Schistosomiasis mansoni in Kenya: relationship between infection and anaemia in schoolchildren at the community level.

Abstract

Haematological surveys were carried out in 3 schools in 2 areas where Schistosoma mansoni is endemic in Machakos District, Kenya, before and after a treatment campaign using praziquantel. Earlier clinical impressions of differences in the levels of anaemia between the 2 areas were not confirmed. Although individual haemoglobin levels and haematocrits often fell below international norms, significant anaemia with abnormal red blood cell morphology was rare (< 5%), but varied between schools. Altitude could have accounted for some of these differences, but other factors, including diet and parasitism, were involved. Anaemia was associated with splenomegaly and, to a lesser extent, hepatosplenomegaly. Epidemic malaria (mainly Plasmodium falciparum) appeared to be the main cause of parasite-induced anaemia. There was no significant association with the scarce hookworm infections (mainly Necator americanus); nor did the much commoner S. mansoni cause severe anaemia at the community level, but haemoglobin levels dropped as its intensity increased. Treatment with praziquantel eliminated this trend except in a few subjects with splenomegaly alone (probably due to malaria) or with schistosomal hepatosplenic disease. Possible pathogenic mechanisms are reviewed, including the consumption of red blood cells by adult schistosomes as a possible cause of anaemia.

• Authors: R F Sturrock, H C Kariuki, F W Thiongo, J W Gachare, B G Omondi, J H Ouma, G Mbugua, A E Butterworth
• Journal: Transactions of the Royal Society of Tropical Medicine and Hygiene (Trans R Soc Trop Med Hyg) 1996 Jan-Feb Vol. 90 Issue 1 Pg. 48-54 ISSN: 0035-9203 [Print] England
• PMID: 8730312 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antiplatyhelmintic Agents
• Hemoglobins
• Praziquantel

Topics

• Adolescent
• Anemia (blood, complications, epidemiology)
• Antiplatyhelmintic Agents (therapeutic use)
• Child
• Child, Preschool
• Erythrocyte Indices
• Erythrocytes (pathology)
• Female
• Hematocrit
• Hemoglobins (analysis)
• Hookworm Infections (blood, complications, epidemiology)
• Humans
• Kenya (epidemiology)
• Malaria (blood, complications, epidemiology)
• Male
• Praziquantel (therapeutic use)
• Schistosomiasis mansoni (blood, complications, drug therapy, epidemiology)
• Splenomegaly (complications)