The morbidity of schistosomiasis mansoni in Maniema (Zaire)

The morbidity of schistosomiasis mansoni was assessed in Makundju (population 547; prevalence 96%, mean egg load 791 epg) and Massimelo (pop. 363; prev. 19%, mean egg load 39 epg), 2 similar villages in the forest zone of Maniema, Zaire. The prevalences of other parasites including malaria (holoendemic) were comparable. "Intermittent diarrhoea" (mostly bloody) was a complaint of 55% and 3% of the populations, respectively, "intermittent abdominal pain" of 63% and 25%, and "fatigue" of 33% and 19%. Enlargement of the left liver lobe was present in 45% and 9% of the populations, right lobe hepatomegaly in 32% and 3%, splenomegaly in 29% and 9%. Hepatomegaly and splenomegaly in Makundju were often very impressive, and most frequent in the 6- to 18-year-old group. Anaemia (haematocrit less than or equal to 35%) was present in 30% and 9% of males and 36% and 21% of females. Mean length and weight were lower in Makundju for boys aged 11 to 18 years. Ergometric results (Astrand cyclometer, male adults only) were comparably low in both villages (mean VO2max. 19.3 and 18.9). Analysis of the data according to egg load within the Makundju community revealed a significant relationship only in the following cases: higher frequencies of diarrhoea, abdominal pain and fatigue in those excreting more than 200 epg compared with those excreting fewer; left lobe splenomegaly gradually increased with egg load in children under 18; in people over 40 it occurred at a higher frequency in those excreting more than 2000 epg than in those excreting fewer.(ABSTRACT TRUNCATED AT 250 WORDS)