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
Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
Universidade Federal de Ouro Preto (UFOP), Ouro Preto, MG, Brazil.
Radiol Bras. 2020 Jan-Feb;53(1):7-13. 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.
利用超声调查沙克里亚巴族原住民中与血吸虫病相关的发病率。
这是一项在沙克里亚巴族领地开展的基于现场的普查研究。共邀请了166人，148人（年龄≤77岁）同意参与。大多数参与者接受了腹部超声、体格检查和粪便检查。采用曼-惠特尼U检验和卡方检验进行比较。通过计算比值比（OR）确定风险，并进行逻辑回归分析。
在116份接受检查的粪便样本中，31份（26.7%）发现虫卵，其中31份中的22份（70.9%）来自4至16岁的个体。虫卵计数中位数为144个/克粪便（四分位间距为264）。在105名接受超声检查的参与者中，68人（64.8%）有肝肿大（左叶），6人（5.7%）有脾肿大，4人（3.8%）有门静脉高压。虫卵阳性粪便样本在左叶肿大者中更为常见（OR = 3.4；95%置信区间（CI）：1.1 - 11.2；P = 0.043）。30名参与者（28.6%）发现有门静脉周围纤维化，其中9人（30%）为C型，10人（33.3%）为D型，11人（36.7%）为Dc型。年龄是纤维化的唯一独立危险因素（P = 0.007）。纤维化在饮酒者中的发生率比不饮酒者高9倍（OR = 9.28；95% CI：2.60 - 33.06；P < 0.001）。在138名已分类临床类型的参与者中，54人（39.1%）为慢性肝病型，其中32人（59.2%）年龄在30岁以下，1人（1.8%）为肝脾型。
沙克里亚巴族人群中的血吸虫病特点是虫卵阳性粪便样本频率高，主要见于儿童/青少年，且年轻人中以慢性肝病型为主，尤其是饮酒者。
