Fulford A J, Mbugua G G, Ouma J H, Kariuki H C, Sturrock R F, Butterworth A E
Department of Pathology, University of Cambridge, UK.
Trans R Soc Trop Med Hyg. 1991 Jul-Aug;85(4):481-8. doi: 10.1016/0035-9203(91)90229-r.
The relationship between intensity of Schistosoma mansoni infection and the degree of related morbidity was suspected to differ locally within the Machakos district of Kenya. To test this possibility, prevalences of hepatomegaly and splenomegaly among 1483 school children were compared between 2 areas, Kangundo and Kambu, within this district. These areas, which were similar in many geographical and economic respects and populated by the same tribe (Akamba), had comparable levels of S. mansoni infection and no S. haematobium infection. A relationship was observed between the prevalence of hepatomegaly and intensity of S. mansoni infection, which showed no consistent difference between the 2 areas. In contrast, a relationship between the prevalence of splenomegaly and intensity of S. mansoni infection was observed only in the Kambu schools, and not in the Kangundo schools where the overall prevalence of splenomegaly was much lower. It was possible that part of the splenomegaly observed in Kambu was due to malaria. However, the observation that malaria and schistosomiasis in 2 Kambu schools were not positively correlated allowed approximations to be made of the relative contributions of each to the prevalence of splenomegaly. It was concluded that, in a school close to the river that formed the main transmission site of S. mansoni, schistosomiasis-related hepatosplenomegaly was present in at least 17% of children. The reason for the high prevalence in Kambu of hepatosplenic schistosomiasis remains uncertain, but it could include a synergistic interaction of schistosome infection with malaria.
在肯尼亚马查科斯区，人们怀疑曼氏血吸虫感染强度与相关发病程度之间的关系在当地存在差异。为了验证这种可能性，对该地区康贡多和坎布两个区域的1483名学童的肝肿大和脾肿大患病率进行了比较。这两个区域在许多地理和经济方面相似，且由同一部落（阿坎巴族）居住，曼氏血吸虫感染水平相当，且无埃及血吸虫感染。观察到肝肿大患病率与曼氏血吸虫感染强度之间存在关联，且两个区域之间没有一致的差异。相比之下，仅在坎布的学校中观察到脾肿大患病率与曼氏血吸虫感染强度之间的关系，而在脾肿大总体患病率低得多的康贡多学校中未观察到这种关系。坎布观察到的部分脾肿大可能是由疟疾引起的。然而，坎布两所学校中疟疾和血吸虫病没有正相关这一观察结果，使得可以对二者对脾肿大患病率的相对贡献进行近似估算。得出的结论是，在靠近形成曼氏血吸虫主要传播地点的河流的一所学校中，至少17%的儿童存在与血吸虫病相关的肝脾肿大。坎布肝脾血吸虫病患病率高的原因尚不确定，但可能包括血吸虫感染与疟疾的协同相互作用。
