A cross-sectional study of periportal fibrosis and Schistosoma mansoni infection amongst school aged children in a hard-to-reach area of Madagascar

Hannah J. Russell; James M.Stj Penney; Cortland Linder; Elizabeth C. Joekes; Amaya L. Bustinduy; Russell Stothard; Daniel A.L. Rakotomampianina; Emmanuel H. Andriamasy; Lalarizo R. Mahary; Elodie P. Ranjanoro; Alain M. Rahetilahy; Stephen Spencer

doi:10.1093/trstmh/traa009

A cross-sectional study of periportal fibrosis and Schistosoma mansoni infection amongst school aged children in a hard-to-reach area of Madagascar

Hannah J. Russell, James M.Stj Penney, Cortland Linder, Elizabeth C. Joekes, Amaya L. Bustinduy, Russell Stothard, Daniel A.L. Rakotomampianina, Emmanuel H. Andriamasy, Lalarizo R. Mahary, Elodie P. Ranjanoro, Alain M. Rahetilahy, Stephen Spencer

Research output: Contribution to journal › Article › peer-review

13 Citations (Scopus)

Abstract

Background: A cross-sectional survey was performed to estimate the prevalence of periportal fibrosis in children based on ultrasound examination in the Marolambo District of the Atsinanana Region of Madagascar. This is a remote area known to have a high prevalence

of intestinal schistosomiasis.

Methods: School-aged children (5-14 years) were selected from six villages for parasitological and sonographic examination. Circulating cathodic antigen (CCA) tests and Kato Katz (KK) stool microscopy were performed. Video clips of liver views were recorded with a SonoSite i-

Viz and interpreted in the UK by comparison with standardised images (WHO protocol).

Results: The prevalence of schistosomiasis according to CCA testing was 97.8% (269/275) and 73.8% (203/275) by KK. Sonographic evidence of periportal fibrosis was observed in 11.3% (31/275). The youngest children with fibrosis were six years old. Fibrosis was more

common in older children (p=0.03) but was not associated with infection intensity category(p= 0.07) or gender (p=0.67).

Conclusions: Findings of periportal fibrosis amongst children in these hard-to-reach villages suggests chronic Schistosoma mansoni infection from a very young age. This may reflect other similarly remote schistosomiasis-endemic areas and reinforces the need to investigate

morbidity in neglected communities in order to understand the true extent of disease burden in endemic countries.

Original language	English
Pages (from-to)	315-322
Number of pages	8
Journal	Transactions of the Royal Society of Tropical Medicine and Hygiene
Volume	114
Issue number	4
DOIs	https://doi.org/10.1093/trstmh/traa009
Publication status	Published - 17 Mar 2020

Keywords

fibrosis
liver
Madagascar
schistosomiasis
ultrasound

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Cite this

Russell, H. J., Penney, J. M. S., Linder, C., Joekes, E. C., Bustinduy, A. L., Stothard, R., Rakotomampianina, D. A. L., Andriamasy, E. H., Mahary, L. R., Ranjanoro, E. P., Rahetilahy, A. M., & Spencer, S. (2020). A cross-sectional study of periportal fibrosis and Schistosoma mansoni infection amongst school aged children in a hard-to-reach area of Madagascar. Transactions of the Royal Society of Tropical Medicine and Hygiene, 114(4), 315-322. https://doi.org/10.1093/trstmh/traa009

@article{40e526c207194813bf25691e53083b77,

title = "A cross-sectional study of periportal fibrosis and Schistosoma mansoni infection amongst school aged children in a hard-to-reach area of Madagascar",

abstract = "Background: A cross-sectional survey was performed to estimate the prevalence of periportal fibrosis in children based on ultrasound examination in the Marolambo District of the Atsinanana Region of Madagascar. This is a remote area known to have a high prevalence of intestinal schistosomiasis. Methods: School-aged children (5-14 years) were selected from six villages for parasitological and sonographic examination. Circulating cathodic antigen (CCA) tests and Kato Katz (KK) stool microscopy were performed. Video clips of liver views were recorded with a SonoSite i- Viz and interpreted in the UK by comparison with standardised images (WHO protocol). Results: The prevalence of schistosomiasis according to CCA testing was 97.8\% (269/275) and 73.8\% (203/275) by KK. Sonographic evidence of periportal fibrosis was observed in 11.3\% (31/275). The youngest children with fibrosis were six years old. Fibrosis was more common in older children (p=0.03) but was not associated with infection intensity category(p= 0.07) or gender (p=0.67). Conclusions: Findings of periportal fibrosis amongst children in these hard-to-reach villages suggests chronic Schistosoma mansoni infection from a very young age. This may reflect other similarly remote schistosomiasis-endemic areas and reinforces the need to investigate morbidity in neglected communities in order to understand the true extent of disease burden in endemic countries.",

keywords = "fibrosis, liver, Madagascar, schistosomiasis, ultrasound",

author = "Russell, \{Hannah J.\} and Penney, \{James M.Stj\} and Cortland Linder and Joekes, \{Elizabeth C.\} and Bustinduy, \{Amaya L.\} and Russell Stothard and Rakotomampianina, \{Daniel A.L.\} and Andriamasy, \{Emmanuel H.\} and Mahary, \{Lalarizo R.\} and Ranjanoro, \{Elodie P.\} and Rahetilahy, \{Alain M.\} and Stephen Spencer",

year = "2020",

month = mar,

day = "17",

doi = "10.1093/trstmh/traa009",

language = "English",

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pages = "315--322",

journal = "Transactions of the Royal Society of Tropical Medicine and Hygiene",

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Russell, HJ, Penney, JMS, Linder, C, Joekes, EC, Bustinduy, AL, Stothard, R, Rakotomampianina, DAL, Andriamasy, EH, Mahary, LR, Ranjanoro, EP, Rahetilahy, AM & Spencer, S 2020, 'A cross-sectional study of periportal fibrosis and Schistosoma mansoni infection amongst school aged children in a hard-to-reach area of Madagascar', Transactions of the Royal Society of Tropical Medicine and Hygiene, vol. 114, no. 4, pp. 315-322. https://doi.org/10.1093/trstmh/traa009

A cross-sectional study of periportal fibrosis and Schistosoma mansoni infection amongst school aged children in a hard-to-reach area of Madagascar. / Russell, Hannah J.; Penney, James M.Stj; Linder, Cortland et al.
In: Transactions of the Royal Society of Tropical Medicine and Hygiene, Vol. 114, No. 4, 17.03.2020, p. 315-322.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - A cross-sectional study of periportal fibrosis and Schistosoma mansoni infection amongst school aged children in a hard-to-reach area of Madagascar

AU - Russell, Hannah J.

AU - Penney, James M.Stj

AU - Linder, Cortland

AU - Joekes, Elizabeth C.

AU - Bustinduy, Amaya L.

AU - Stothard, Russell

AU - Rakotomampianina, Daniel A.L.

AU - Andriamasy, Emmanuel H.

AU - Mahary, Lalarizo R.

AU - Ranjanoro, Elodie P.

AU - Rahetilahy, Alain M.

AU - Spencer, Stephen

PY - 2020/3/17

Y1 - 2020/3/17

N2 - Background: A cross-sectional survey was performed to estimate the prevalence of periportal fibrosis in children based on ultrasound examination in the Marolambo District of the Atsinanana Region of Madagascar. This is a remote area known to have a high prevalence of intestinal schistosomiasis. Methods: School-aged children (5-14 years) were selected from six villages for parasitological and sonographic examination. Circulating cathodic antigen (CCA) tests and Kato Katz (KK) stool microscopy were performed. Video clips of liver views were recorded with a SonoSite i- Viz and interpreted in the UK by comparison with standardised images (WHO protocol). Results: The prevalence of schistosomiasis according to CCA testing was 97.8% (269/275) and 73.8% (203/275) by KK. Sonographic evidence of periportal fibrosis was observed in 11.3% (31/275). The youngest children with fibrosis were six years old. Fibrosis was more common in older children (p=0.03) but was not associated with infection intensity category(p= 0.07) or gender (p=0.67). Conclusions: Findings of periportal fibrosis amongst children in these hard-to-reach villages suggests chronic Schistosoma mansoni infection from a very young age. This may reflect other similarly remote schistosomiasis-endemic areas and reinforces the need to investigate morbidity in neglected communities in order to understand the true extent of disease burden in endemic countries.

AB - Background: A cross-sectional survey was performed to estimate the prevalence of periportal fibrosis in children based on ultrasound examination in the Marolambo District of the Atsinanana Region of Madagascar. This is a remote area known to have a high prevalence of intestinal schistosomiasis. Methods: School-aged children (5-14 years) were selected from six villages for parasitological and sonographic examination. Circulating cathodic antigen (CCA) tests and Kato Katz (KK) stool microscopy were performed. Video clips of liver views were recorded with a SonoSite i- Viz and interpreted in the UK by comparison with standardised images (WHO protocol). Results: The prevalence of schistosomiasis according to CCA testing was 97.8% (269/275) and 73.8% (203/275) by KK. Sonographic evidence of periportal fibrosis was observed in 11.3% (31/275). The youngest children with fibrosis were six years old. Fibrosis was more common in older children (p=0.03) but was not associated with infection intensity category(p= 0.07) or gender (p=0.67). Conclusions: Findings of periportal fibrosis amongst children in these hard-to-reach villages suggests chronic Schistosoma mansoni infection from a very young age. This may reflect other similarly remote schistosomiasis-endemic areas and reinforces the need to investigate morbidity in neglected communities in order to understand the true extent of disease burden in endemic countries.

KW - fibrosis

KW - liver

KW - Madagascar

KW - schistosomiasis

KW - ultrasound

U2 - 10.1093/trstmh/traa009

DO - 10.1093/trstmh/traa009

M3 - Article

SN - 0035-9203

VL - 114

SP - 315

EP - 322

JO - Transactions of the Royal Society of Tropical Medicine and Hygiene

JF - Transactions of the Royal Society of Tropical Medicine and Hygiene

IS - 4

ER -

A cross-sectional study of periportal fibrosis and Schistosoma mansoni infection amongst school aged children in a hard-to-reach area of Madagascar

Abstract

Keywords

UN SDGs

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