urine)(13.3%)in the area(t=16.48,P=0.000).Water contact activities of the children revealed that children that were involved in irrigation and those that went swimming in water bodies were observed to be at higher risk of becoming infected with urinary schistosomiasis in the area with odd ratios(risk factors)of 2.756(1.334-5.693)and 2.366(1.131-4.948)respectively at P<0.05 level.Conclusions:The study revealed the hyperendemicily of urinary schistosomiasis in the preschool and school aged children in Guma Local Government Area.It is therefore recommended that praziquantel should be administered to children in the area and systematic epidemiological studies should be undertaken in the whole Local Government Area and the State at large to discover new foci of infection.

Experimental evaluation of Candonocypris novaezelandiae(Crustacea:Ostracoda) in the biocontrol of Schistosomiasis mansoni transmission

Objective:To test Candonocypris novaezelandiae(Baird)(C.novaezelandiae),sub-class Ostracoda,obtained from the Nile,Egypt for its predatory activity on snail,Biomphalaria alexandrina(B.alexandrina),intermediate host of Schistosoma mansoni(S.mansoni)and on the free-living larval stages of this parasite(miracidia and cercariae).Methods:The predatory activity of C.novaezelandiae was determined on B.alexandrina snail(several densities of eggs,newly hatched and juveniles).This activity was also determined on S.mansoni miracidia and cercariae using different volumes of water and different numbers of larvae.C.novaezelandiae was also tested for its effect on infection of snails and on the cercarial production.Results:C.novaezelandiae was found to feed on the eggs,newly hatched and juvenile snails,but with significant reduction in the consumption in the presence of other diet like the blue green algae(Nostoc muscorum).This ostracod also showed considerable predatory activity on the free-living larval stages of S.mansoni which was affected by certain environmental factors such as volume of water,density of C.novaezelandiae and number of larvae of the parasite.Conclusions:The presence of this ostracod in the aquatic habitat led to significant reduction of snail population,infection rate of snails with schistosme miracidia as well as of cercarial production from the infected snails.This may suggest that introducing C.novaezelandiae into the habitat at schistosome riskv sites could suppress the transmission of the disease.

Schistosomiasis:progress and problems

INTRODUCTIONSchistosomiasis,also commonly known asbilharziasis,is one of the most significant parasiticdiseases of humans.A report of World HealthOrganization in 1996 estimated that over 200 millionpeople were infested worldwide,mainly in ruralagricultural and periurban areas.Of these,20million suffer severe consequences from the

Detection of schistosomiasis antibodies in urine patients as a promising diagnostic maker

Objective:To determine secreted antischistosoma antibodies in urine and to discern the epidemiological situation of schistosomiasis in the agricultural field labourers’camps city in the Gezira State-central Sudan.Methods:Total of 66 urine and 66 serum paired samples were collected from those who confirmed parasitologically positive and negative with schistosomiasis from the two camps.Samples were tested using ELBA technique to measure and compare the immunoglobulin G(IgG) levels in serum and urine samples of schistosomiasis patients.Results: The overall prevalence of S.mansoni and S.haematobium was 53.8%and 15.4%,while the intensity were(2.04 GMEC) and(0.9 GMEC) respectively.The relative percentage of positive IgG individulas in urine was 92.40%where as 96.97%in serum.Statistically no significant difference between the IgG levels in serum and urine samples was observed.Conclusions:This study shows that the detection of secreted IgG antibodies in urine can substitute serum for diagnosis of schistosomiasis.

Aspartate transaminase to platelet ratio index in hepatitis C virus and Schistosomiasis coinfection

AIM: To assess the diagnostic accuracy,of aminotransferase-to-platelet ratio index(APRI) alone and with antischistosomal antibody(Ab) in patients with hepatitis C virus(HCV) and schistosomiasis coinfection. METHODS: This retrospective study included medical records of three hundred and eighty three Egyptianmen patients who had undergone percutaneous liver biopsy between January 2006 to April 2014 in tertiary care hospital in Qatar for diagnosis or monitoring purpose were selected. Data of patients > 18 years of age were included in the study. The values of HCV RNA titer and antischistosomal antibody titer were also taken into consideration. Patients were excluded from the study if they had any other concomitant chronic liver disease,including; history of previous antiviral or interferon therapy,immunosuppressive,therapy,chronic hepatitis B infection,human immunodeficiency virus co-infection,autoimmune hepatitis,decompensated liver disease,hepatocellular carcinoma,prior liver transplantation,and if no data about the liver biopsy present. RESULTS: Median age of patients was 46 years. About 7.1% had no fibrosis,whereas 30.4%,37.5%,20.4%,and 4.6% had fibrosis of stage Ⅰ,Ⅱ,Ⅲ,and Ⅳ respectively. In bivariate analysis,APRI score,levels of AST,platelet count and age of patient showed statistically significant association with liver fibrosis(P < 0.0001); whereas antischistosomal antibody titer(P = 0.52) and HCV RNA titer(P = 0.79) failed to show a significant association. The respective AUC values for no fibrosis,significant fibrosis,severe fibrosis and cirrhosis of APRI score were 63%,73.2%,81.1% and 88.9% respectively. This showed good sensitivity and specificity of APRI alone for grading of liver fibrosis. But the inclusion of anti-Schistosoma antibody did not improve the prediction of fibrosis stage. CONCLUSION: The study results suggest that noninvasive biochemical markers like APRI are sensitive and specific in diagnosing the degree of fibrosis and cirrhosis in patients with coinfection of HCV and schistosomiasis as compared to biopsy. The addition of antischistosomal Ab to APRI did not improve sensitivity for predicting the degree of cirrhosis.

Institution-based Network on China-Africa Cooperation for Schistosomiasis Elimination (INCAS): Driving schistosomiasis elimination in Africa

The burden of schistosomiasis remains a global public health problem,especially in sub-Saharan Africa despite progress in terms of morbidity control.Successful control efforts achieved by China in the last six decades came with considerable experience and lessons that could benefit schistosomiasis control programs in other endemic countries.China's role and commitment to global health cooperation has become increasingly important;this has created a platform for partnership with developing partners for the establishment of Forum on China-Africa health cooperation which prioritizes the pursuit of global elimination target for schistosomiasis and malaria,control of HIV/AIDS,and improved access to reproductive health care.Chinese government's commitment towards achieving schistosomiasis elimination in Africa prompted the establishment of Institution-based Network on China-Africa Cooperation for Schistosomiasis Elimination (INCAS),by the National Institute of Parasitic Diseases to promote schistosomiasis elimination in Africa.Schistosomiasis experts from six provincial institutions and counterparts from 10 African countries participated in the first workshop on China-Africa cooperation for Schistosomiasis Elimination in Africa at Lilongwe,Malawi,in 2015.Experts at the inaugural meeting shared experiences from their national schistosomiasis control programs,as well as identified areas for collaborative synergy targeting schistosomiasis elimination in Africa.The establishment of INCAS,which comprises of 28 member-institutions from China and Africa,was proposed at this meeting.We,therefore,provide information on INCAS activities,cooperation mechanism,as well as assess the strengths,weaknesses,opportunities,and threats as we target schistosomiasis elimination in Africa using the INCAS platform.

Coinfection with hepatitis C virus and schistosomiasis:Fibrosis and treatment response

AIM:To assess whether schistosomiasis coinfection with chronic hepatitis C virus (HCV) influences hepatic fibrosis and pegylated-interferon/ribavirin (PEG-IFN/ RIB) therapy response. METHODS:This study was designed as a retrospective analysis of 3596 chronic HCV patients enrolled in the Egyptian National Program for HCV treatment with PEG-IFN/RIB. All patients underwent liver biopsy and anti-schistosomal antibodies testing prior to HCV treatment. The serology results were used to categorize the patients into group A (positive schistosomal serology) or group B (negative schistosomal serology). Patients in group A were given oral antischistosomal treatment(praziquantel, single dose) at four weeks prior to PEG-IFN/RIB. All patients received a 48-wk course of PEG-IFN (PEG-IFNα2a or PEG-IFNα2b)/RIB therapy. Clinical and laboratory follow-up examinations were carried out for 24 wk after cessation of therapy (to week 72). Correlations of positive schistosomal serology with fibrosis and treatment response were assessed by multiple regression analysis. RESULTS:Schistosomal antibody was positive in 27.3% of patients (15.9% females and 84.1% males). The patients in group A were older (P = 0.008) and had a higher proportion of males (P = 0.002) than the patients in group B. There was no significant association between fibrosis stage and positive schistosomal serology (P = 0.703). Early virological response was achieved in significantly more patients in group B than in group A (89.4% vs 86.5%, P = 0.015). However, significantly more patients in group A experienced breakthrough at week 24 than patients in group B (36.3% vs 32.3%, P = 0.024). End of treatment response was achieved in more patients in group B than in group A (62.0% vs 59.1%) but the difference did not reach statistical significance (P = 0.108). Sustained virological response occurred in significantly more patients in group B than in group A (37.6% vs 27.7%, P = 0.000). Multivariate logistic regression analysis of patient data at treatment weeks 48 and 72 showed that positive schistosomal serology was associated with failure of response to treatment at week 48 (OR = 1.3, P = 0.02) and at week 72 (OR = 1.7, P < 0.01). CONCLUSION:Positive schistosomal serology has no effect on fibrosis staging but is significantly associated with failure of response to HCV treatment despite antischistosomal therapy.