International Journal of Infectious Diseases (Jan 2017)

Diagnosing schistosomiasis-induced liver morbidity: implications for global control

  • David U. Olveda,
  • Marianette Inobaya,
  • Remigio M. Olveda,
  • Marilyn L. Vinluan,
  • Shu-Kay Ng,
  • Kosala Weerakoon,
  • Donald P. McManus,
  • Grant A. Ramm,
  • Donald A. Harn,
  • Yuesheng Li,
  • Alfred K. Lam,
  • Jerric R. Guevarra,
  • Allen G. Ross

DOI
https://doi.org/10.1016/j.ijid.2016.10.024
Journal volume & issue
Vol. 54, no. C
pp. 138 – 144

Abstract

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Background: Subclinical morbidity due to schistosomiasis was evaluated in 565 patients, and the enhanced liver fibrosis (ELF) test was assessed for the first time as a potential screening tool for disease. Methods: The prevalence and intensity of infection were determined by Kato–Katz thick smear stool examination at baseline and 2 years after curative treatment. The degree of hepatic fibrosis was assessed by ultrasound. Non-invasive serum biomarkers of hepatic fibrosis were also evaluated. Results: The baseline human prevalence and infection intensity were found to be moderately high at 34% and 123 eggs per gram, respectively. However, hepatic parenchymal fibrosis occurred in 50% of subjects, with grade II fibrosis in 19% and grade III in 6%. The ELF score and higher serum levels of tissue inhibitor of metalloproteinase 1 (TIMP-1) and hyaluronic acid (HA) correlated with the grade of liver fibrosis. Conclusions: The findings of this study demonstrated that praziquantel treatment had a short-term impact on both the prevalence and intensity of infection, but less of an impact on established morbidity. Higher TIMP-1 and HA serum levels, and an ELF cut-off score of 8 were found to be correlated with the grade of liver fibrosis; these values may, therefore, assist physicians in identifying individuals at greater risk of disease.

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