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Submitted: 25 January 2017 Modified: 06 February 2017

Herdin Record #: PCHRD17012514314443

Diagnosing schistosomiasis-induced liver morbidity: Implications for global control.


1D. U. Olveda Author
2M.  Inobaya Author
3R. M. Olveda Author
4M. L. Vinluan Author
5S. K. Ng Author
6K. Weerakoon Author
7D. P.  McManus Author
8G. A. Ramm Author
9D. A. Harn Author
10Y. Li Author
11A. K. Lam Author
12J. R. Guevarra Author
13A G. Ross Author

Publication Information

Publication Type:
Publication Sub Type:
Journal Article, Original
International Journal of Infectious Diseases
Publication Date:
January 2017
International Society for Infectious Diseases
Hamilton, ON : Elsevier
Hamilton, ON : Decker


BACKGROUND: Subclinical morbidity due to schistosomiasis was evaluated in 565 patients, and the enhanced liver fibrosis (ELF) test was assessed for the first time as a potential screening tool for disease.

METHODS: The prevalence and intensity of infection were determined by Kato-Katz thick smear stool examination at baseline and 2 years after curative treatment. The degree of hepatic fibrosis was assessed by ultrasound. Non-invasive serum biomarkers of hepatic fibrosis were also evaluated.

RESULTS: The baseline human prevalence and infection intensity were found to be moderately high at 34% and 123 eggs per gram, respectively. However, hepatic parenchymal fibrosis occurred in 50% of subjects, with grade II fibrosis in 19% and grade III in 6%. The ELF score and higher serum levels of tissue inhibitor of metalloproteinase 1 (TIMP-1) and hyaluronic acid (HA) correlated with the grade of liver fibrosis.


CONCLUSIONS: The findings of this study demonstrated that praziquantel treatment had a short-term impact on both the prevalence and intensity of infection, but less of an impact on established morbidity. Higher TIMP-1 and HA serum levels, and an ELF cut-off score of 8 were found to be correlated with the grade of liver fibrosis; these values may, therefore, assist physicians in identifying individuals at greater risk of disease.

Physical Location

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U.S. National Library of Medicine: PubMed/Medline Abstract External Link (View)