A quantitative post mortem analysis of urinary schistosomiasis in Egypt. II. Evolution and epidemiology.

The American Journal of Tropical Medicine and Hygiene
J H SmithF von Lichtenberg

Abstract

Further analysis of the data obtained from 190 unselected autopsies at the University of Cairo (Faculty of Medicine) hospitals reinforces our conclusion that a high prevalence of urinary schistosomiasis leads to infection intensity causing severe uropathy and mortality, both directly and by way of complications and sequelae. Based on histological study, two stages of urinary schistosomiasis must be considered in epidemiological work: "active disease", characterized by significant egg excretion; and "inactive disease", in which eggs are excreted rarely. The proportion between active and inactive cases is progressively reversed with advancing age, while mean tissue egg burdens rise, plateau, and ultimately decrease, most sharply beyond 50 years of age. A model of the progression of active disease has been derived from the relations of individual organ egg burdens to overall infection intensity, showing that both the onset and the termination of oviposition probably begin in the urinary bladder and spread centrifugally. Therefore, extravesical activity may persist longer than bladder activity. Severe uropathy and mortality occur at all stages of the disease and depend principally, but not exclusively, on egg burden, i.e., on infec...Continue Reading

Citations

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