RESUMO
BACKGROUND AND AIMS: Human schistosomiasis is one of the most important and unfortunately neglected tropical diseases. The aim of the current study was to investigate the prevalence and characteristics of colonic schistosomiasis among symptomatic rural inhabitants of the Middle Northern region of the Egyptian Nile delta. PATIENTS AND METHODS: This study recruited 193 inhabitants of the rural community in the Egyptian Nile Delta referred for colonoscopy because of variable symptoms. After giving written informed consent, they were exposed to thorough history, clinical examination, stool analysis, abdominal ultrasonography, and pan-colonoscopy with biopsies. RESULTS: Twenty-four cases out of the 193 patients had confirmed active schistosomiasis with a prevalence rate of 12.4%. Bleeding with stool was the predominant manifestation of active Schistosoma infection among the cases either alone or in combination with abdominal pain. On clinical examination, most patients (n=17; 70.8%) did not have organomegaly, and 25% had clinically palpable splenomegaly as far as 75% of them had sonographically detected hepatic periportal fibrosis. Also, 66.6% of patients have significant endoscopic lesions (polyps, ulcers, mass-like lesions), and 16.6% of them had colonic affection beyond the recto-sigmoid region. CONCLUSION: Colonic schistosomiasis is still prevalent among the Egyptian Nile Delta's symptomatic rural inhabitants at a rate of 12.4%. Of them, 66.6% had significant endoscopic colorectal lesions. This persistent transmission of schistosomiasis in the Egyptian Nile Delta's rural community sounds the alarm for continuing governmental efforts and plans to screen the high-risk groups. The prevalence rate reported in the current study is lower than the actual prevalence rate of schistosomiasis due to focusing only on a subgroup of individuals.
RESUMO
BACKGROUND & AIMS: There is a possible significant difficulty in differentiating between non-specific colitis (NSC) and early IBD patients with no cardinal endoscopic features. This clarifies the need to find markers with high sensitivity and specificity for distinguishing between both and other forms of specific colitis. The aim of this study to investigate the ability to use a chemokine panel (CCR9, CD146 and Foxp3) among patients with lower gastrointestinal symptoms found to have NSC (but do not have current IBD) to predict which patients progress to/develop future IBD or other diagnoses of specific colitis. METHODS: Colonoscopy was done for 182 patients complaining of chronic diarrhea and or constipation, abdominal distention and pain with negative history for IBD, after Histopathological evaluation; 138 cases showing non-specific inflammation submitted for further immunohistochemical CCR9, CD146 and Foxp3 staining. On follow up patients with persistent symptoms or worsen symptoms recolonoscopy was done followed by Histopathological examination of samples and compared by the earlier results. RESULTS: The studied markers expressed significantly in IBD patients differentiating them from NSC patients (p < 0.001) except for CCR9 expression was statistically insignificant in CD patients (p = 0.528). According to the ROC curves in prediction of progression using studied panel, the use of studied markers in combination was more statistically significant in comparison to each marker alone. Median follow up for studied patients was 12 months. CONCLUSIONS: This panel of markers holds a promising hope for early IBD as predictive markers, discriminating IBD from NSC and as potential therapeutic targets.