Publications
Predictive ultrasonographic criteria for portal hypertension due to Schistosoma mansoni in a recently established endemiz zone
Bonnard P, Lanuit R, Dompnier JP, Remoue F, Diop A, Ly A, Capron A, Riveau G.
Médecine tropicale: revue du corps de santé coloniale, 2000, 60(1):42-6 (PMID : 10989786)
The first cases of Schistosoma mansoni infection were reported in the Senegal River Basin ten years ago. Today endemicity is so high that prevalence rates exceed 90 p. 100 in some areas. Schistosomiasis sometimes goes undiagnosed until the occurrence of portal hypertension with rupture of esophageal varices. Endoscopy is the gold standard for detection of esophageal varices but it is impractical in remote areas. Ultrasonography has been proposed as a non-invasive alternative. The purpose of this study is to describe the results of simultaneous endoscopic and ultrasonographic assessment in 101 subjects from the Richard-Toll area of the Senegal River Basin. Findings showed that severe forms of schistosomiasis complicated by portal hypertension were already present in the region less 10 years after description of the first case. This study also proposes a diagnostic score for portal hypertension based on ultrasonographic findings. The features included in this score are thickening of portal vessel walls, portal vessel diameter, and collapsed appearance of the splenic vein during inspiration. In our hands this score allowed reliable prediction of the development of esophageal varices. Ultrasonography is a good tool for identifying severe forms of schistosomiasis. It should be useful for routine screening in recently established endemic zones.
Digestive and hepatic signs of schistosomiasis
Bonnard P, Kalach N, Cadranel JF, Remoué F, Riveau G, Capron A.
Gastroentérologie clinique et biologique, 2000, 24(4):409-19 (PMID : 10844286)
Specificity of circulating antigen detection for schistosomiasis mansoni in Senegal and Burundi.
Polman K, Diakhate MM, Engels D, Nahimana S, Van Dam GJ, Falcão Ferreira ST, Deelder AM, Gryseels B.
Tropical Medicine and International Health, 2000, 5(8):534-7 (PMID : 10995094)
The specificity of schistosome circulating antigen detection was determined in negative individuals from two S. mansoni- endemic countries, Senegal and Burundi, and compared with results from Dutch control individuals. A nearly absolute specificity was achieved for circulating anodic antigen (CAA) detection in serum, irrespective of the target population or sample pretreatment method. Circulating cathodic antigen (CCA) detection in serum and urine resulted in a lower specificity than serum CAA detection. Apparent large differences in specificity of CCA detection between countries were mainly due to pretreatment methods. Apparently, the alkaline/heating pretreatment method is not as effective as trichloroacetic acid (TCA)-pretreatment in removing (certain) interfering components, which may vary between populations. In view of the development of the urine CCA assay into a noninvasive screening test, a slightly lower specificity may still be acceptable. For precise epidemiological analyses the highly specific serum CAA assay remains the method of choice.
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