{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:57:02Z","timestamp":1787021822257,"version":"build-2736575974"},"reference-count":47,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T00:00:00Z","timestamp":1638403200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Poverty Foundation, Basel"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Reducing morbidity is the main target of schistosomiasis control efforts, yet only rarely do control programmes assess morbidity linked to\n                      <jats:italic>Schistosoma<\/jats:italic>\n                      sp. infection. In the Democratic Republic of Congo (DRC), and particularly in north-eastern Ituri Province, little is known about morbidity associated with\n                      <jats:italic>Schistosoma mansoni<\/jats:italic>\n                      infection. For this reason, we aimed to assess intestinal and hepatosplenic morbidity associated with\n                      <jats:italic>S<\/jats:italic>\n                      .\n                      <jats:italic>mansoni<\/jats:italic>\n                      infection in Ituri Province.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods\/Principal findings<\/jats:title>\n                    <jats:p>\n                      In 2017, we conducted a cross-sectional study in 13 villages in Ituri Province, DRC.\n                      <jats:italic>S<\/jats:italic>\n                      .\n                      <jats:italic>mansoni<\/jats:italic>\n                      infection was assessed with a Kato-Katz stool test (2 smears) and a point-of-care circulating cathodic antigen (POC-CCA) urine test. A questionnaire was used to obtain demographic data and information about experienced intestinal morbidity. Each participant underwent an abdominal ultrasonography examination to diagnose hepatosplenic morbidity. Of the 586 study participants, 76.6% tested positive for\n                      <jats:italic>S<\/jats:italic>\n                      .\n                      <jats:italic>mansoni<\/jats:italic>\n                      . Intestinal morbidity reported in the two preceding weeks was very frequent, and included abdominal pain (52.7%), diarrhoea (23.4%) and blood in the stool (21.5%). Hepatosplenic morbidity consisted of abnormal liver parenchyma patterns (42.8%), hepatomegaly (26.5%) and splenomegaly (25.3%). Liver pathology (adjusted odds ratio [aOR] 1.20, 95% confidence interval [CI] 1.06\u20131.37,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.005) was positively and significantly associated with\n                      <jats:italic>S<\/jats:italic>\n                      .\n                      <jats:italic>mansoni<\/jats:italic>\n                      infection. Hepatomegaly (aOR 1.52, 95% CI 0.99\u20132.32,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.053) and splenomegaly (aOR 1.12, 95% CI 0.73\u20131.72,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.619) were positively but not significantly associated with\n                      <jats:italic>S<\/jats:italic>\n                      .\n                      <jats:italic>mansoni<\/jats:italic>\n                      infection at the individual level. At the village level,\n                      <jats:italic>S<\/jats:italic>\n                      .\n                      <jats:italic>mansoni<\/jats:italic>\n                      prevalence was positively associated with the prevalence of hepatomegaly and splenomegaly. High-intensity\n                      <jats:italic>S<\/jats:italic>\n                      .\n                      <jats:italic>mansoni<\/jats:italic>\n                      infections were associated with diarrhoea, blood in the stool, hepatomegaly, splenomegaly, and liver parenchyma (C, D, E and F pathology patterns). Four study participants were diagnosed with ascites and five reported hematemesis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Conclusions\/Significance<\/jats:title>\n                    <jats:p>\n                      Our study documents a high burden of intestinal and hepatosplenic morbidity associated with\n                      <jats:italic>S<\/jats:italic>\n                      .\n                      <jats:italic>mansoni<\/jats:italic>\n                      infection status in Ituri Province. The findings call for targeted interventions to address both\n                      <jats:italic>S<\/jats:italic>\n                      .\n                      <jats:italic>mansoni<\/jats:italic>\n                      infection and related morbidity.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0009375","type":"journal-article","created":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T13:43:25Z","timestamp":1638452605000},"page":"e0009375","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["Morbidity associated with Schistosoma mansoni infection in north-eastern Democratic Republic of the Congo"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0687-5604","authenticated-orcid":true,"given":"Maurice M.","family":"Nigo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Odermatt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Wully","family":"Nigo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9219-5778","authenticated-orcid":true,"given":"Georgette B.","family":"Salieb-Beugelaar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6638-3679","authenticated-orcid":true,"given":"Manuel","family":"Battegay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1880-5117","authenticated-orcid":true,"given":"Patrick R.","family":"Hunziker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,12,2]]},"reference":[{"key":"pntd.0009375.ref001","article-title":"Schistosomiasis Key facts","author":"WHO","year":"2020"},{"issue":"5","key":"pntd.0009375.ref002","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/j.jare.2012.12.001","article-title":"Hepatic and intestinal schistosomiasis: review","volume":"4","author":"T Elbaz","year":"2013","journal-title":"J Adv Res"},{"issue":"7","key":"pntd.0009375.ref003","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0002268","article-title":"A Very High Infection Intensity of Schistosoma mansoni in a Ugandan Lake Victoria Fishing Community Is Required for Association with Highly Prevalent Organ Related Morbidity","volume":"7","author":"EM Tukahebwa","year":"2013","journal-title":"Plos Neglect Trop D"},{"issue":"12","key":"pntd.0009375.ref004","first-page":"2058460116686392","article-title":"Is ultrasonography useful for population studies on schistosomiasis mansoni? 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