Study of schistosomiasis and its relation with some microbes

number: 
804
إنجليزية
Degree: 
Imprint: 
Medicine
Author: 
Maysara Samir Khalif Al-Shujairi
Supervisor: 
Dr.Tariq I. Al-Jeboori
Dr. Layla S. Al-Omar
year: 
2002
Abstract:

Seventy one patients with acute (26), and chronic (45) schistosomiasis , were included in this study . The mean age was 11.38 and 58.27 years, respectively . Patients with acute schistosomiasis were children from an endemic area with the disease The diagnosis of patients with chronic schistosomiasis was based primarily on the history of haematuria, finding calcified ova in the bladder wall by cystoscopy , sonography or histopathological findings. Those patients were attending the University Teaching Hospital of Saddam college of medicine , and Al-Karama Teaching Hospital, during the period from November 2001 to April 2002 . In addition , 40 healthy individuals with a comparable mean age, as a control group . Urine , blood and saliva samples were collected from each subject included in this study. Both general urine examination and nucleopor filtration technique , were used , and revealed the presence of S. haematobium ova in 13 (50%) of 26 urine samples obtained from patients with acute schistosomiasis . This may be due to the fact that most acute patients were under anti-schistosomal therapy , while no Ova were found in urine samples of 45 patients with chronic schistosomiasis, and 40 control group. The incidence of acute and chronic schistosomiasis in males were significantly ( p < 0.05 ) higher 63 ( 88.7 % ) than the females , 8(11.3%). This may be due to the fact that females are more confined to house work, where as males work in farms and usually exposed to the contaminated water. Most patients with schistosomiasis were living or had lived in a rural area endemic with this disease , or worked as fanners and swimmed in contaminated water streams . Patients with chronic schistosomiasis showed a significant difference in urinary bacterial infection compared to that of the acute form ( 84.4% ) and ( 30.8% ), respectively . E . coli was the predominant bacteria isolated from both groups of the study, and the least common one was Proteus spp in acute cases , and Pseudomonus spp in chronic ones .The difference in the secondary bacterial infection between acute and chronic may be due to the fact, that the acute group were under treatment, and also secondary bacterial infection is the most common complication of chronic schistosomiasis . S.typhi was isolated from only one ( 2.6 % ) urine of a chronic patient .However , Widal test was performed to find out the association of chronic schistosomiasis with Salmonella ,and 28 ( 62.2 % ) of 45 sera of patients were positive for S. typhi and S. paratyphi B antibodies , the majority of sera, their titers were between 1/160 - 1/320 . Using adult worm antigens of S.haematobium , the ELISA technique was applied on sera of both the acute and chronic schistosomiasis and gave a sensitivity of 96% and 95.5%, respectively. However, using ELISA on saliva to detect IgA antibodies of patients with chronic schistosomiasis, the sensitivity was (66.7%), and its statistically significant as compared with the control group (P<0.05). The current study , also demonstrated that , there was an association between chronic and acute schistosomiasis with HBV (20%; 7.7%, respectively) .The proportional rate of anti - HCV was found to be (3.8% ) and (4.4%) , among patients with acute and chronic schistomiasis, respectively .However, only one (2.5) case with HCV infection in the control group was positive. Also the result showed that there was an association between exposure to parenteral route as a risk factor, and the development of both HCV and HBV infection . Furthermore, our results showed that there was a significant association (PO.05) between development of HCV with blood transfusion and surgical operations as a risk factor, however the dentist visit was with HBV. In addition, our data showed that both HBV and bacterial urinary tract infection were found in both acute and chronic cases (3.8% and 20%, respectively) (4.4%) of patients with chronic schistosomiasis showed both HCV and bacterial infection. Furthermore, the coexistence of both hepatitis viruses (HCV and HBV) was not observed in both groups.