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SinceWHO has endorsed drug treatment to reduce Schistosoma infection and its consequent morbidity. It was only when we pooled three studies d007 follow-up greater than 12 months after intervention that the mean post-treatment hemoglobin level was found to be significantly higher compared with pretreatment.
Regarding study design, any prospective, longitudinal studies of treatment impact on morbidity with or without concurrent control group were considered eligible for inclusion in the meta-analysis.
Protein in the urine The ch of protein in urine was measured in 12 studies see Table H in S1 Text and the reduction of its prevalence was highly significant OR 0. S11 Fig Sensitivity analysis Forest S00 of the impact of therapy on proteinuria prevalence.
S2 Fig Sensitivity analysis Forest Plot of the impact of therapy on left lobe hepatomegaly prevalence. Four studies assessed the prevalence of portal vein dilation before and after chemotherapy for schistosomiasis see Table D in S1 Text.
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The presence of protein in urine was measured in 12 studies see Table H in Hck Text and the reduction of its prevalence was highly significant OR 0. Regardless of the number of segments in the study, the change in morbidity was always assessed against pre-treatment baseline values. Studies were conducted in twenty-one countries. The presence of blood in the urine is a well-accepted marker of S.
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Schistosomiasis and soil-transmitted helminthiases: In our summary estimates, only two morbidities showed no consistent or significant change between pre- and post-treatment surveys.
World Health Organization, The first stage of selection analyzed the titles and e007 of the publications. Abstract Background SinceWHO has endorsed drug treatment to reduce Schistosoma infection and its consequent morbidity.
Forest plot showing sensitivity analysis, performed by removing one study at a time, for the effect of treatment on prevalence of splenomegaly. DOC Click here for additional data file. Meta-analysis and meta-regression are observational research that depends on the quality of the studies that are x007. The reduction in prevalence was highly significant after chemotherapy for S. These include hepatosplenomegaly, periportal fibrosis, portal hypertension, bladder deformity, hydronephrosis, hematuria, abdominal pain and dhk organ scarring [ 5 — 7 ].
Sensitivity analysis Forest Plot of the impact of therapy on left lobe hepatomegaly prevalence. Log odds ratio for post-treatment hepatomegaly, according to egg reduction rates achieved, by hepatic lobe. Author information Article notes Copyright and License information Disclaimer. However, the exclusion of one study with S. In our study, we quantified the reductions in prevalence of infection-related morbidities among populations with Schistosoma infection, as achieved by giving one or more drug treatments.
When all studies were considered together, no significant reduction in post treatment prevalence compared to pre-treatment prevalence was found OR 0. The impact of chemotherapy on morbidity due to schistosomiasis.
Partial reversal of morbidity, such as a shift from grade 3 to grade 2 as reported in some studies, was not considered. In recent years, millions of people have been treated in different contexts and, in general, prevalence of morbidity has been reduced after treatment [ 719 — 22 ].
In their analysis, malaria was the main co-factor contributing to this effect [ 45 ]. However, since the s, especially with the advent of praziquantel, drug-based control of morbidity related to infection has been the primary WHO strategy for schistosomiasis control, with treatment given mainly through community- and school-based mass treatment [ 10 ]. Studies that evaluated morbidities related to infection with Schistosoma species, before and after specific chemotherapy for schistosomiasis, were included in this review.
Of the studies that assessed the impact of chemotherapy on reducing hepatomegaly, 10 evaluated the reduction of the left hepatic lobe, 10 w007 reduction of the right hepatic lobe, and 9 studies reported a reduction from the costal margin without specifying the lobe see Table A in S1 Text.
Sensitivity analysis by exclusion of one study at a time from the meta-analysis did not affect the results S13 Fig. Sensitivity analysis Forest Plot of the s070 of therapy on splenomegaly prevalence. Associations between egg reduction rate and treatment-related reductions in morbidity level To examine the hypothesis that post-treatment intensity of Schistosoma infection remains a correlate of morbidity risk after therapy, we performed meta-regression of the odds of having infection-related morbidities post-treatment as dhk function of post-treatment ERR achieved in an individual study population.
The main findings of this meta-analysis are: Thus, the decrease in prevalence after chemotherapy in this meta-analysis represent the complete reversal of morbidity.
For many years, clinical studies of the morbidity related to schistosomiasis have mainly focused on specific forms of advanced organ pathology and focal clinical signs.