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Relationship between circulating antigen level and morbidity in Schistosoma mansoni-infected children evaluated by
M M Hassan1, M H Hegab, S Z Soliman
1Department of Parasitology, Faculty of Medicine, Zagazig University, Egypt.
Insights
Ultrasonography and circulating antigen levels effectively predict morbidity in children with Schistosoma mansoni infection. These methods help assess disease severity and complications in endemic areas.
Area of Science:
- Tropical Medicine
- Parasitology
- Medical Imaging
Background:
- Schistosomiasis mansoni is a significant parasitic disease affecting children in endemic regions.
- Accurate assessment of morbidity is crucial for effective disease management.
Purpose of the Study:
- To evaluate the utility of abdominal ultrasonography and circulating antigen levels in predicting morbidity in Schistosoma mansoni-infected children.
- To correlate antigen levels and ultrasound findings with clinical and pathological stages of the disease.
Main Methods:
- Ninety-eight infected children underwent abdominal ultrasonography to assess liver and spleen size, periportal fibrosis, and splenic vein diameter.
- Circulating antigen levels were measured using a highly sensitive and specific double sandwich ELISA.
- Disease staging was performed using both physical examination and ultrasound findings.
Main Results:
- No significant relationship was found between antigen levels and clinical stages determined by physical examination.
- Mean antigen levels were significantly higher in hepatosplenic cases compared to intestinal cases when staged by ultrasound (P < 0.05).
- A direct correlation was observed between antigen levels and ultrasonographically determined disease severity, including periportal fibrosis (P < 0.01).
Conclusions:
- Ultrasonography is a valuable tool for staging Schistosoma mansoni morbidity.
- Measurement of circulating antigen levels, combined with ultrasonography, can effectively predict disease morbidity in infected children.
Abstract:
Ninety-eight Schistosoma mansoni-infected children from an endemic area in Sharkia Governorate, Egypt were evaluated by abdominal ultrasonography to determine liver and spleen sizes, grade of periportal fibrosis, and splenic vein diameter. Circulating antigen levels were measured using a double sandwich ELISA in which the sensitivity was 91.8% and specificity was > 99%, with no evidence of cross-reactivity with other parasites. No significant relationship was observed between antigen level and clinical stages of the disease as assessed by physical examination (P > 0.05). When ultrasound was used to stage disease, the mean antigen level was significantly higher among hepatosplenic cases than intestinal cases (P < 0.05). No difference in mean antigen levels were found between the splenic and hepatic cases. Furthermore, a direct correlation (P < 0.01) was observed between antigen level and disease severity as monitored by ultrasonography. Antigen level showed a positive correlation with the degree of periportal fibrosis (P < 0.05). Moreover, a significant increase in the percent of children who were antigen positive (> 80 ng/ml) was found in those with more severe periportal fibrosis (P < 0.001). The findings suggest that ultrasonography along with measurement of circulating antigen levels predict morbidity in schistosomiasis mansoni.