Abstract

EPIDEMIOLOGICAL, CLINICAL AND THERAPEUTIC ASPECTS OF HEPATIC SCHISTOSOMIASIS AT THE UNIVERSITY HOSPITAL OF TAMBOHOBE FIANARANTSOA MADAGASCAR

Mamisoa Anicet Rakotovao, Tojo Rémi Rafaralahivoavy*, Mampionona Ranaivomanana, Lova Dany Ella Razafindrabekoto, Rija Fanantenantsoa, Ralaivelo
Langelot, Rivo Andry Rakotoarivelo, Mamiarisoa Rabarijaona and Soloniana Hélio Razafimahefa

Abstract

Background: Hepatic schistosomiasis is a severe clinical form of Schistosoma mansoni infection. It is one of the main causes of portal hypertension and it is responsible of high morbidity and mortality. The aim of this study was to describe the epidemiological, clinical and therapeutic aspects of hepatic schistosomiasis. Patients and methods: A retrospective study has been conducted during 5 years, including 1137 patients with liver schistosomiasis at the University Hospital of Tambohobe Fianarantsoa. Results: The mean age was 37.90 years. Medical history revealed gastrointestinal bleeding in 10.29 %. Splenomegaly associated with portal hypertension syndrome were the main clinical sign. The majority of patients (72.03%) received an antiparasitic drug, praziquantel. The surgical treatment was splenectomy in 3.51 %. Mortality was 0.52%, mainly due to hemorrhagic recurrence. Conclusion: Liver schistosomiasis is common in the University Hospital of Tambohobe Fianarantsoa and mainly affects young adults. A therapeutic combination of praziquantel and propranolol reduces the mortality rate. Splenectomy would reduce the risk of recurrent bleeding.

Keywords: gastrointestinal bleeding, hepatic schistosomiasis, Schistosoma mansoni, splenomegaly.