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.

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.

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.

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.

Influence of the Three Gorges Dam on schistosomiasis control in the middle and lower reaches of the Yangtze River

This paper summarizes the factors affecting schistosomiasis transmission in the middle and lower reaches of the Yangtze River before and after the completion of the Three Gorges Dam and analyzes schistosomiasis prevalence trends to provide a basis for the application of the Three Gorges project methodologies in other areas.The Three Gorges Dam has demonstrated a positive effect on schistosomiasis control.Hubei,Hunan,Jiangxi,Anhui,and Jiangsu in the middle and lower reaches of the Yangtze River are currently regions with a high prevalence of schistosomiasis.These five provinces contained 97.62% of known snail areas and 93.66% of calculated schistosomiasis cases with 90.07% of counties (cities,districts) not yet meeting the criteria for schistosomiasis transmission interruption by the end of 2016.After the Three Gorges Dam was built,the prevalence of schistosomiasis in the middle and lower reaches of the Yangtze River decreased.By the end of 2016,the estimated number of cases decreased by 92.75% and the snail habitat areas decreased by 6.56% compared to 2004.No acute schistosomiasis cases have occurred for two consecutive years since 2015.

Global Transmission Dynamics of a Schistosomiasis Model and Its Optimal Control

Drug treatment, snail control, cercariae control, improved sanitation and health education are the effective strategies which are used to control the schistosomiasis. In this paper, we consider a deterministic model for schistosomiasis transmission dynamics in order to explore the role of the several control strategies. The global stability of a schistosomiasis infection model that involves mating structure including male schistosomes, female schistosomes, paired schistosomes and snails is studied by constructing appropriate Lyapunov functions. We derive the basic reproduction number R0 for the deterministic model, and establish that the global dynamics are completely determined by the values of R0. We show that the disease can be eradicated when R0?&le;1;otherwise, the system is persistent. In the case where ?R0?>1, we prove the existence, uniqueness and global asymptotic stability of an endemic steady state. Sensitivity analysis and simulations are carried out in order to determine the relative importance of different control strategies for disease transmission and prevalence. Next, optimal control theory is applied to investigate the control strategies for eliminating schistosomiasis using time dependent controls. The characterization of the optimal control is carried out via the Pontryagins Maximum Principle. The simulation results demonstrate that the insecticide is important in the control of schistosomiasis.

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.

Complete rectal prolapse in young Egyptian males: Is schistosomiasis really condemned?

AIM To investigate the assumption that schistosomiasis is the main cause of rectal prolapse in young Egyptian males. METHODS Twenty-one male patients between ages of 18 and 50 years with complete rectal prolapse were included in the study out of a total 29 patients with rectal prolapse admitted for surgery at Colorectal Surgery Unit, Ain Shams University hospitals between the period of January 2011 and April 2014. Patients were asked to fill out a specifically designed questionnaire about duration of the prolapse, different bowel symptoms and any past or present history of schistosomiasis. Patients also underwent flexible sigmoidoscopy and four quadrant midrectal biopsies documenting any gross or microscopic rectal pathology. Data from questionnaire and pathology results were analyzed and patients were categorized according to their socioeconomic class.RESULTS Twelve patients(57%) never contracted schistosomiasis and were never susceptible to the disease, nine patients(43%) had history of the disease but were properly treated. None of the patients had gross rectal polypsand none of the patients had active schistosomiasis on histopathological examination. Fifteen patients(71%) had early onset prolapse that started in childhood, majority before the age of 5 years. Thirteen patients(62%) were habitual strainers, and four of them(19%) had straining dating since early childhood. Four patients(19%) stated that prolapse followed a period of straining that ranged between 8 mo and 2 years. Nine patients(43%) in the present study came from the low social class, 10 patients(48%) came from the working class and 2 patients(9%) came from the low middle social class. CONCLUSION Schistosomiasis should not be considered the main cause of rectal prolapse among young Egyptian males. Childhood prolapse that continues through adult life is likely involved. Childhood prolapse probably results from malnutrition, recurrent parasitic infections and diarrhea that induce straining and prolapse, all are common in lower socioeconomic classes.

Does granulocyte-colony stimulating factor administration induce damage or repair response in schistosomiasis?

AIM:To introduce Granulocyte-colony stimulating factor (G-CSF) as a new therapeutic modality for schistosomiasis through stem cell mobilization,immunomodulation or fibrosis remodeling. METHODS:In this study,a 5 d course of human recombinant G-CSF (100 μg/kg sc) was applied to Schis-tosoma mansoni-infected mice at different stages of disease (5 d before infection as well as 3,5 and 7 wk post-infection). The animals were sacrificed at 10 d as well as 4,6 and 8 wk post infection. Mice were examined for:(1) Total leukocyte count which is an accepted surrogate marker for the stem cell mobilization into the circulation; (2) Egg count in intestine and liver tissue to assess the parasitic load; and (3) Histopathological changes in Hx/E and Masson trichrome stained sections as well as collagen content in Sirius redstained liver sections to determine the severity of liver fibrosis. RESULTS:Mice developed leukocytosis. The egg load and the number of granulomas were not affected by the G-CSF treatment but there was an obvious change in the composition of granulomas towards an increased cellularity. Moreover,fibrosis was significantly decreased in treated groups compared to untreated animals (collagen content either preinfection or at 3 and 5 wk post infection:5.8 ± 0.5,4.7 ± 0.5,4.0 ± 0.7 vs 8.2 ± 0.9; P ≤ 0.01). CONCLUSION:Although G-CSF did not cause direct elimination of the parasite,it enhanced granulomatous reaction and reduced the fibrosis. Further investigation of the underlying mechanisms of these two actions is warranted.

Deterministic and Stochastic Schistosomiasis Models with General Incidence

In this paper, deterministic and stochastic models for schistosomiasis involving four sub-populations are developed. Conditions are given under which system exhibits thresholds behavior. The disease-free equilibrium is globally asymptotically stable if R0 ?and the unique endemic equilibrium is globally asymptotically stable when R0 >?1. The populations are computationally simulated under various conditions. Comparisons are made between the deterministic and the stochastic model.

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.

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.

Publication output of the new integrated strategy for schistosomiasis japonica control in China: a PubMed-based bibliometric assessment

Background:Although sustainable control since 1950s has achieved great successes,schistosomiasis japonica remains a major public health problem in China.Since 2004,a new integrated strategy was developed aiming to control the transmission of Schistosoma japonicum through the implementation of a package of interventions.To date,no systematic review or meta-analysis assessing the effectiveness of this new integrated strategy for schistosomiasis control in China has been published.We performed a PubMed-based bibliometric assessment of publications on the new integrated strategy for schistosomiasis japonica control in China,to understand the global transmissibility and sharing of the new integrated strategy.Methods:An in-depth bibliometric analysis of all publications on the new integrated strategy for schistosomiasis japonica control in China was performed through a PubMed search using the terms 'schistosomiasis' and 'China,'from January 1,2004 to August 31,2018.All titles and abstracts were read carefully,and the publications reporting the effectiveness,experiences,lessons,or problems of the new integrated strategy were included in the bibliometric analysis.Results:Overall,2,361 titles were screened,and 70 eligible publications were accessed for analyses,including 23 studies in English,published in 15 international journals,and 47 studies in Chinese with abstracts in English,published in 3 national journals.Chinese Journal of Schistosomiasis Control (Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi) published 60% of the research output,Research articles (48.6%) and short reports (37.1%) were the dominant manuscript types.Furthermore,471 contributing authors from 277 affiliations across 9 countries produced these 70 publications.Conclusion:This is the first PubMed-based quantitative analysis of the research output of the new integrated strategy,and our data indicate a low global transmissibility of Chinese new integrated strategy.We therefore call for more research outputs of the new integrated strategy for schistosomiasis japonica control in China to be communicated through international platforms.

Schistosomiasis Mansoni in the Amazon Region:Malacological Surveys of Intermediate Hosts for the Identification of Disease Transmission Areas in Belem,Para,Brazil

In Brazil,schistosomiasis occurrence is related to the presence of the etiological agent Schistosoma mansoni.The presence of mollusks for Biomphalaria genus is a necessary condition for development of the parasite cycle.In Parástate,the species B.schrammi,B.kuhniana,B.straminea and B.glabrata have already been identified,with reports of the last two occurring in Belém.The aim of this study was to determine the spatial distribution of Biomphalaria species in Belém,Pará,Brazil,identifying risk areas for schistosomiasis transmission.Biannual malacological surveys were carried out between September 2013 and October 2017 in 35 neighborhoods of Belém.The collection points were georeferenced using a Global Positioning System(GPS)receiver and the Kernel Density Estimation(KDE)was used to the spatial analysis.The mollusks,after measurement,were exposed to light to verify the presence of S.mansoni cercariae.Subsequently,mollusks were sacrificed and fixed for dissection and morphological identification of species.The surveys resulted in a total of 10,803 mollusks collected,of which 9,367(86.70%)specimens were examined.Among the analyzed mollusks,5,820(62.14%)were identified as B.glabrata and 3,547(37.86%)as B.straminea.The presence of the parasite was observed in 208(2.22%)specimens,all B.glabrata.Positive mollusks were found in six neighborhoods:Guamá(51 mollusks/24.5%),Sacramenta(47 mollusks/22.6%),Telégrafo(47 mollusks/22.6%),Terra Firme(36 mollusks/17.3%),Condor(20 mollusks/9.6%)and Barreiro(7 mollusks/3.4%).This study confirms that B.glabrata species actively participates as intermediate host in the disease maintenance in Belém.The KDE allowed to analyze the spatial distribution of collection sites and consequently to determine possible risk areas of schistosomiasis transmission in Belem.The development of maps identifying sites with schistosomiasis positive snails may support efforts of this municipality by directing activities related to endemic disease control.

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.

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

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.

Schistosomiasis and the Philippine campaign

Schistosomiasis is an infection with one of a series of related trematode parasites that are endemic to at least 76 tropical and subtropical countries.Schistosomiasis affects over 200 million people in tropical and subtropical regions of South America,Africa and Asia.This paper reported more than 1500 soldiers of US troops and 560 men of Australian Air Force were affected schistosomiasis japonicum in the Leyte of the Philippines during the liberation of the Philippines from Octorber 1944 to the early months of 1945.Many troops there were affected by contaminated water with snail hosts.At first,the medical corps knew little about the situations of the schistosomiasis japonica in the Leyte,no preventive measure was adopted.On December 23,1944 CPT morris Goldberg discovered schistosomes first from the hospitalized soldiers while conducting a liver biopsy.Some soldiers with markedly signs and symptoms were admitted to hospital for treatment.Preventive measure was taken since.The US sent a lot of experts to Philippines for the research of schistosomiasis japonicum,including epidemiology, prevention,diagnosis,treatment and so on.Nineteen chemicals were used to control snail hosts. In clinical,schistosomiasis has acute and chronic stages,the manifestations are plenty and various,the liver, intestine,veins,spleen and skin etc are common sites of impingement.An extensive educational program was carried out in the troops through different means,which yielded remarkable effect,the new incidence of schistosomiasis dropped.Though hospitalized soldiers were a few,but there were scare and some morale and psychological problems among them and the other affected victims,they worried about their prognoses or being infected. Some patients were evacuated to United States for treatment after diagnosis,some patients were treated in Leyte.Before World WarⅡ,schistosomiasis was treated generally with trivalent antimony compounds,Fuadin and tartar emetic.In this event,no case died,relapses were rare.It was a successful campaign against schistosomiasis in the army.

Comparative analysis of urinary schistosomiasis among primary school children and rural farmers in Obollo-Eke,Enugu State,Nigeria:Implications for control

Objective:To determine the prevalence,sex-age related intensity of urinary schistosomiasis and to compare such parameters among rural school children and rural fanners in selected communities in Obollo-Eke located in Southeast,Nigeria.Methods:A cross-sectional survey involving 1 337 school children and farmers was conducted in Obollo-Eke community between September 2006 and July 2007.Demographic data of subjects was collected using a questionnaire prepared for this purpose.Urine samples were collected and examined for haematuria and ova of Schistosoma haematobium(S.haematobium) using Medi-test Combi 9 and sedimentation technique respectively.Results:The prevalence of urinary schistosomiasis based on microscopic examination of the urine sediment for the ova of 5.haematobium was 17.5%while the prevalence of haematuria was 15.6%.Infection intensity varied from light to heavy.In general,the prevalence was higher among males(20.8%) than females(14.6%;P】0.05) and was slightly higher among primary school children(18.0%;n=762) than farmers(16.9%;n=575;P】0.05).The age-specific prevalence of schistosomiasis among the study subjects ranged from 8.3%to 21.2%in 0-5 years and 11-15 years age groups respectively.Conclusions:Haematuria and mean egg/10 mL urine (r = 0.95;P【0.01) showed that both procedures are reliable for the diagnosis of the disease and can be used to ascertain the prevalence of the disease in any community.The comparative analysis of urinary bilharziasis among primary school children and rural farmers demonstrated that the infection is moderately high in these two risk population groups at Obollo-Eke.A robust intervention strategy is clearly needed.