Clinical Sequelae Associated with Unresolved Tropical Splenomegaly in a Cohort of Recently Resettled Congolese Refugees in the United States-Multiple States, 2015-2018

Use of Point-of-Care Handheld Ultrasound for Splenomegaly in United States-Bound Refugees: A Novel Technology with Far-Reaching Implications

Ultrasound (US) is an invaluable clinical tool. New point-of-care US technology holds great promise for hard-to-reach and mobile populations such as refugees. The implementation of US in unique and challenging settings has been hindered by cost, fragility of equipment, need for uninterrupted electricity, training, and difficulty in sharing data/image files impeding quality assurance. The recent development of more flexible, durable, high-quality, low-cost, handheld US technology has offered increased potential to address many of these barriers. We describe a pilot program using a new point-of-care US technology to identify and monitor splenomegaly in United States-bound Congolese refugees. This experience and model may hold lessons for planning and development of similar approaches in other hard-to-reach mobile populations.

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.

Macroscopic and microscopic imaging modalities for diagnosis and monitoring of urogenital schistosomiasis

Urogenital schistosomiasis remains a major global challenge. Optimal management of this infection depends upon imaging-based assessment of sequelae. Although established imaging modalities such as ultrasonography, plain radiography, magnetic resonance imaging (MRI), narrow band imaging, and computerized tomography (CT) have been used to determine tissue involvement by urogenital schistosomiasis, newer refinements in associated technologies may lead to improvements in patient care. Moreover, application of investigational imaging methods such as confocal laser endomicroscopy and two-photon microscopy in animal models of urogenital schistosomiasis are likely to contribute to our understanding of this infection's pathogenesis. This review discusses prior use of imaging in patients with urogenital schistosomiasis and experimentally infected animals, the advantages and limitations of these modalities, the latest radiologic developments relevant to this infection, and a proposed future diagnostic standard of care for management of afflicted patients.