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Reversibility of Schistosomal Periportal Thickening/Fibrosis after Praziquantel Therapy: A Twenty-Six Month Follow-up Study in Ethiopia

To study outcome determinants of schistosomal periportal thickening/fibrosis (PPT/F), 199 subjects (mean age = 24.0 years, range = 7–68 years), 109 with mild (image pattern C) PPT/F, 69 with moderate (image pattern D) PPT/F, and 21 with severe (image patterns E and F) PPT/F were treated with praziquantel and evaluated every six months for a mean duration of 26 months. Subjects excreting Schistosoma mansoni eggs during any of the six-month evaluations were offered repeat treatment. Thirty-five had some improvement, and 69 had total resolution of PPT/F, of which 63.8% resolved within one year. Compared with subjects with moderate lesions, a significantly higher proportion of subjects with mild lesions had resolution/improvement of PPT/F (40.6% versus 69.7%, P < 0.001). Subjects with severe PPT/F showed no improvement. Resolution of PPT/F was significantly more frequent at a younger age, among seronegative for hepatitis B virus and among those with a lower frequency of post-treatment recurrence of S. mansoni infections.

Received August 19, 2007. Accepted for publication November 7, 2007.

Acknowledgments: We thank Endashaw Habte and Abraham Redda for excellent laboratory assistance, the staff of Kemisse Health Centre and Cheretee Clinic for unreserved assistance in our fieldwork, and the administrative and technical staff of the Institue of Pathobiology for encouragement and support.

Financial support: This work was supported by Centre for Imported and Tropical Diseases of Ullevål University Hospital and the Norwegian Research Council through project "Control of Schistosomiasis by Local Production and Use of the Ethiopian Soapberry Endod." Nega Berhe is a recipient of PhD scholarship from the Norwegian Statens Lånekasse.

^* Address correspondence to Nega Berhe, Department of Infectious Diseases, Centre for Imported and Tropical Diseases, Ulleva °l University Hospital, 0407 Oslo, Norway. E-mail: nega_berhe{at}yahoo.com

Authors’ addresses: Nega Berhe, Department of Infectious Diseases, Centre for Imported and Tropical Diseases, Ullevål University Hospital, 0407 Oslo, Norway, Telephone: 47-2211-9097, Fax: 47-2301-6020, E-mail: nega_berhe{at}yahoo.com, the Institute for International Health, University of Oslo, PO Box 1130, N-0318 Oslo, Norway, E-mail: nega.berhe{at}studentmed.uio.no, and the Aklilu Lemma Institute of Pathobiology, Addis Ababa University, PO Box 1176, Addis Ababa, Ethiopia. Bjørn Myrvang, Department of Infectious Diseases, Centre for Imported and Tropical Diseases, Ullevål University Hospital, 0407 Oslo, Norway, Telephone: 47-2211-9097, Fax: 47-2301-6020, E-mail: Bjorn.Myrvang{at}ulleval.no. Svein G. Gundersen, Sorlandet Hospital HF and Agder University College, Box 416, 4604 Kristiansand, Norway, Telephone: 47-3807-4474, Fax: 47-3807-4173, E-mail: s.g.gundersen{at}sshf.no.

Reprint requests: Nega Berhe, Department of Infectious Diseases, Centre for Imported and Tropical Diseases, Ullevål University Hospital, 0407 Oslo, Norway, Telephone: 47-2211-9097, Fax: 47-2301-6020, E-mail: nega_berhe{at}yahoo.com.

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