Schistosomiasis: A Case Series, With Review Of Literature.

摘要

Background and Objective: Schistosomiasis is one of the most prevalent parasitic infections in the world, and continues to be a global public health concern in the developing world. The main objective of the article is to study the various clinicopathological features of Chronic schistosomiasis in different anatomical sites; also emphasizing on the need to suspect this parasitic disease even in non-endemic or low-endemicity areas.Material and methods: Ours was a prospective study, conducted at King Faisal Hospital (Taif, Kingdom of Saudi Arabia) from year 2001 to 2005. The study included 32 cases of schistosomiasis involving various organs.Results:32 cases of schistosomiasis affecting various organs were reported. Appendix was the most common organ involved with 16 cases, while ureteric involvement was seen only in 1 case. Urinary bladder involvement was seen in 5 cases while 4 cases affected intestinal tract. Liver, gall bladder and prostate involvement was seen in 2 cases each. All cases were completely cured on treatment with Praziquantel except 2 cases of urinary bladder which developed squamous cell carcinoma.Conclusion: Early diagnosis and treatment of the infection results in complete cure without any complication, and therefore high level of suspicion is required in persons visiting or residing in highly endemic areas. Introduction Schistosomiasis remains one of the most prevalent parasitic infections in the world. It is endemic in 76 countries and territories, and continues to be a global public health concern in the developing world. Because it is a chronic insidious disease, it is poorly recognized at early stages, and becomes a threat to development by disabling men and women during their most productive years. It is particularly linked to agricultural and water development schemes and is typically a disease of the poor who live in conditions that favour transmission and have no access to proper care or effective prevention measures. Although the distribution of schistosomiasis has changed over the past 50 years and there have been successful control programmes, the number of people estimated to be infected or at risk of infection remains unchanged. 1 Despite major advances in control and substantial decrease in morbidity and mortality, schistosomiasis continues to spread to new geographic areas. Environmental changes that result from the development of water resources and the growth and migration of population can facilitate the spread of schistosomiasis. 2 According to WHO, 200 million people are infected world wide, leading to loss of 1.53 million disability adjusted life years. 3 Depending on the parasitic species liver, colon, urinary bladder and ureter are the main organs affected, however any organ can be affected even like lungs, skin, kidney and central nervous system. An expatriate doctor going to work in non-endemic or low-endemicity areas should be aware of the disease and should always be on a look out for an encounter with schistosomal eggs in stool, or in the tissue sections of appendix, urinary bladder, ureter, rectal biopsy etc., because a timely administration of praziquantel can considerably reduce the morbidity associated with the disease. Material And Methods We present a review of 32 cases of Chronic schistosomiasis presenting over a span of 4 years (2001 to 2005) at King Faisal Hospital, Taif, Kingdom of Saudi Arabia. Schistosomiasis was not the suspected initial clinical diagnosis in these cases. These were collected prospectively from the department of surgical pathology. Detailed clinical histories, examination, routine as well as all relevant investigations were obtained later from all the concerned departments. Results There were 32 cases of Schistosomiasis of various anatomical organs. The clinical presentations of the cases are given in Table 1.