Subclinical vascular damage in Schistosoma spp. endemic regions.

Background: Cardiovascular abnormalities have been described in patients with schistosomiasis. Their true prevalence and clinical features in endemic settings are unknown. Patients and methods: The study aimed to assess the prevalence of subclinical cardiovascular damage in a population endemic to schistosomiasis. A cross-sectional study was conducted using colour-ultrasound assessment of abdominal and carotid arteries among adults aged >18 years living in Kome Island, Tanzania. Carotid intimal medial thickness, carotid plaque, mean abdominal aortic diameter, and presence of aneurysms were assessed. Anamnestic data on previous Schistosoma infection was collected; the actual prevalence of Schistosoma mansoni and Schistosoma haematobium was also assessed through stool and urine investigations. Results: A total of 264 participants (166 female, 98 male) were enrolled (mean age of 50±15.5 years). The history of previous schistosomiasis was 27.3%, and actual positivity for Schistosoma mansoni was 5.9%. The Latero-lateral Abdominal Aortic Diameter was significantly increased among participants with a previous history of schistosomiasis (16.7±2.8 mm vs. 17.6±3 mm; p=0.02), with an aOR of 1.15 [CI 1.04-1.28]; p=0.007]. Conclusions: The significant difference in the Latero-lateral Abdominal Aortic Diameter in participants with previous Schistosomiasis history schistosomiasis, suggests the need for further investigations on aortic damage in endemic populations, independently from the positive laboratory investigations.

Blood Flukes and Arterial Damage: A Review of Aneurysm Cases in Patients with Schistosomiasis.

Introduction: Schistosomiasis, caused by trematode worms of the genus Schistosoma, has organ-specific morbidity due to host's inflammatory response to the oviposition of parasite eggs in vessels and organs. Damage to the cardiovascular system, including aneurysms, has been described in patients. Aims and Methods. Aims of the review of case reports and series published in literature were to describe the occurrence of aneurysm in patients with schistosomiasis. Investigation Outcomes. A total of 13 cases (seven males and six females) with a mean age of 41.3 ± 14.9 years were included. Aneurysm occurred in patients with active or previous infection. In more than half of the cases, an intestinal or hepato-splenic involvement was reported, followed by pulmonary schistosomiasis and urinary or testicular involvement. The most frequently involved arterial district was the pulmonary artery. Immunomodulation and thrombophilia were featuring challenging surgery. Conclusions: More studies are needed to shed light on the vascular complications of schistosomiasis, to ascertain the true burden of aneurysms in patients with schistosomiasis, to establish the pathophysiology of vessel damage and aneurysm formation, and to assess if there is an association between schistosomiasis and aneurysm formation in line with WHO 2021-2030 NTD Roadmap.

Aortic aneurysm lesions in Echinococcus infection. A review of cases in literature.

BACKGROUND: Parasitic infections are common in developing countries, due to poor sanitation and inadequate hygiene. Undiagnosed and untreated parasitic infections can have severe acute and chronic consequences, including cardiovascular lesions. Aortic aneurysms have been described in patients with disease of parasitological interest, including hydatidosis. AIM AND METHODS: We have described, through a review of case reports in literature, the occurrence of aortic aneurysm in patients with hydatidosis, analysing the specific clinical features, peculiarities of vascular involvement, treatment and outcome. RESULTS: A total of 9 case reports has been included. Mean age of patients was 41.7 ± 12.2 years (range 12-54). Vascular pathology presentation was chronic in the majority of cases, acute in three and subacute in one. The majority of lesions occurred in the descending thoracic aorta; one case involved the ascending aorta and arch, one the abdominal aorta. Open surgical intervention was reported in the majority of cases, endovascular treatment in two. Complications, reported twice at follow up, included one endograft stenosis and, in two cases, vertebral erosion. No deaths were reported. CONCLUSION: Aortic aneurysms can occur in patients with hydatidosis. The surgical vascular treatment of this non communicable complication of a disease of parasitological interest needs to take into account the specific clinical and surgical context in which occurs, to better target pharmacological and surgical treatment.