Volume 74, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


The course of hepatosplenic schistosomiasis after mass chemotherapy with oxamniquine has been rarely reported. We report the effect of treatment in patients with advanced schistosomiasis mansoni living in area of Brazil highly endemic for this disease. A total of 739 inhabitants of a village were subjected to clinical and abdominal ultrasound examinations and were treated with oxamniquine. We have identified 84 individuals with hepatosplenic schistosomiasis. Alcohol abuse was associated with periportal thickening. Four years after treatment, 42 of the 84 individuals were re-examined and regression of splenomegaly was observed in 59% and of periportal thickening in 32%. Our data indicate that mass chemotherapy can lead to reduction of schistosomiasis morbidity but a significant group of patients (68%) will not improve. The association with alcohol abuse should be further evaluated. Thickening of the gallbladder wall can be a useful predictor of no involution of liver fibrosis after treatment.


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  1. Andrade ZA, 1987. Pathogenesis of pipe-stem fibrosis of the liver: experimental observation on murine schistosomiasis. Mem Inst Oswaldo Cruz 82 : 325–334. [Google Scholar]
  2. Andrade ZA, Grimaud JA, 1986. Evolution of schistosomal hepatic lesions in mice after curative chemotherapy. Am J Pathol 124 : 59–65. [Google Scholar]
  3. Morcos SH, Mansour MM, Khayyal MT, Saleh S, Ishak EA, Girgis NI, 1992. Evaluation of hepatic fibrosis after oxamniquine therapy of murine schistosomiais. Ann Trop Med Parasitol 86 : 511–516. [Google Scholar]
  4. Costa G, Aguiar BG, Coelho PM, Cunha-Melo JR, 2003. On the increase of portal pressure during the acute and chronic phases of murine schistosomiasis mansoni and its reversibility after treatment with oxamniquine. Acta Trop 89 : 1–16. [Google Scholar]
  5. Homeida MA, El Tom I, Nash T, Bennett JL, 1991. Association of the therapeutic activity of praziquantel with the reversal of Symmer’s fibrosis induced by Schistosoma mansoni. Am J Trop Med Hyg 45 : 360–365. [Google Scholar]
  6. Doehring-Schwerdtfeger E, Abdel-Rahim IM, Kardorff R, Kaiser C, Franke D, Schlake J, Richter J, Elsheikh M, Mohamed-Ali Q, Ehrich JH, 1992. Ultrasonographical investigation of periportal fibrosis in children with Schistosoma mansoni infection: reversibility of morbidity twenty-three months after treatment with praziquantel. Am J Trop Med Hyg 46 : 409–415. [Google Scholar]
  7. Boisier P, Ramarokoto CE, Ravaoalimalala VE, Rabarijaona L, Serieye J, Roux J, Esterre P, 1998. Reversibility of Schistosoma mansoni-associated morbidity after yearly mass praziquantel therapy: ultrasonographic assessment. Trans R Soc Trop Med Hyg 92 : 451–453. [Google Scholar]
  8. Frenzel K, Grigull L, Odongo-Aginya E, Ndugwa CM, Loron-Lakwo T, Schweigmann U, Vester U, Spannbrucker N, Doehring E, 1999. Evidence for a long-term effect of a single dose of praziquantel on Schistosoma mansoni-induced hepatosplenic lesions in northern Uganda. Am J Trop Med Hyg 60 : 927–931. [Google Scholar]
  9. De Jesus AR, Miranda DG, Miranda RG, Araújo I, Magalhães A, Bacellar M, Carvalho EM, 2000. Morbidity associated with Schistosoma mansoni infection determined by ultrasound in an endemic area of Brazil, Caatinga do Moura. Am J Trop Med Hyg 63 : 1–4. [Google Scholar]
  10. Skinner HA, Holt HA, Schuller R, Israel Y, 1984. Identification of alcohol abuse using laboratory tests and a history of trauma. Ann Intern Med 101 : 847–851. [Google Scholar]
  11. Pinto-Silva RA, Abrantes WL, Antunes CM, Lambertucci JR, 1994. Sonographic features of portal hypertension in schistosomiasis mansoni. Rev Inst Med Trop de São Paulo 36 : 355–361. [Google Scholar]
  12. WHO Niamey Working Group, 2000. Ultrasound in Schistosomiasis—A Practical Guide to the Standardized Use of Ultrasonography for the Assessment of Schistosomiasis-Related Morbidity (Revised and Update). Second International Workshop, October 22–26, 1996, Niamey, Niger and Satellite Symposium on Ultrasound Methodology in Schistosoma mansoni infection, October 19–24, 1997, Belo Horizonte, Brazil. World Health Organization/TDR/STR/SCH/00.1, Geneva, Switzerland, 2001.
  13. Lambertucci JR, Cota GF, Pinto-Silva RA, Serufo JC, Gersparcher-Lara R, Drummond SC, Antunes CM, Nobre V, Rayes A, 2001. Hepatosplenic schistosomiasis in field-based studies: a combined clinical and ultrasonographic definition. Mem Inst Oswaldo Cruz 96 : 147–150. [Google Scholar]
  14. Richter J, Domingues AL, Barata CH, Prata AR, Lambertucci RJ, 2001. Report of the second satellite symposium on ultrasound in schistosomiasis. Mem Inst Oswaldo Cruz 96 (Suppl): 151–156. [Google Scholar]
  15. Lambertucci JR, Serufo JC, Gersparcher-Lara R, Rayes AA, Teixeira R, Nobre V, Antunes C, 2000. Schistosoma mansoni: assessment of morbidity before and after control. Acta Trop 77 : 101–109. [Google Scholar]
  16. Karanja DMS, Hightower AW, Colley DG, Mwinzi PNM, Galil K, Andove J, Secor WE, 2002. Resistance to reinfection with Schistosoma mansoni in occupationally exposed adults and effect of HIV-1 co-infection on susceptibility to schistosomiasis: a longitudinal study. Lancet 360 : 592–596. [Google Scholar]
  17. Afdhal NH, Nunes D, 2004. Evaluation of liver fibrosis: a concise review. Am J Gastroenterol 99 : 1160–1174. [Google Scholar]
  18. Oberti F, Valsesia E, Rousselet PC, Bedossa P, Aube C, Gallois Y, Rifflet H, Maiga MY, Penneau-Fontbonne D, Cales P, 1997. Nonivasive diagnosis of hepatic fibrosis or cirrhosis. Gastroenterology 113 : 1609–1616. [Google Scholar]
  19. Bina JC, 1983. A regressão da hepatoesplenomegalia pelo tratamento específico da esquistossomose. Rev Soc Bras Med Trop 16 : 213–218. [Google Scholar]
  20. Dietze R, Prata A, 1986. Rate of reversion of hepatosplenic schistosomiasis after specific therapy. Rev Soc Bras Med Trop 19 : 69–73. [Google Scholar]
  21. Barbosa FS, 1966. Morbidade da esquistossomose. Rev Bras Malariol D Trop 3 : 159–163. [Google Scholar]
  22. Gerspacher-Lara R, Pinto-Silva RA, Serufo JC, Rayes AAM, Drummond SC, Lambertucci JR, 1998. Splenic palpation for the evaluation of morbidity due to schistosomiasis mansoni. Mem Inst Oswaldo Cruz 93 : 245–248. [Google Scholar]
  23. Lambertucci JR, Gerspacher-Lara R, Pinto-Silva RA, Barbosa MM, Teixeira R, Barbosa HF, Serufo JC, Rezende DF, Drummond SC, Rayes AA, 1996. The Queixadinha Project: morbidity and control of schistosomiasis in an endemic area in the northeast of Minas Gerais, Brazil. Rev Soc Bras Med Trop 29 : 127–135. [Google Scholar]
  24. Homeida M, Ahmed S, Dafalla A, Suliman S, El Tom I, Nash T, Bennett JL, 1988. Morbidity associated with Schistosoma mansoni infections as determined by ultrasound: a study in Gezira, Sudan. Am J Trop Med Hyg 39 : 196–201. [Google Scholar]
  25. Serufo JC, Antunes CM, Pinto-Silva RA, Gersparcher-Lara R, Rayes AAM, Drummond SC, Reis CMF, Martins MJ, Mingoti AS, Lambertucci JR, 1998. Chronic carriers of hepatitis B surface antigen in an endemic area for schistomsomiais mansoni in Brazil. Mem Inst Oswaldo Cruz 93 : 249–253. [Google Scholar]
  26. Lambertucci JR, Greco DB, Pedroso ER, da Costa Rocha MO, Salazar HM, de Lima DP, 1982. A double blind trial with oxamniquine in chronic schistosomiasis mansoni. Trans R Soc Trop Med Hyg 76 : 751–755. [Google Scholar]
  27. Katz N, Rocha RS, Lambertucci JR, Greco DB, Pedroso ER, Rocha MO, Flan S, 1983. Clinical trial with oxamniquine and praziquantel in the acute and chronic phases of schistosomiasis mansoni. Rev Inst Med Trop São Paulo 25 : 173–177. [Google Scholar]
  28. Orrego H, Israel Y, Crossley IR, Mahmound AA, Peters PA, Varghese G, Wanless IR, 1981. Effect of chronic alcohol intake on hepatic fibrosis and granulomas in murine schistosomiasis mansoni. Hepatology 1 : 416–418. [Google Scholar]
  29. Houston S, Munjoma M, Kanyimo K, Davidson RN, Flowerdew G, 1993. Use of ultrasound in a study of schistosomal periportal fibrosis in rural Zimbabwe, 1993. Acta Trop 53 : 51–58. [Google Scholar]
  30. Liu Y, Yuan HC, Lin DD, Hu F, Zhao GM, Giang QW, Zhang SJ, 2000. Studies on risk factors for liver fibrosis of schistosomiasis japonica. Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi 18 : 18–20. [Google Scholar]

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  • Received : 19 Jun 2005
  • Accepted : 05 Aug 2005

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