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Schistosomiasis in childhood
1Abteilung für Pädiatrische Nieren, Medizinische Hochschule, Hannover, Federal Republic of Germany.
Insights
Schistosomiasis, a tropical parasitic disease, affects millions globally, particularly children. Praziquantel treatment offers high cure rates and significant reversibility of symptoms.
Area of Science:
- Tropical Medicine
- Parasitology
- Infectious Diseases
Background:
- Schistosomiasis is a major tropical parasitic disease affecting up to 300 million people worldwide.
- Children in endemic areas exhibit the highest prevalence and intensity of infection.
- Two main forms, urinary schistosomiasis (Schistosoma haematobium) and intestinal schistosomiasis (Schistosoma mansoni), affect different organ systems.
Purpose of the Study:
- To summarize the epidemiology, clinical manifestations, diagnosis, and treatment of schistosomiasis.
- To highlight the increasing incidence of imported cases in non-endemic regions like Europe.
- To emphasize the effectiveness of praziquantel in treating schistosomiasis.
Main Methods:
- Diagnosis relies on identifying schistosome eggs in human excreta or biopsy samples.
- Clinical presentations include hematuria, proteinuria, and gastrointestinal symptoms.
- Treatment involves a single dose of praziquantel (40 mg/kg bodyweight).
Main Results:
- Schistosoma haematobium infections primarily target the urinary tract, potentially causing renal failure.
- Schistosoma mansoni infections affect the intestines and liver, leading to portal hypertension.
- Praziquantel treatment achieves cure rates of approximately 90% with significant reversibility of pathological changes.
Conclusions:
- Schistosomiasis remains a significant global health concern, particularly in tropical regions.
- Early diagnosis and effective treatment with praziquantel are crucial for managing the disease.
- Increased international travel necessitates heightened awareness and diagnostic vigilance for imported cases.
Abstract:
Schistosomiasis is a parasitic disease of the tropics which is estimated to affect up to 300 million people worldwide. In endemic areas the childhood age group has the highest prevalence and intensity of infection. There are several distinct species of schistosomes. The principal organ system involved in Schistosoma haematobium infection is the urinary tract since parasite eggs penetrate the bladder and are excreted in the urine. Hematuria, proteinuria, leukocyturia and symptoms like dysuria or nocturia are the most common clinical presentations. Heavily infected patients show obstructive uropathy of different severity which may lead to renal failure. Intestinal schistosomiasis is caused by Schistosoma mansoni infection. Initial symptoms can be diarrhea and blood-tinged stool. Chronic infection is characterized by fibrotic involvement of the liver and consecutive portal hypertension. The diagnosis of schistosomiasis depends on the demonstration of schistosome eggs in human excreta or biopsy material. Imported cases of schistosomiasis to Europe show an increasing tendency due to expanding international travel. Furthermore imported cases are usually not diagnosed until years after the patients have left an endemic area. The treatment of choice is a single dose of praziquantel 40 m/kg bodyweight resulting in cure rates of around 90% and considerable reversibility of pathological abnormalities due to schistosome infections.