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Biomedical subjects

M F Abdel-Wahab

Publications and source records attributed to M F Abdel-Wahab.

At least 19 recordsLinked to original sources
PubMed2000

The epidemiology of schistosomiasis in Egypt: methods, training, and quality control of clinical and ultrasound examinations.

Morbidity due to schistosomiasis was evaluated in a subpopulation of 14,000 of the randomized sample in the Epidemiology 1, 2, 3 Project. It was measured by using a standardized questionnaire for obtaining medical history and symptoms and by performing standardized physical and ultrasound examinations. Reported herein are descriptions of the methods and training and quality control efforts made to insure that the morbidity data was reliable and consistent when collected by 7 different teams in 9 different governorates.

Egypt↗
PubMed2000

The epidemiology of schistosomiasis in Egypt: Menofia Governorate.

Health questionnaires and parasitologic examinations of urine and stool were performed upon a stratified random sample of 10,899 individuals from 1,537 households in 27 rural communities in Menofia Governorate in Egypt in 1992 to investigate the prevalence of, risk factors for, and changing pattern of infection with Schistosoma sp. in the governorate. A subset, every fifth household, or 1,480 subjects, had physical and ultrasound examinations to investigate prevalence of and risk factors for morbidity. The prevalence of S. mansoni ranged from 0.3% to 72.9% and averaged 28.5%. The geometric mean egg count was 81.3 eggs/gram of stool. Age-stratified prevalence and intensity of infection was 30-40% and 60-80 eggs/gram of stool from the age of 10 onward; males had higher infection rates and ova counts than females in all age groups > 10 years old. Schistosoma haematobium was rare, being consequential in only 1 community. Risk factors for S. mansoni infection were male gender; age > 10 years; living in smaller communities; exposures to canal water; history of or treatment for schistosomiasis or blood in the stool; detection of splenomegaly by either physical or ultrasound; and ultrasound-detected periportal fibrosis (PPF). The more severe grades of PPF were rarely (21 of 1,450 examinations) detected. Risk factors for morbidity, i.e., ultrasound-detected PPF, were similar to those for infection. Schistosoma mansoni has almost totally replaced S. haematobium in Menofia. The prevalence of S. mansoni in rural communities remains high and average intensities of infection are moderate. The association of morbidity with schistosomal infection was variable and is obviously markedly influenced by both the frequent use of antischistosomal chemotherapy in communities in Menofia and by the prevalence of complications from chronic viral hepatitis in the population: hepatomegaly did not correlate with infection; PPF and splenomegaly, however, were related to S. mansoni infection in both individuals and communities.

Adolescent↗
PubMed2000

The epidemiology of schistosomiasis in Egypt: Fayoum Governorate.

Health questionnaires and parasitologic examinations of urine and stool were performed upon a stratified random sample of 7,710 individuals from 1,109 households in 21 rural communities in Fayoum Governorate, Egypt in 1992 to investigate the prevalence of, risk factors for, and changing pattern of, infection with Schistosoma sp. in the governorate. A subset, every fifth household, or 1,038 subjects, had physical and ultrasound examinations to investigate prevalence of, and risk factors for, morbidity. The prevalence of S. haematobium ranged from 0% to 27.1% and averaged 13.7%. The geometric mean egg count (GMEC) was 10.0 eggs/10 ml of urine. Age-stratified prevalence and intensity of infection were 18-25% and 10-15 eggs/10 ml of urine in those 5-25 years of age. Schistosoma mansoni were detected in inhabitants of 13 communities, but 78.5% of the infections were focally present in a group of 4 satellite hamlets around a single village. The overall prevalence of S. mansoni in the governorate was 4.3% and the GMEC was 44.0 ova/g of stool. Risk factors for infection with either species were male gender, an age <20 years, living in smaller communities, and exposures to canal water by males. Histories of burning micturation, blood in the urine, or prior schistosomiasis and reagent strip-detected hematuria and proteinuria were risks for S. haematobium, but not for S. mansoni. Both urinary tract and higher grades of hepatic morbidity were rare. Obstructive uropathy was present in 6.3% of the subjects and was more common in males and older people. Ultrasonography-detected bladder lesions were present in 5.2% and correlated with S. haematobium only in younger subjects and in those with hematuria and proteinuria. The prevalences of hepatomegaly, splenomegaly, and periportal fibrosis (PPF) were associated with each other and increased with age and in males. Ultrasonography-detected hepatomegaly and splenomegaly were weakly associated with S. mansoni infections only in children. The prevalence of PPF was greater in the 4 communities with >25% S. mansoni infection rates in comparison with the 17 other villages and ezbas. Transmission of S. mansoni is focally well established in Fayoum, which also has the highest prevalence of S. haematobium in the governorates surveyed by the Epidemiology 1, 2, 3 Project. However, both urinary tract and hepatic morbidity are relatively rare in the governorate. This probably results from the long-standing schistosomiasis control program in Fayoum, which suppressed intensity more than prevalence of infection, leading to less community morbidity.

Adolescent↗
PubMed1994

High seroprevalence of hepatitis C infection among risk groups in Egypt.

High prevalence rates of hepatitis C virus (HCV) were recently reported among Egyptian blood donors. To confirm these observations and estimate the magnitude of HCV infection in this country, we determined the prevalence of antibodies to HCV (anti-HCV) in samples collected in 1992 from seven different populations of children and adults living in Egypt. Anti-HCV was found in 12.1% of rural primary schoolchildren, 18.1% of residents of a rural village, 22.1% of army recruits, 16.4% of children with hepatosplenomegaly, 54.9% of hospitalized, multitransfused children, 46.2% of adults on hemodialysis, and 47.2% of adults with chronic liver disease or hepatoma. Age-related prevalence of anti-HCV in a random sample of 270 inhabitants of a rural village increased progressively from zero in those 5-10 years of age to 41% in adults greater than the age of 50. Although the increased prevalence of anti-HCV among children and adults with parenteral exposures and chronic liver disease was expected, the prevalence of anti-HCV among persons representing the general population of Egypt was strikingly high. These data demonstrate the magnitude of HCV infection and its importance in chronic liver disease in Egypt. Future studies are needed to determine the routes of transmission of HCV in this country.

Adolescent↗
PubMed1993

Is Schistosoma mansoni replacing Schistosoma haematobium in the Fayoum?

Schistosoma mansoni is progressively replacing S. haematobium along the Nile River in Egypt. This change has occurred in the past 15-20 years following construction of the Aswan High Dam in the 1960s. The cause is a shift in relative abundance of the snail vectors Biomphalaria alexandrina and Bulinus truncatus. Biomphalaria is increasing while the latter has disappeared from a village in the Fayoum where formerly only schistosomiasis haematobia was endemic. A cross-sectional household survey in this village in 1991 showed the following prevalence values: S. mansoni, 22.3%; S. haematobium, 3.4%; and mixed infections, 2.8%. Only two children less than 10 years of age had S. haematobium infections. A review of the local Ministry of Health records showed that 1) both species were parasitologically diagnosed during the past 7.5 years, 2) Biomphalaria had been abundantly present in the local waterways for the past 10 years and has been found infected with S. mansoni since 1985, 3) Bulinus has not been detected in the local canals and drains since 1986 and the few found between 1981 and 1985 were not infected, and 4) Biomphalaria in this village and in two others in the Fayoum were believed infected by laborers from the Delta who helped build schools in 1984. This change in the distribution of schistosomiasis will impact upon public health and medical practice in Middle and Upper Egypt as it already has in Lower Egypt.

Adolescent↗
PubMed1993

Ultrasonographic prediction of esophageal varices in Schistosomiasis mansoni.

Bleeding from esophageal varices is a common and serious problem in Schistosomiasis mansoni. A simple and accurate method of detection would facilitate measurement of individual and community morbidity and allow institution of preventive measures. An ultrasonographic scoring system grading periportal fibrosis, portal vein diameter, spleen size, and portasystemic anastomoses was evaluated as a predictor of esophageal varices and a past history of upper gastrointestinal hemorrhage in 43 patients with hepatosplenic schistosomiasis. Ultrasonographic variceal score correlated (r = 0.86, p < 0.001) with the endoscopic variceal grade. Patients with a sonographic score of 5 or greater were highly likely (21 of 23) to have varices of grade II or greater (sensitivity, 91.3%; specificity, 94.7%). Only those with sonographic scores of 5 or greater (15 of 23) had bled from esophageal varices. The ultrasonographic score provided a simple, inexpensive, accurate, and noninvasive means of screening individuals with hepatosplenic schistosomiasis for esophageal varices, and correlated strongly with prior gastrointestinal hemorrhage. It is not known whether a similar score would be useful in hepatic cirrhosis.

Adolescent↗
PubMed1992

A review of the literature on the use of ultrasonography in schistosomiasis with special reference to its use in field studies. 1. Schistosoma haematobium.

This review presents an outline of the pathology resulting from Schistosoma haematobium infections, and the ways in which the lesions can be investigated. The use of ultrasonography is covered in detail. Ultrasonography can provide direct information about lesions in internal organs, and thus provide information about patterns of morbidity and about the regression of pathological changes after treatment. The method has the advantages that it is non-invasive, and is also relatively inexpensive and can be used under field conditions. Ultrasonography has already been used in a number of epidemiological studies in areas where S. haematobium is endemic. The method has proved to be feasible and useful. However, the methodology used for ultrasound studies has varied considerably, so that it is difficult to make valid comparisons between results obtained in different places or at different times. A standardized methodology for making observations and recording the results is needed if the full potential benefit of using ultrasound in the monitoring of schistosomiasis control projects is to be realised. The correlation of results obtained using ultrasound with the results of clinical, parasitological and other observations has been investigated in a number of studies, but many questions remain to be answered.

Confounding Factors, Epidemiologic↗
PubMed1992

A review of the literature on the use of ultrasonography in schistosomiasis with special reference to its use in field studies. 2. Schistosoma mansoni.

This review presents an outline of the pathology resulting from Schistosoma mansoni infections, and the ways in which it can be investigated. The use of ultrasonography is covered in detail. Ultrasonography can provide direct information about lesions in internal organs, and thus provide information about patterns of morbidity and about the regression of pathological changes after treatment. The method is non-invasive, and can be used under field conditions. Ultrasonography is valuable for the study of hepatosplenic pathology, to detect lesions such as the development of periportal fibrosis and the enlargement of the portal vein, which can indicate the development of portal hypertension. This may lead to a severe outcome, including bleeding from oesophageal varices, which is a principal cause of death from S. mansoni infection. A problem with the use of ultrasonography is that the mild lesions likely to be observed in population surveys are not always easy to assess. Ultrasonography has already been used in a number of epidemiological studies of S. mansoni infection, and has proved to be feasible and useful. However, the methodology used for ultrasound studies has varied considerably, so that it is difficult to make valid comparisons between results obtained in different places or at different times. A standardized methodology for making observations and recording the results is needed if the full potential benefit of using ultrasound in the monitoring of schistosomiasis control projects is to be realised.

Diagnosis, Differential↗
PubMed1992

Ultrasound for detecting Schistosoma haematobium urinary tract complications: comparison with radiographic procedures.

Chronic infection with Schistosoma haematobium primarily causes urinary tract complications. These lesions are often silent or ignored and not detected until irreversible changes have occurred. However, early chemotherapy can prevent progression and usually reverse all but the more severe abnormalities. Recently, abdominal ultrasound has been shown to be an inexpensive, portable and safe means of detecting schistosomal morbidity. A prospective study was performed on 40 patients comparing abdominal radiography, excretory urography (IVP), cystoscopy and ultrasound to detect urinary tract morbidity due to S. haematobium infection. Ultrasound was as sensitive as an IVP in detecting bladder masses, hydronephrosis and renal stones. It detected hydroureter less frequently (sensitivity 62.5%) than an IVP but visualized this lesion and hydronephrosis in some patients with nonfunctioning kidneys. Ultrasound demonstrated bladder stones as well as an x-ray but it detected bladder wall calcification with less sensitivity (65%) and was much less sensitive (12.5%) for detecting ureteral stones.

Adult↗
PubMed1992

Efficacy of hepatitis B vaccination in primary school children from a village endemic for Schistosoma mansoni.

To determine whether chronic Schistosoma mansoni infection interferes with hepatitis B virus (HBV) immunization, 308 schoolchildren aged 6-12 years with no evidence of prior HBV infection (156 with active schistosomiasis) were vaccinated with three 5-micrograms injections of recombinant DNA-derived HBV vaccine. The vaccine was given in the deltoid muscle at time 0 and 1 and 7 months later. All vaccinees were examined 1 and 3 years after vaccination for quantitative antibody to hepatitis B surface antigen (anti-HBs). Seroconversion was detected in 284 vaccinated children (92%), of whom 271 had a good (51-300 mIU/mL) or excellent (greater than 300 mIU/mL) anti-HBs response. Sixteen other children (5%) had evidence of natural HBV infection (antibody to hepatitis B core antigen). Of those with good or excellent response, 99% retained high antibody titers for 3 years. Response was not influenced by S. mansoni infection. Hepatomegaly and splenomegaly were associated with reduced vaccine response.

Child↗
PubMed1992

Grading of hepatic schistosomiasis by the use of ultrasonography.

Forty-three subjects with pure hepatic schistosomiasis having ultrasonographic assessment of periportal fibrosis were grouped according to the thickness of their portal tracts: grade I = 3-5 mm, grade II = greater than 5-7 mm, and grade III = greater than 7 mm. A history of hematemesis, blood transfusion, sclerotherapy, and lower limb edema correlated with the ultrasonographic grade of periportal fibrosis. With increasing grade, the average liver size was smaller and the average spleen size was larger, as determined by physical examination and by ultrasonography. Abnormalities in serum enzyme levels were more frequent in those with thicker portal tracts. Greater diameters of the portal and splenic veins and ultrasonographically detectable collateral blood vessels were associated with increasing thickness of portal tracts. The grade of endoscopically determined esophageal varices was highly correlated with the grade of periportal fibrosis. We concluded that this method of grading accurately reflects the hemodynamic changes and provides a good estimate of the clinical status of patients who have periportal fibrosis due to schistosomiasis mansoni. Where available, it should replace clinical grading based upon the liver and spleen size as detected by physical examination.

Adult↗
PubMed1989

Characteristic sonographic pattern of schistosomal hepatic fibrosis.

The hepatic sonographic patterns from 50 patients undergoing operations for bleeding esophageal varices were compared with the interpretation of the histological findings in a hepatic wedge biopsy obtained during surgery. The sonographic pattern for schistosomiasis periportal fibrosis is characteristic and is not mimicked by other hepatic diseases we have studied. Sonography agreed with pathology in 44 out of 50 patients. Schistosomiasis could be separated from cirrhosis, as well as from combined lesions. Where there was a discordance, we believe that sonography gave a more accurate diagnosis.

Adult↗
PubMed1988

Hepatobiliary disorders presenting as fever of unknown origin in Cairo, Egypt: the role of diagnostic ultrasonography.

Among 130 patients with fever of unknown origin (FUO) studied from 1981 to 1985, 34 were diagnosed as having hepatobiliary disorders: amoebic liver abscess (11), pyogenic liver abscess (4), hepatic hydatid cysts (2), hepatic fascioliasis (2), tuberculous hepatic granulomas (1), chronic calcular cholecystitis with recurrent cholangitis (2), chronic active hepatitis (2), hepatocellular carcinoma (3), lymphoma involving the liver (4) and hepatic metastasis in (3) cases. Hepatobiliary disorders were the cause in 27% of FUO seen during 4 years.

Adolescent↗
PubMed1984

Clinical characteristics and response to therapy in Egyptian children infected with Schistosoma haematobium.

Forty-one Egyptian students with infections due to Schistosoma haematobium, who were selected by results of a urine screening examination, were evaluated for morbidity and response to chemotherapy. Symptoms associated with infection were hematuria, dysuria, and swimmer's itch. A positive correlation existed between the intensity of infection and frequency of exposure to water. Laboratory abnormalities included eosinophilia (41), anemia (9), hematuria (38), pyuria (33), and proteinuria (8). Three of 26 subjects had abnormalities intravenous pyelograms: hydroureter, bladder polyp , and bladder calcification. The bladder polyp was noted also by sonography. Cure rates were 66.7% in 18 subjects treated with two 10-mg/kg doses of trichlorfon and were 89.5% in 19 subjects given three doses. Those not cured had an average reduction in ova excretion of 96%. Follow-up at 12 months of 33 subjects showed that nine had S. haematobium ova in urine, although 75% admitted to exposure to canal or irrigation water in the interim.

Adolescent↗
PubMed1981

Evaluation of portal hypertension in cases of hepatosplenic schistosomiasis using ultrasound.

Patients with hepatic schistosomiasis develop high degrees of portal hypertension. Various invasive techniques have been used to evaluate this degree of portal hypertension. In this work sonography was used as a safe, noninvasive technique to study the relationship between the degree of portal hypertension, as measured by percutaneous splenic manometry, and the diameters of the portal and splenic veins. A total of 25 patients were included in this study. A positive correlation was found between the degree of portal hypertension and the increase in the diameters of the portal and splenic veins.

Female↗