Clinical study of Mekong schistosomiasis at Khong Island, Southern Laos

Abstract

Though the number of cases and the opportunity to study them were limited, certain characteristics of Mekong schistosomiasis could be observed. In general, the clinical manifestation is similar to typical schistosomiasis japonica. This is opposite to the former belief that the Mekong schistosome in Laos had mild manifestations as in the neighbouring countries of Thailand and Cambodia. The present study has shown that there are no definite symptoms in mild cases to distinguish them from other common intestinal parasitic infections. Complaints of gastrointestinal disturbances were equally common in stool positive and negative groups. However, from physical examination, hepatosplenomegaly was common (55.0%) in the stool positive cases 8-19 years of age. Pronounced portal hypertension appeared in the form of moderate or severe ascites with collateral circulation in some cases. The blood chemistry study revealed no significant differences between the stool positive and negative groups except that alkaline phosphatase levels were high in most of the study cases. It is uncommon for schistosomiasis to produce such a high level of this enzyme; unless further investigation supports this finding, technical error should be taken into consideration. From this investigation it was concluded that Mekong schistosomiasis showed the severe clinical appearances as in other countries and could become a major health problem in the Lower Mekong Basin unless precautionary measures to control the disease are implemented.