[Value of hepatosplenic ultrasonography in the surveillance of Schistosoma mansoni endemics (a study conducted in the Richard Toll region of Senegal)].

Abdominal ultrasound is a reliable and reproducible technique for monitoring the progression of hepatosplenic schistomiasis. It was used in the framework of the @Hope" program against endemic Schistosoma mansoni in the Senegal River region. A total of 166 patients presenting Schistosoma mansoni eggs in stools were divided into age groups with a sex ratio of 1. All patients underwent the same ultrasound examination including measurement of the liver and assessment of the branches of the portal vein system. Our findings indicated that highly sensitive hypertrophy of the left lobe of the liver occurs early since this feature was observed in all patients over the age of 15 years. Alterations of the portal system were observed in 73% of patients but were moderate, stage 1, in the zone where incidence of positive stools is over 90%. Grade III lesions were only found in patients over 23 years of age. Although these lesions accounted for 4% of the cases, this finding underscores the need for surveillance in a region where infestation became endemic less then ten years ago raising fears that severe schistosomal portal hypertension would become widespread. A mobile ultrasonographic surveillance unit would be useful in the region.