THE USE AND LIMITATIONS OF ULTRASONOGRAPHY IN THE DIAGNOSIS OF LIVER MORBIDITY ATTRIBUTABLE TO SCHISTOSOMA-MANSONI INFECTION IN COMMUNITY-BASED SURVEYS

The objective of this population-based study was to estimate the liver morbidity attributable to Schistosoma mansoni infection by ultrasonog raphy adopting the proposed standard protocols of the Cairo Meeting on Ultrasonography, 1991. We examined 2384 individuals representing 20% of the households of the rural population of the Ismailia Governorate, East of Delta, Egypt. Prevalence of S. mansoni and S. haematobium inf ections were 40.3% and 1.7% respectively. Portal tract thickening (PTT ) grade 1, 2 and 3 considered diagnostic of schistosomal liver morbidi ty was detected in 35.1%, 1.3 and 0.2 individuals respectively. Genera lly, ultrasonographically detected pathological changes increased with age, but correlated with intensity of infection only in age group 20- 59 years. Comparing individuals with and without S. mansoni infections in an endemic and a non-endemic community indicated no significant di fference between the former and the latter in either case. In conclusi on: ultrasonography had a limited value in estimating schistosomal liv er morbidity in our population-based study where early grades of liver morbidly were prevalent. The criteria of diagnosing grade I portal fi brosis need to be revised as well as the staging system proposed by th e Cairo Meeting on ultrasonography in schistosomiasis.