Authors

C Fall²; S Lambert³; E Leger³; L Yasenev⁴; A Garba¹; SD Diop⁵; ND Diouf⁷; SA Sarr⁶; B Faye⁶; M Walker³; M Sene⁷; JP Webster³;  ¹ RISEAL (Reseau International Schistosomoses Environnements Amenagements et Lutte), Niger;  ² Cheikh Anta Diop University, Senegal, Senegal;  ³ Centre for Emerging, Endemic and Exotic Diseases, Department of Pathobiology and Population Sciences, Royal Veterinary College, UK;  ⁴ London Centre for Neglected Tropical Disease Research (LCNTDR), Faculty of Medicine, Imperial College, UK;  ⁵ Institut Supérieur de Formation Agricole et Rurale, Université de Thiès, Senegal;  ⁶ Service de Parasitologie—Mycologie, Faculté de Médecine, Pharmacie et Odontologie, Université Cheikh Anta Diop, Senegal;  ⁷ Unité de Formation et de Recherche des Sciences Agronomiques, d’Aquaculture et de Technologies Alimentaires, Université Gaston Berger, Senegal

Discussion

Background

Schistosomiasis is a major neglected tropical disease. Across West Africa, co-infections between human urogenital Schistosoma haematobium and human intestinal Schistosoma mansoni, as well as infections with viable hybrids between human urogenital S. haematobium and intestinal livestock Schistosoma bovis are prevalent. Morbidity profiles are known to be influenced by mixed S. haematobium with S. mansoni coinfections, but the impact of S. haematobium-S. bovis hybrid infection on morbidity remains unknown.

Methods Dans trois region au senengal Dakar zone temoin

Two surveys were conducted from May to August 2016 and from October 2017 to January 2018 Across three regions in Senegal (Richard Toll/ Barkedji/Dakar) in children (n=1326) and adults (n=304). Morbidity indicators of intestinal and urogenital schistosomiasis, measured using ultrasound of the liver and urogenital tract, anaemia and haematuria profiles, were assessed for each individual according to the infecting species combination and intensity. Doppler echocardiography was used to measure the heart chambers. Pulmonary arterial systolic pressure was assessed by tricuspid regurgitation flow (n=250).

Findings

Hepatomegaly was significantly higher, whilst the number of ureter lesions significantly lower in S. haematobium-S. bovis hybrid infections compared to single species S. haematobium infections (controlling for S. mansoni co-infections). Haematuria and lesions of the urogenital tract were positively associated with presence and intensity of S. haematobium or S. haematobium-S. bovis urogenital schistosomiasis. The heart of the school-aged child in endemic area is characterized by larger cavitary dimensions. The average pulmonary systolic arterial pressure was greater in Richard-Toll: 26.38 ± 3.16 mmHg versus 21.82 ± 1.73 mmHg in Dakar (p < 0.001). There was a correletion between pulmonary systolic arterial pressure and presence of hematuria, anemia and parasitological positivity.

Conclusion

The results of our study show the impact of parasite hybridization on bilharzian morbidity, with lesions that can progress to cancer and chronic heart failure. Further studies with larger numbers will be needed to confirm our results.