Health implications of chronic hepatosplenomegaly in Kenyan school-aged children chronically exposed to malarial infections and Schistosoma mansoni
Open Access
- 28 February 2010
- journal article
- Published by Oxford University Press (OUP) in Transactions of the Royal Society of Tropical Medicine and Hygiene
- Vol. 104 (2), 110-116
- https://doi.org/10.1016/j.trstmh.2009.08.006
Abstract
Hepatosplenomegaly among school-aged children in sub-Saharan Africa is highly prevalent. Two of the more common aetiological agents of hepatosplenomegaly, namely chronic exposure to malaria and Schistosoma mansoni infection, can result in similar clinical presentation, with the liver and spleen being chronically enlarged and of a firm consistency. Where co-endemic, the two parasites are thought to synergistically exacerbate hepatosplenomegaly. Here, two potential health consequences, i.e. dilation of the portal vein (indicative of increased portal pressure) and stunting of growth, were investigated in a study area where children were chronically exposed to malaria throughout while S. mansoni transmission was geographically restricted. Hepatosplenomegaly was associated with increased portal vein diameters, with enlargement of the spleen rather than the liver being more closely associated with dilation. Dilation of the portal vein was exacerbated by S. mansoni infection in an intensity-dependent manner. The prevalence of growth stunting was not associated with either relative exposure rates to malarial infection or with S. mansoni infection status but was significantly associated with hepatosplenomegaly. Children who presented with hepatosplenomegaly had the lowest height-for-age Z-scores. This study shows that hepatosplenomegaly associated with chronic exposure to malaria and schistosomiasis is not a benign symptom amongst school-aged children but has potential long-term health consequences.Keywords
This publication has 29 references indexed in Scilit:
- Hepatosplenomegaly Is Associated with Low Regulatory and Th2 Responses to Schistosome Antigens in Childhood Schistosomiasis and Malaria CoinfectionInfection and Immunity, 2008
- Age-adjusted Plasmodium falciparum antibody levels in school-aged children are a stable marker of microgeographical variations in exposure to PlasmodiuminfectionBMC Infectious Diseases, 2007
- Boys are more stunted than girls in Sub-Saharan Africa: a meta-analysis of 16 demographic and health surveysBMC Pediatrics, 2007
- Detailed clinical and ultrasound examination of children and adolescents in a Schistosoma mansoni endemic area in Kenya: hepatosplenic disease in the absence of portal fibrosisTropical Medicine & International Health, 2004
- Associations between Anti–Schistosoma mansoniand Anti–Plasmodium falciparumAntibody Responses and Hepatosplenomegaly, in Kenyan SchoolchildrenThe Journal of Infectious Diseases, 2003
- Nutritional status of children with schistosomiasis mansoni in two different areas of Machakos District, KenyaTransactions of the Royal Society of Tropical Medicine and Hygiene, 1992
- Differences in the rate of hepatosplenomegaly due to Schistosoma mansoni infection between two areas in Machakos District, KenyaTransactions of the Royal Society of Tropical Medicine and Hygiene, 1991
- Anthropometric Measures in Relation to Schistosomiasis Mansoni and Socioeconomic VariablesInternational Journal of Epidemiology, 1988
- Asymptomatic malaria infections — Do they matter?Parasitology Today, 1987
- The epidemiology and consequences of Schistosoma mansoni infection in West Nile, Uganda: I. Field studies of a community at PanyagoroTransactions of the Royal Society of Tropical Medicine and Hygiene, 1972