Ultrasound evaluation of schistosomiasis-related morbidity among the Xakriabá people in the state of Minas Gerais, Brazil

• Published in: Radiologia brasileira Vol. 53; no. 1; pp. 7 - 13
• Main Authors: Marinho, Carolina Coimbra, Nicolato, Aline Joice Pereira Gonçalves, Reis, Vivian Walter, Dos Santos, Rosiane Cristina, Silva, Jaime Costa, Faria, Henrique Pereira, Machado-Coelho, George Luiz Lins
• Format: Journal Article
• Language: English
• Published: Brazil Colégio Brasileiro de Radiologia e Diagnóstico por Imagem 2020; Publicação do Colégio Brasileiro de Radiologia e Diagnóstico por Imagem
• Subjects: Original; RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING; Schistosomiasis mansoni; Population groups; Ultrasonography; Grupos populacionais; Ultrassonografia; Esquistossomose mansoni
• ISSN: 0100-3984; 1678-7099; 1678-7099
• DOI: 10.1590/0100-3984.2019.0047

To use ultrasound to investigate the morbidity related to schistosomiasis in the Xakriabá indigenous population. This was a field-based census study conducted in the territory of the Xakriabá people. A total of 166 individuals were invited, and 148 (≤ 77 years of age) agreed to participate. Most participants underwent abdominal ultrasound, physical examination, and stool examination. Mann-Whitney U and chi-square tests were used for comparisons. We determined risk by calculating odds ratio (OR) and performed logistic regression analysis. eggs were found in 31 (26.7%) of the 116 stool samples examined, 22 (70.9%) of the 31 being from individuals 4-16 years of age. The median count was 144 eggs/g of feces (interquartile range, 264). Of the 105 participants examined with ultrasound, 68 (64.8%) had hepatomegaly (left lobe), 6 (5.7%) had splenomegaly, and 4 (3.8%) had portal hypertension. Egg-positive stool samples were more common in those with an enlarged left lobe (OR = 3.4; 95% confidence interval (CI): 1.1-11.2; = 0.043). Periportal fibrosis was found in 30 participants (28.6%), of whom 9 (30%) had pattern C, 10 (33.3%) had pattern D, and 11 (36.7%) had pattern Dc. Age was the only independent risk factor for fibrosis ( = 0.007). Fibrosis was up to nine-fold more common in alcohol drinkers than in nondrinkers (OR = 9.28; 95% CI: 2.60-33.06; < 0.001). Among the 138 participants in whom the clinical form was classified, the chronic hepatic form was identified in 54 (39.1%), of whom 32 (59.2%) were under 30 years of age and one (1.8%) was hepatosplenic. Schistosomiasis in the Xakriabá population is characterized by a high frequency of egg-positive stool samples, predominantly in children/adolescents, and by chronic hepatic form in the young, especially among alcohol drinkers.