Organomegaly in Mali before and after praziquantel treatment. A possible association with Schistosoma haematobium
Chalotte Willemann Stecher,
Henry Madsen,
Shona Wilson,
Moussa Sacko,
Christian Wejse,
Adama D. Keita,
Aly Landouré,
Mamadou S. Traoré,
Per Kallestrup,
Eskild Petersen,
Birgitte Vennervald
Affiliations
Chalotte Willemann Stecher
Department of Infectious Diseases, Aarhus University Hospital, Denmark; Center for Global Health (GloHAU), Department of Public Health, Aarhus University, Denmark; Corresponding author.
Henry Madsen
Section for Parasitology and Aquatic Diseases, SUND, University of Copenhagen, Denmark
Shona Wilson
Department of Pathology, University of Cambridge, United Kingdom
Moussa Sacko
Laboratory of Parasitology, Institut National de Recerche en Sante Publique, Bamako, Mali
Christian Wejse
Department of Infectious Diseases, Aarhus University Hospital, Denmark; Center for Global Health (GloHAU), Department of Public Health, Aarhus University, Denmark
Adama D. Keita
University of Sciences, Techniques and Technology, Bamako, Mali
Aly Landouré
Laboratory of Parasitology, Institut National de Recerche en Sante Publique, Bamako, Mali
Mamadou S. Traoré
Laboratory of Parasitology, Institut National de Recerche en Sante Publique, Bamako, Mali
Per Kallestrup
Center for Global Health (GloHAU), Department of Public Health, Aarhus University, Denmark
Eskild Petersen
Department of Infectious Diseases, The Royal Hospital, P.O. Box 1331, Muscat, Oman; Institute for Clinical Medicine, University of Aarhus, Denmark
Birgitte Vennervald
Section for Parasitology and Aquatic Diseases, SUND, University of Copenhagen, Denmark
Continuous exposure to schistosome-infested water results in acute and chronic morbidity in all ages. We analysed occurence of organomegaly via ultrasonography and investigated a possible additive effect of dual-dose drug administration in 401 Schistosoma haematobium infected individuals from a highly endemic area in Mali. Mean intensity of infection at baseline (22.0 eggs per 10 ml) was reduced to 0.22 eggs per 10 ml 9 weeks after treatment (both treatments combined). Odds of persistent infection among those given dual-dose treatment was 41% of that in people given single dose (b = 0.41; p = 0.05; 95% CI 0.17–1.00), but after two years, 70.7% of the 157 participants, who completed the survey, were re-infected with no significant difference in prevalence and intensity of infection between treatment groups. Resolution of organomegaly occurred in all age groups after treatment. A novel association between Schistosoma haematobium infection and moderate portal vein enlargement was found in 35% (n: 55). Severe portal vein diameter enlargement was found in 3.2%. After two years, moderate hepatomegaly was present in 50.6%, moderate splenomegaly in 45.6% and moderate portal vein diameter enlargement in 19%. A subsequent dose of PZQ did not provide any additional long-term advantages.
