ABDOMINAL ULTRASONOGRAPHY FOR ASSESSING MORBIDITY FROM SCHISTOSOMIASIS .1. COMMUNITY STUDIES

Portable abdominal ultrasonography has been used to measure community morbidity from schistosomiasis in schoolchildren and cross-sectional p opulation samples and to assess efficacy of chemotherapy. Periportal f ibrosis and hepatosplenomegaly have been common findings, usually asso ciated with each other and with prevalence and intensity of infection as measured by faecal Schistosoma mansoni ova excretion. Similar, less severe, lesions have been noted in subjects infected with S. haematob ium. Inhabitants of villages where praziquantel therapy was systematic ally provided had less periportal fibrosis and hepatosplenomegaly than those living in nearby villages where treatment was not available. Co mmunity-based screening in S. haematobium endemic areas has shown high prevalence of bladder wall thickening, irregularities, and polyps whi ch were usually more frequent and severe in children and in those excr eting most ova. Obstructive uropathy was frequent in most studies. Che motherapy usually rapidly resolved the bladder wall abnormalities. In some studies hydronephrosis and hydroureter were more persistent. Reve rsibility of chronic, stable lesions in adults remains unproven.