Avaliação da fibrose periportal da esquistossome Mansoni utilizando o método qualitativo das pranchas propostas pela Organização Mundial de Saúde

Abstract

In a area of high prevalence of Schistosomiasis (57%) and in one of medium prevalence (27%), a total of 473 patients with 5 years old or above (336 at the highly endemic area and 137 at the other one) were submitted to a stool examination, physics exams and abdominals ultrasound. Were evaluated the periportal fibrosis using the qualitative method considered by the World Health Organization (WHO), and were also made a comparison of between the two areas regarding the ultrasound protocol. The ultrasound exam includes a comparison of the liver fibrosis with schematically draws that correspond to images standards, and with the measure of the following variables: external diameter and diameter of the light (internal part) of two segmented branches vestibules of second order, internal diameter of the hepatic portal vein, length of right and left livers lobes, length of the spleen and thickness of the anterior wall of the biliary vesicle. All measures were adapted according to the height of the patient, except the last one. This study demonstrated that the presence of periportal fibrosis constitutes a trustful criterion on the diagnosis of the Schistosomiasis hepatosplenic, indentified through the ultrasound. The presence of periportal fibrosis was related to the standards C. DC and EC, praised by the WHO, corresponding to the standards of central distribution or associated central peripheral. The using of a method, diagnosis based on the identification of periportal fibrosis, through the use of schematically draws allows identifying with higher precision, rapidity and simplicity the patients that may have Schistosomiasis and demarcate the areas of high, medium and low prevalence of the respective illness.