Abstract
The levels of IgE and IgG4 increased strongly between cohorts, indicating a dynamic immunological situation, but no immediate impact on infection levels. Morbidity was little specific abdominal discomfort was reported by 61%, diarrhoea by 33% of the subjects; mild hepatomegaly was found in 16%, splenomegaly in 0.5%. No relation to egg counts was observed for any symptom. This mild morbidity may be due to the recent nature of the focus. In the first cohort, the percentage of people with negative egg counts ten weeks after treatment was only 18%, though egg counts declined strongly. Antigen detection confirmed these results. Praziquantel treatment provoked transient but impressive side effects (colics, vomiting, urticaria, aedema), the occurrence of which correlated with intensity of infection. Cure rates in subsequent cohorts were followed up shorter after treatment but remained low. Reinfection nevertheless oppears limited. This lower drug efficacy may be due to very rapid reinfection and/or to the lack of immunity in the population, but also reduced susceptibility of the local parasite strain must be considered and studied.
Schistosoma mansoni; immunology; epidemiology; morbidity; chemotherapy; praziquantel; Senegal
Immuno-epidemiology of Schistosoma mansoni infections in a recently exposed community in Senegal
B. Gryseels1
F. Stelma1
I. Talla2
K. Polman1
G. Van Dam1
S. Sow2
M. Diaw3
R. F. Sturrock4
C. Decam2
M. Niang2
A. M. Deelder1
University of Leiden, Medical Faculty, Department of Parasitology, Leiden, Netherlands
Centre de Santé de Richard Toll, Richard Toll, Senegal
Institu Supérieur de Recherche Medicine, DService de Parasitologie, Dakar, Senegal
London School of Hygiene and Tropical Medicine, Dept of Parasitology, London, UK
The levels of IgE and IgG4 increased strongly between cohorts, indicating a dynamic immunological situation, but no immediate impact on infection levels. Morbidity was little specific abdominal discomfort was reported by 61%, diarrhoea by 33% of the subjects; mild hepatomegaly was found in 16%, splenomegaly in 0.5%. No relation to egg counts was observed for any symptom. This mild morbidity may be due to the recent nature of the focus. In the first cohort, the percentage of people with negative egg counts ten weeks after treatment was only 18%, though egg counts declined strongly. Antigen detection confirmed these results. Praziquantel treatment provoked transient but impressive side effects (colics, vomiting, urticaria, aedema), the occurrence of which correlated with intensity of infection. Cure rates in subsequent cohorts were followed up shorter after treatment but remained low. Reinfection nevertheless oppears limited. This lower drug efficacy may be due to very rapid reinfection and/or to the lack of immunity in the population, but also reduced susceptibility of the local parasite strain must be considered and studied.
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Publication Dates
-
Publication in this collection
01 June 2009 -
Date of issue
Apr 1995