Stool examination and rectal biopsy in the diagnosis and evaluation of therapy of schistosomiasis mansoni Exame de fezes e biópsia retal no diagnóstico e controle de cura da esquistossomose mansoni

• Published in: Revista do Instituto de Medicina Tropical de São Paulo
• Main Authors: Ana Lúcia Teles Rabello, Roberto Sena Rocha, João Paulo Mendes de Oliveira, Naftale Katz, José Roberto Lambertucci
• Format: Article in Journal/Newspaper
• Language: English
• Published: Universidade de São Paulo (USP) 1992
• Subjects: Schistosoma mansoni; Stool examination; Egg counts; Rectal biopsy; Oxamniquine; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1590/S0036-46651992000600016; https://doaj.org/article/919c655bedba46469ec9b6b7b236c195

From each of a group of 217 adult males selected through enzyme-immunoassay or skin-test (Group A), six stool samples were examined by both the Lutz/Hoffman, Pons & Janer (Lutz/HPJ) and Kato/Katz methods. In addition, one oogram of the rectal mucosa was performed. By these methods, schistosomiasis was detected in 44.7%, 47.5% and 40.1% of the individuals respectively. To evaluate the methods in the assessment of cure, the last 40 patients from group A, treated with a single oral dose of oxamniquine at 15 mg/kg were followed up for six months (Group B). The criteria for parasitological cure included three stool examinations by Kato/Katz and Lutz/HPJ methods, one, three and six months post-treatment and a rectal biopsy between the fourth and sixth months post-treatment. The examinations were negative in 87.5%, 90% and 95% of the patients, respectively. The efficacy of oxamniquine was 82.5% when the three methods were considered together and there was no statistically significant difference between the sensitivity of the individual methods. Em um grupo de 217 adultos do sexo masculino selecionados através de ELISA ou intradermoreação, realizaram-se seis exames de fezes pelos métodos de Lutz/Hoffman, Pons e Janer (Lutz/HPJ) e Kato/Katz e um oograma da mucosa retal, observando-se positividade em 44,7%, 47,5% e 40,1%, respectivamente. A análise comparativa dos resultados mostrou: 1) aumento da sensibilidade de ambos os métodos de exames de fezes até a terceira amostra examinada; 2) maior sensibilidade da biópsia retal quando comparada ao exame de uma única amostra fecal pelos métodos de Lutz/HPJ ou Kato/Katz; 3) igual sensibilidade pelo exame de duas a cinco amostras fecais pelo método de Kato/Katz ou duas a seis amostras pelo método de Lutz/HPJ e a biópsia retal; 4) sensibilidade superior de seis amostras fecais pelo método de Kato/Katz, quando comparado à biópsia retal; 5) igual sensibilidade entre o mesmo número de amostras examinadas pelos métodos de Lutz/HPJ e Kato/Katz. Para avaliar a cura parasitológica, os ...