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The first stage of selection analyzed the titles and abstracts of the publications.
Immunopathogenesis of human schistosomiasis. Duplicate publications and papers reporting reanalysis of previously published data were excluded at this stage. Results Study selection Using the selected search terms, initial screening of the databases yielded study reports after removing duplicates. Other reviews of Schistosoma -related ultrasound morbidities have suggested that the regression of splenomegaly, while sometimes observed after anti-schistosomal therapy, is not specific enough to be used as an indicator for the regression of Schistosoma -associated disease.
Splenomegaly Spleen size was evaluated before and after chemotherapy for schistosomiasis in 21 studies see Table B in S1 Text. Because of pathology caused by parasite eggs deposited into human tissues, schistosomiasis turns into a multi-year inflammatory disease of the intestine, liver, urinary tract, and other critical organs.
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No restrictions were placed in terms of location of the study, Schistosoma species, or publication date. This article has been cited by other articles in PMC. The presence of microhematuria was evaluated in 17 studies see Table G in S1 Text. Support Center Support Center. Quantitative meta-analysis Quantitative pooled analysis of treatment effects catalogued from the eligible studies was performed using Comprehensive Meta-Analysis software, v.
Sensitivity analysis Forest Plot of the impact of therapy on urinary vhk abnormality prevalence. Significant heterogeneity was observed among the studies, which the subgroup s07 did not change see Table I in S3 Text. The unacknowledged impact of chronic schistosomiasis. Studies that evaluated more than one form of morbidity a007 included in the meta-analysis for each individual morbidity outcome. Impact of repeated community-based selective chemotherapy on morbidity due to schistosomiasis mansoni.
Significant heterogeneity was observed among the studies included Fig 2 which could be modified by subgroup stratification chi to region, age, and time of follow-up. In addition, the meta-analysis also suggests differences between S.
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Forest plot showing sensitivity analysis, performed by removing one study at a time, for the effect of treatment on prevalence of periportal fibrosis PDF Click here for additional data file. Schistosomiasis is the disease caused s070 infection with Schistosoma parasitic flukes.
Main portal vein Four studies assessed the prevalence of portal vein dilation before and after chemotherapy for chhk see Table D in S1 Text.
Nine studies assessed the reversal of lesions in the upper urinary tract see Table J in S1 Text. S10 Fig Sensitivity analysis Forest Plot of the impact of therapy on hematuria prevalence.
There was greater strength of association when studies included only individuals of school age or when the follow-up was conducted in the first six months after chj Table G in S3 Text. Log odds ratio of hematuria, proteinuria, and bladder abnormalities according to post-treatment egg reduction rate. S1 Text Tables A-K indicating the main characteristics of included studies evaluating the impact of chemotherapy on different Schistosoma infection-related morbidities.
National Center for Biotechnology InformationU. Parameters associated with Schistosoma haematobium infection before and after chemotherapy in school children from two villages in the coast province of Kenya. The least impact was for splenomegaly, whereas the largest observed decrease was for blood in the stool. Regarding study design, any prospective, longitudinal studies ch treatment impact on morbidity with or without concurrent control group were considered eligible for inclusion in the meta-analysis.
Progress in assessment of morbidity due to Schistosoma haematobium infection. Forest plot showing sensitivity analysis, performed by removing one study at a time, for the effect of treatment on prevalence of splenomegaly. For studies that evaluated the morbidities more than once after the treatment, the first follow-up after the intervention was selected for inclusion in the pooled analysis and calculation of summary estimates.
We appreciate the helpful comments of the SCORE Project leaders and participants, and their encouragement for completion of this project. The reduction of fibrosis prevalence was measured in 12 studies see Table C in S1 Text that found, overall, a significant reduction in the odds of fibrosis after chemotherapy compared to pretreatment levels OR 0.
Assessment for potential publication bias was carried out by visual inspection cgk funnel plots, and statistically by calculating the Egger test [ 32 ]. Protocol registration This research was developed by the authors and performed according to a protocol in which all the stages of the study were pre-defined.
Publications in English, Portuguese, Spanish, and French were included. Protein in the urine The presence 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. Quantification of the net changes in Schistosoma infection-associated morbidity prevalence, from before to after treatment, is one way to critically value the impact of drug-based control of schistosomiasis, which is the strategy currently recommended by WHO and other agencies [ 10 ].
Four main factors were associated with greater treatment impact in reducing hepatomegaly: S4 Fig Sensitivity analysis Forest Plot of the impact of therapy on hepatomegaly prevalence, lobe unspecified.
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Author information Article notes Copyright and License information Disclaimer. Moreover, when a paper reported more than one study with the same morbidity performed among different subjectsthis publication was listed twice.
Sensitivity analysis Forest Plot of the impact of therapy on proteinuria prevalence. Abstract Background SinceWHO has endorsed drug treatment to reduce Schistosoma infection and its consequent morbidity. Hemoglobin Fifteen studies evaluated circulating blood hemoglobin levels before and after specific chemotherapy for schistosomiasis see Table K in S1 Text. This suggests that repeated z007 more effective anti-parasite drug treatment will be a valuable tool for greater reduction of Schistosoma -related patient morbidities in affected areas.