Effects of Improving the Nutrition of Malnourished People Infected with Schistosoma Mansoni

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Summary and Conclusions

As an extension of laboratory studies in experimental animals a 15-month study was conducted in Puerto Rico on the effects of improving the nutrition of malnourished people infected with Schistosoma mansoni. At the beginning and at intervals during the study the patients were hospitalized for brief periods for extensive laboratory and clinical examinations. After they were provided an enriched diet for 9 months some were cured by stibophen therapy and the effects of treatment were observed for an additional 6 months. A group of similarly malnourished individuals were studied as controls.

Evaluation of the results of the study led to the following conclusions:

Nutritional inadequacies of the usual diet of the people studied included (a) protein, especially of animal origin, (b) ascorbic acid, (c) riboflavin, (d) niacin, and (e) calories.

All patients had a history of more or less ill health characterized by excessive fatigue, aching, anorexia, stomach discomfort, frequent colds and chills, and underweight. After the enriched diet was provided, marked improvement in the health of the patients was observed.

A regimen of stibophen therapy devised for this study (0.5 mg stibophen per kg body weight twice daily for 10 days) resulted in cures in every case without accompanying severe side effects. Following treatment the malnourished individuals in the control group showed improvement in respect to liver function, erythrocyte sedimentation rate, weight gain and general health. Further improvement of the health of individuals in the enriched-diet group following treatment was also observed.

Serological tests using fluorescent antibody, slide flocculation, complement-fixation and circumoval precipitin techniques remained reactive at high titers in most cases up to the end of the observation period, 10 months after treatment was completed. No difference in diet effect could be detected.

The results of egg counts on patients receiving the enriched diet were inconclusive. In some cases there was an apparent increase while in others either no change or a decrease. Fluctuations in the number of eggs passed, however, were sufficiently great to make interpretation difficult or impossible.

Author Notes

Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Public Health Service, U. S. Department of Health, Education and Welfare, Bethesda 14, Maryland.

School of Medicine, University of Puerto Rico, San Juan, Puerto Rico.

Municipal Hospital, Rio Piedras, Puerto Rico.