GASTROINTESTINAL MANIFESTATIONS OF THE INITIAL PHASE OF SCHISTOSOMIASIS-MANSONI

Clinical gastro-intestinal manifestations were studied in 34 patients in the initial phase of schistosomiasis mansoni. The patients, all men , were of similar age and in similar nutritional condition and had bee n infected simultaneously at the same transmission site. Most (85%) sh owed some gastro-intestinal sign or symptom, generally of light or mod erate intensity; 56% had liquid or pasty diarrhoea, 41% abdominal pain , 29% hepatomegaly, 21% dysentery, 15% anorexia, 12% pain on colon pal pation and 9% nausea and/or vomiting. High worm burden was associated with blood in faeces but apparently not with any other clinical manife station. There was no apparent association between any clinical manife station and peripheral-blood eosinophil counts or titres of IgE specif ic for Schistosoma mansoni (evaluated by the area of immediate intrade rmal reaction to injected adult worm antigen). The absence of associat ion between worm burden and nearly all the clinical gastro-intestinal manifestations strengthens the concept that factors other than worm bu rden, such as host reactivity, constitute important pathogenetic eleme nts in the initial phase of schistosomiasis mansoni.