The epidemiology and consequences of Schistosoma mansoni infection in West Nile, Uganda II. Hospital investigation of a sample from the Panyagoro community

A community at Panyagoro in West Nile, Uganda, had already been investigated in the field and shown to be very heavily infected with Schistosoma mansoni. A sample of 45 patients from the community was further studied in hospital. Their commonest symptoms were abdominal pain and intermittent bloody diarrhoea. Many patients were anaemic and had hepatosplenomegaly. 22 of the 45 had ascites and 2 had varices of the abdominal wall. The ascites was tapped in 5 patients and shown to be a transudate. Egg counts for S. mansoni were high and for hookworm were very low. Liver biopsy specimens commonly showed schistosome eggs, granulomata, pigment and fibrosis, often several of these together, and excluded true cirrhosis and virus hepatitis. The observed syndromes and evidence of portal hypertension are therefore probably due in large part to schistosomiasis. Taken with the preceding community study, the findings indicate severe disease due to S. mansoni in a sub-Saharan African community.