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[Survey on newly-developed advanced schistosomiasis patients in schistosomiasis transmission-interrupted areas].

OBJECTIVE
To understand the status of newly-developed advanced schistosomiasis patients in schistosome transmission-interrupted areas.


METHODS
The newly diagnosed advanced schistosomiasis patients confirmed by professionals at province and county levels according to the available standards were investigated. Their detailed epidemiology history and present signs/ symptoms were surveyed, and the relevant medical examinations were performed.


RESULTS
There were 75 patients including 22 males and 53 females. The average age was (70.0 +/- 7.0) years and they were all infected with schistosome previously. They received anti-schistosome therapy (mean 1.85 times) and stool examinations (mean 26.24 times) continuously from 1976 to 1985, and the results of stool examination were all negative. In majority of the patients' resident areas, the last time that Oncomelania hupensis snails were found was 1976, and the latest was 1983. During this period, no patients were up to the diagnostic criteria of advanced schistosomiasis after multiple examinations, and they were diagnosed as advanced cases between 2008 and 2011. The survey indicated that liver fibrosis was found in all the patients with 82.7% showing grad III pathological change, 90.7% of them had splenomegaly, 20.0% had ascites, and 22.7% had portal vein broadening. The mean value of enzyme indexes of liver function was 31.81 U/L (ALT), 53.19 U/L (AST) and 89.28 U/L (gamma-GT), and the positive rate was 21.3%, 49.3% and 57.3%, respectively. As for the fibrosis indexes, the positive rate of HA, LN, C VI and P III P was 73.3%, 13.3%, 17.3% and 9.3%, respectively, and the mean value of HA was 3 times higher than that of the upper limit of normal standard. Conclusions Newly-developed advanced schistosomiasis patients are those who were dignosed and cured parasitologically but progressed pathologically without any chance of re-infection. Anti-fibrosis therapy is necessary as the patients show considerable progressive liver fibrosis.