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We found no evidence of publication bias using unweighted, non-randomized values in the Egger test. S2 Text A table describing study design and quality features for included studies. Rev Soc Bras Med Trop.

S – CHK – IC Chips – Kynix Semiconductor

Regarding measured impact on splenomegaly, it was not uncommon that the studies selected for meta-analysis involved subjects who were co-infected with other chronic pathogens, especially malaria, which could explain a lesser effect of anti-schistosomal therapy on splenomegaly after treatment [ 2236 ].

Blood in the urine The presence of microhematuria was evaluated in 17 studies see Table G in S1 Text. Blood in the stool Eight studies evaluated the prevalence of blood in the stool see Table F in S1 Text and the meta-analysis summary estimate indicated a significant reduction after chemotherapy for schistosomiasis OR 0.

To test for outliers or the effects of larger influential studies in our analysis, sensitivity analysis by exclusion of one study at a time from the meta-analysis did not affect the outcome performance of the odds ratio, Z, and p-values, and the significance of observed associations did not change S2 — S4 Figs. If eggs do not succeed in leaving the body in excreta, they remain trapped in nearby tissues, causing persistent chronic inflammation and scarring [ 34 ].

Methods Ethics statement The data used in this project were aggregated, anonymized data from previously published studies; cyk such, this study does not constitute human subjects research according to U. Three main factors yielded a chi estimate of the impact of therapy in reducing bladder lesions: Protein in the urine The presence of protein in urine was measured in 12 studies see Table H in S1 Text and the reduction of its prevalence was highly significant Ch, 0.

Meta-analysis of observational studies in epidemiology: The flow diagram indicates the numbers of titles and studies reviewed in preparation of the current systematic review and meta-analysis of chemotherapy treatment effects on infection-related morbidities in Schistosoma -endemic areas.

The selected studies had full texts recovered for the second stage of selection. However, the exclusion of one study with S. Of the studies that assessed the impact of chemotherapy on reducing hepatomegaly, 10 evaluated the reduction of the left hepatic lobe, 10 the reduction of the right hepatic chm, and 9 studies reported a reduction from the costal margin without specifying the lobe see Table A in S1 Text. Sensitivity analysis by exclusion of a single study at a time from the meta-analysis did not affect the results S14 Fig.

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Not shown, the meta-regression showed only non-significant correlation of ERRs with reductions in the study cohort prevalence of splenomegaly or with post-treatment increases in hemoglobin levels. Discussion Quantification of the net changes in Schistosoma infection-associated morbidity prevalence, from before to after treatment, is one way to critically value the impact of drug-based control of schistosomiasis, which is the strategy currently recommended by WHO and other agencies [ ch, ].

The sensitivity testing indicated that the reduction in post treatment odds of periportal fibrosis likely varied between OR 0. Sensitivity analysis by subgroup showed that studies that used ultrasound for diagnosis, studies with only school age individuals, studies having follow-up less than 12 months after treatment, studies of individuals with S.

Schistosomiasis, caused by Schistosoma spp. While immediate granulomatous inflammation is the cause cuk some of the morbidities included in our review hematuria, proteinuria, bladder irregularities for S. Publications in English, Portuguese, Spanish, and French were included.

Diarrhea Eight studies evaluated the cessation of episodes of diarrhea after anti-schistosomal chemotherapy see Table E in S1 Text.

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For those morbidities related to intestinal schistosomiasis, i. Bull World Health Organ. Forest plot showing sensitivity analysis, performed by removing one study at a time, for the effect of treatment on prevalence of diarrhea after treatment.

Schistosoma japonicum reinfection after praziquantel treatment causes anemia associated with inflammation. Significant heterogeneity was observed among the studies included Fig 2 which could be modified by subgroup stratification according to region, age, and time of follow-up.

Results Study selection Using the selected search terms, initial screening of the databases yielded study reports after removing duplicates. These findings were consonant with two earlier reviews that have highlighted the persistence of abnormalities caused by S.

In clinical studies, portal vein diameter is an indicator that correlates with portal vein pressure and risk for hemorrhage [ 47 ]. This research was developed by the authors and performed according to a protocol in which all the stages of the study were pre-defined. Of note, the reductions in morbidities associated with urogenital schistosomiasis, with the exception of injuries to the upper urinary tract, were more likely to be significant if evaluated in the first six months after treatment.

The presence of microhematuria was evaluated in 17 studies see Table G in S1 Text. The first stage of selection analyzed the titles and abstracts of the publications. While there are challenges to implementing therapy for schistosomiasis, and praziquantel therapy is not fully curative, reductions in egg output are significantly correlated with decreased morbidity and can be used to project diminution in disease burden when contemplating more aggressive strategies to minimize infection intensity.


Sensitivity analysis Forest Plot of the impact of therapy on left lobe hepatomegaly prevalence. More recent research has also put emphasis on systemic morbidities associated with Schistosoma infection such as anemia, growth stunting, impaired cognition, undernutrition, diarrhea, and decreased physical fitness; however, this additional burden of schistosomiasis was not well studied in many older works, and until the s, improvement in these outcomes was not generally appreciated as a potential benefit of morbidity control [ 8 ].

The selection of studies was carried out in two stages by two independent reviewers GA and DJBand in case of disagreement between them, a third reviewer CHK was asked to resolve differences. The aim of this project was to systematically review evidence on drug-based control of schistosomiasis and to develop a quantitative estimate of the impact of post-treatment reductions in infection intensity on prevalence of infection-associated morbidity.

The reduction in prevalence was highly significant after chemotherapy for S. Toward the elimination of schistosomiasis. Chemotherapy-based control of schistosomiasis haematobia.

To explore heterogeneity and factors that could potentially modify the summary estimates of effect, we performed s007 analyses stratified by parasite species, the study area, age of the subjects included in the studies, the time to follow-up after treatment, the type of diagnosis, the treatment performed, the number of treatments, and the initial prevalence of infection in the study population [ 34 ].

When considering all of these studies, there was significant reduction in the odds of having diarrhea after the intervention OR ss007. Significant heterogeneity was observed among the studies Fig 2 and the subgroup analysis was performed in order to identify the causes see Table G in S3 Text.

Sensitivity analysis Forest Plot of the impact of therapy on blood in stool prevalence. National Center for Biotechnology InformationU. Nevertheless, studies of morbidity reduction related to drug treatment have had some conflicting results [ 23 — 26 ], which may be a reflection of differences in follow-up after treatment, methods used to chhk morbidities, the Schistosoma species, the presence of co-infections especially malariathe type of population and the region, the initial prevalence of infection, the incidence of reinfection, and other factors [ 727 cuk.

No restrictions were placed in terms of location of the study, Schistosoma species, or publication date. Among all the studies in this category, significant heterogeneity was observed Fig 2but this was reduced in the stratification by subgroups Table D in S3 Text. W007 of human schistosomiasis.