ABSTRACT
Schistosomiasis is a chronic enteropathogenic disease caused by blood flukes of the genus Schistosoma. Chronic infections with morbidity and mortality occur as a result of granuloma formation in the intestine, liver or in the case of S. haematobium, the bladder. Various methods are utilized to diagnose and evaluate liver fibrosis due to schistosomiasis. Liver biopsy is still considered the gold standard but it is invasive. Diagnostic imaging has proven to be an invaluable method in assessing hepatic morbidity in the hospital setting but has practical limitations in the field. The potential of non-invasive biologic markers, serum antibodies, cytokines and circulating host microRNAs to diagnose hepatic fibrosis are presently undergoing evaluation and are discussed.
The classic sign of urogenital schistosomiasis is haematuria and is specifically noted with S. haematobium (Ross et al. 2002, 2013). Bladder, ureter fibrosis and kidney damage are sometimes seen in advanced cases. The urogenital form may present with genital lesions (e.g., vulvar nodules), vaginal bleeding, dyspareunia and fallopian tube damage (in the late stages) in females. Genital infection in males may result in damage to seminal vesicles, prostate and other related organs; this may lead to irreversible infertility (Ross et al. 2002). Urogenital schistosomiasis in both sexes is a significant risk factor for Human Immunodeficiency Virus (HIV) infection due to both local genital tract and systemic immunological effects (Ross et al. 2002). Schistosomal co-infection may hasten HIV disease progression in individuals already infected with HIV and facilitate viral transmission to sexual partners (Ross et al. 2013).
