Johansen M V, Simonsen P E, Butterworth A E, Ouma J H, Mbugua G G, Sturrock R F, Orinda D A, Christensen N O
Danish Bilharziasis Laboratory, Charlottenlund.
Acta Trop. 1994 Oct;58(1):21-8. doi: 10.1016/0001-706x(94)90118-x.
The association between Schistosoma mansoni infection and kidney lesions was investigated in school children selected from three primary schools in Machakos District, Kenya, namely Miu (n = 159), Kitengei (n = 160) and Misuuni (n = 99) schools. The children were examined parasitologically for S. mansoni infection, clinically for enlargement of the liver and spleen, and biochemically for proteinuria and serum and urine creatinine. High prevalences of S. mansoni infection, ranging from 84-96%, were seen in all the schools, but the geometric mean intensity of egg excretion varied, being relatively low in Misuuni (31 eggs/g), medium in Miu (182 eggs/g) and high in Kitengei (413 eggs/g). The prevalence of pathological proteinuria (> or = 200 mg/l) in the schools ranged from 10.1% in Miu to 28.8% in Kitengei. No difference in the levels of proteinuria was noted between age or sex groups. No association between intensity of infection and pathological proteinuria was observed in any of the schools, nor was any correlation between organomegaly and proteinuria observed. However, significant correlations between malaria and organomegaly (p < 0.001) and between malaria and proteinuria (p < 0.05) were observed when pooling data from all schools. These findings suggest that S. mansoni induced nephrotic syndromes are not common in children from this highly endemic area of Kenya.
在肯尼亚马查科斯区三所小学（即缪伊小学（n = 159）、基滕盖伊小学（n = 160）和米苏尼小学（n = 99））选取的学童中，对曼氏血吸虫感染与肾脏病变之间的关联进行了调查。对这些儿童进行了曼氏血吸虫感染的寄生虫学检查、肝脏和脾脏肿大的临床检查以及蛋白尿、血清肌酐和尿肌酐的生化检查。所有学校曼氏血吸虫感染的患病率都很高，在84%至96%之间，但虫卵排泄的几何平均强度有所不同，米苏尼小学相对较低（31个虫卵/克），缪伊小学中等（182个虫卵/克），基滕盖伊小学较高（413个虫卵/克）。各学校病理性蛋白尿（≥200毫克/升）的患病率在缪伊小学为10.1%，在基滕盖伊小学为28.8%。年龄组或性别组之间在蛋白尿水平上没有差异。在任何一所学校中，均未观察到感染强度与病理性蛋白尿之间存在关联，也未观察到器官肿大与蛋白尿之间存在任何相关性。然而，当汇总所有学校的数据时，观察到疟疾与器官肿大之间存在显著相关性（p < 0.001）以及疟疾与蛋白尿之间存在显著相关性（p < 0.05）。这些发现表明，在肯尼亚这个高度流行地区的儿童中，曼氏血吸虫诱发的肾病综合征并不常见。
