{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T07:02:14Z","timestamp":1768287734236,"version":"3.49.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,3,17]],"date-time":"2020-03-17T00:00:00Z","timestamp":1584403200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"British Medical and Dental Students' Trust"},{"DOI":"10.13039\/501100000770","name":"University of Manchester","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000770","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000623","name":"Royal Geographical Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000623","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Scientific Exploration Society"},{"name":"British Society of Immunology"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,4,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>A cross-sectional survey was performed to estimate the prevalence of periportal fibrosis in children based on ultrasound examination in the Marolambo district of the Atsinanana region of Madagascar. This is a remote area known to have a high prevalence of intestinal schistosomiasis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>School-aged children (5\u201314\u00a0y) were selected from six villages for parasitological and sonographic examination. Circulating cathodic antigen (CCA) tests and Kato Katz (KK) stool microscopy were performed. Video-clips of liver views were recorded with a SonoSite iViz and interpreted in the UK by comparison with standardised images (WHO protocol).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The prevalence of schistosomiasis according to CCA testing was 97.8% (269\/275) and 73.8% (203\/275) by KK. Sonographic evidence of periportal fibrosis was observed in 11.3% (31\/275). The youngest children with fibrosis were aged 6 y. Fibrosis was more common in older children (p=0.03) but was not associated with either infection intensity category (p=0.07) or gender (p=0.67).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Findings of periportal fibrosis among children in these hard-to-reach villages suggests chronic Schistosoma mansoni infection from a very young age. This may reflect other similarly remote schistosomiasis-endemic areas and reinforces the need to investigate morbidity in neglected communities to understand the true extent of disease burden in endemic countries.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/trstmh\/traa009","type":"journal-article","created":{"date-parts":[[2020,1,17]],"date-time":"2020-01-17T12:11:15Z","timestamp":1579263075000},"page":"315-322","source":"Crossref","is-referenced-by-count":12,"title":["A cross-sectional study of periportal fibrosis and Schistosoma mansoni infection among school-aged children in a hard-to-reach area of Madagascar"],"prefix":"10.1093","volume":"114","author":[{"given":"Hannah J","family":"Russell","sequence":"first","affiliation":[{"name":"University of Manchester Medical School, Manchester, M13 9PL, UK"},{"name":"Red House, Guilsfield, Powys, Wales, SY21 9NH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James M StJ","family":"Penney","sequence":"first","affiliation":[{"name":"University of Manchester Medical School, Manchester, M13 9PL, UK"},{"name":"University Hospital Monklands, NHS Lanarkshire, Glasgow, Scotland, ML6 0JS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cortland","family":"Linder","sequence":"first","affiliation":[{"name":"University of Manchester Medical School, Manchester, M13 9PL, UK"},{"name":"Maidstone and Tunbridge Wells Hospital, Maidstone and Tunbridge Wells NHS Trust, Kent, England, TN2 4QJ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth C","family":"Joekes","sequence":"first","affiliation":[{"name":"Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amaya L","family":"Bustinduy","sequence":"first","affiliation":[{"name":"Clinical Research Department, London School of Tropical Medicine and Hygiene and Tropical Medicine, London, WC1E 7HT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J Russell","family":"Stothard","sequence":"first","affiliation":[{"name":"Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel A L","family":"Rakotomampianina","sequence":"first","affiliation":[{"name":"Facult\u00e9 de M\u00e9decine, Universit\u00e9 d'Antananarivo, Antananarivo, Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuel H","family":"Andriamasy","sequence":"first","affiliation":[{"name":"Facult\u00e9 de M\u00e9decine, Universit\u00e9 d'Antananarivo, Antananarivo, Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lalarizo R","family":"Mahary","sequence":"first","affiliation":[{"name":"Facult\u00e9 de M\u00e9decine, Universit\u00e9 d'Antananarivo, Antananarivo, Madagascar"},{"name":"Department of Immunology, Joseph Ravoahangy University Hospital Centre, Antananarivo, Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elodie P","family":"Ranjanoro","sequence":"first","affiliation":[{"name":"Facult\u00e9 de M\u00e9decine, Universit\u00e9 d'Antananarivo, Antananarivo, Madagascar"},{"name":"Compassion Madagascar University Hospital, Antananarivo, Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alain M","family":"Rahetilahy","sequence":"first","affiliation":[{"name":"Minist\u00e8re de la Sant\u00e9 Publique, Antananarivo, Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen A","family":"Spencer","sequence":"first","affiliation":[{"name":"University of Manchester Medical School, Manchester, M13 9PL, UK"},{"name":"Infectious Diseases, North Bristol NHS Trust, Bristol, BS10 5NB, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,3,17]]},"reference":[{"issue":"1","key":"2020040802553044600_ref1","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1177\/1742395307084407","article-title":"The unacknowledged impact of chronic schistosomiasis","volume":"4","author":"King","year":"2008","journal-title":"Chronic Illn."},{"issue":"9936","key":"2020040802553044600_ref2","doi-asserted-by":"crossref","first-page":"2253","DOI":"10.1016\/S0140-6736(13)61949-2","article-title":"Human schistosomiasis","volume":"383","author":"Colley","year":"2014","journal-title":"Lancet."},{"issue":"2","key":"2020040802553044600_ref3","doi-asserted-by":"crossref","first-page":"140","DOI":"10.4269\/ajtmh.1996.54.140","article-title":"The effectiveness of annual versus biennial mass chemotherapy in reducing morbidity due to schistosomiasis: A prospective study in Gezira-Managil, 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Korean J Parasitol."},{"issue":"3","key":"2020040802553044600_ref18","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1046\/j.1365-3156.1997.d01-269.x","article-title":"Schistosoma mansoni-related morbidity on Ukerewe Island, Tanzania: Clinical, ultrasonographical and biochemical parameters","volume":"2","author":"Kardorff","year":"1997","journal-title":"Trop Med Int Health."},{"issue":"2","key":"2020040802553044600_ref19","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1046\/j.1365-3156.2003.00994.x","article-title":"Measuring morbidity in schistosomiasis mansoni: Relationship between image pattern, portal vein diameter and portal branch thickness in large-scale surveys using new WHO coding guidelines for ultrasound in schistosomiasis","volume":"8","author":"King","year":"2003","journal-title":"Trop Med Int Health."},{"issue":"4","key":"2020040802553044600_ref20","doi-asserted-by":"crossref","first-page":"58","DOI":"10.3390\/tropicalmed2040058","article-title":"Schistosoma mansoni-associated morbidity among preschool-aged children along the shores of Lake Victoria in Uganda","volume":"2","author":"Nalugwa","year":"2017","journal-title":"Trop Med Infect Dis."},{"issue":"6","key":"2020040802553044600_ref21","doi-asserted-by":"crossref","first-page":"2515","DOI":"10.1007\/s00436-011-2793-6","article-title":"Hepatosplenic morbidity due to Schistosoma mansoni in schoolchildren on Ukerewe Island, Tanzania","volume":"110","author":"El Scheich","year":"2012","journal-title":"Parasitol Res."},{"issue":"6","key":"2020040802553044600_ref22","doi-asserted-by":"crossref","first-page":"1336","DOI":"10.4269\/ajtmh.19-0273","article-title":"Five-year impact of different multi-year mass drug administration strategies on childhood Schistosoma mansoni-associated morbidity: A combined analysis from the Schistosomiasis consortium for operational research and evaluation cohort studies in the Lake Victoria regions of Kenya and Tanzania","volume":"101","author":"Shen","year":"2019","journal-title":"Am J Trop Med Hyg."},{"issue":"4","key":"2020040802553044600_ref23","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1111\/j.1365-3156.2004.01215.x","article-title":"Detailed clinical and ultrasound examination of children and adolescents in a Schistosoma mansoni endemic area in Kenya: Hepatosplenic disease in the absence of portal fibrosis","volume":"9","author":"Vennervald","year":"2004","journal-title":"Trop Med Int Health."},{"issue":"1","key":"2020040802553044600_ref24","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/0001-706X(92)90022-P","article-title":"Inter-observer variance in ultrasonographical assessment of Schistosoma mansoni-related morbidity in young schoolchildren","volume":"51","author":"Doehring-Schwerdtfeger","year":"1992","journal-title":"Acta Trop."},{"issue":"9","key":"2020040802553044600_ref25","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1046\/j.1365-3156.2001.00781.x","article-title":"Geographic differences in hepatosplenic complications of schistosomiasis mansoni and explanatory factors of morbidity","volume":"6","author":"Boisier","year":"2001","journal-title":"Trop Med Int Health."},{"key":"2020040802553044600_ref26","volume-title":"Working to overcome the global impact of neglected tropical diseases: first WHO report on neglected tropical diseases","author":"World Health Organization","year":"2010"},{"issue":"4","key":"2020040802553044600_ref27","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1590\/0037-8682-0110-2013","article-title":"Treatment and education reduce the severity of schistosomiasis periportal fibrosis","volume":"46","author":"Silva","year":"2013","journal-title":"Rev Soc Bras Med Trop."}],"container-title":["Transactions of The Royal Society of Tropical Medicine and Hygiene"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/trstmh\/article-pdf\/114\/4\/315\/33012917\/traa009.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/trstmh\/article-pdf\/114\/4\/315\/33012917\/traa009.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,4,8]],"date-time":"2020-04-08T06:56:29Z","timestamp":1586328989000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/trstmh\/article\/114\/4\/315\/5808797"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,17]]},"references-count":27,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,3,17]]},"published-print":{"date-parts":[[2020,4,8]]}},"URL":"https:\/\/doi.org\/10.1093\/trstmh\/traa009","relation":{},"ISSN":["0035-9203","1878-3503"],"issn-type":[{"value":"0035-9203","type":"print"},{"value":"1878-3503","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,4]]},"published":{"date-parts":[[2020,3,17]]}}}