The Basel ultrasonography protocol for assessing hepatosplenic pathologies in Asian schistosomiasis: report of a WHO expert meeting
Abstract Asian hepatointestinal schistosomiasis due to Schistosoma japonicum is prevalent in the Philippines and in Indonesia, while it is close to elimination in China. The second Asian schistosome, S. mekongi, is found in Cambodia and Laos. The main pathology caused by both species is liver fibros...
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2025-08-01
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| Series: | Infectious Diseases of Poverty |
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| Online Access: | https://doi.org/10.1186/s40249-025-01349-x |
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| author | Joachim Richter Andreas Neumayr Amadou Garba-Djirmay Hiroshi Ohmae Ralph Aniceto Xiao-Nong Zhou Jing Xu Zhaoyu Guo An Ning Edward Mberu Kamau Francesca Tamarozzi Hannah Wei Wu Charles King Birgitte Jyding Vennervald Goylette F. Chami Jürg Utzinger Christoph Hatz |
| author_facet | Joachim Richter Andreas Neumayr Amadou Garba-Djirmay Hiroshi Ohmae Ralph Aniceto Xiao-Nong Zhou Jing Xu Zhaoyu Guo An Ning Edward Mberu Kamau Francesca Tamarozzi Hannah Wei Wu Charles King Birgitte Jyding Vennervald Goylette F. Chami Jürg Utzinger Christoph Hatz |
| author_sort | Joachim Richter |
| collection | DOAJ |
| description | Abstract Asian hepatointestinal schistosomiasis due to Schistosoma japonicum is prevalent in the Philippines and in Indonesia, while it is close to elimination in China. The second Asian schistosome, S. mekongi, is found in Cambodia and Laos. The main pathology caused by both species is liver fibrosis, which can cause significant morbidity and mortality, mainly due to portal hypertension leading to bleeding from esophageal varices. Ultrasonography was introduced several decades ago as a safe, fast, non-invasive, and relatively inexpensive technique for assessing chronic schistosomiasis-related hepatic pathology in the clinical and field settings. A standardized ultrasound protocol had been established by experts at a WHO-chaired meeting in Cairo, Egypt, in 1990. The peculiarities of sonomorphologic abnormalities caused by S. japonicum and S. mekongi were not sufficiently covered in the Cairo protocol and not addressed at all in the subsequent WHO chaired meeting in Niamey 1996. At a follow-up WHO-chaired meeting in Phnom Pehnh, Cambodia, in 2002, an attempt was made to develop a protocol for Asian schistosomiasis, but a protocol resulting from this meeting has never been published. Although several studies investigated the use of ultrasonography to assess S. japonicum- and S. mekongi-related sonomorphological morbidity across endemic areas the lack of a standardized protocol hampered the characterization of sonomorphologic abnormalities with regard to progression, reversibility, prognosis, and correlation to morbidity. In addition, the comparison of data from different endemic areas and populations remained difficult. Therefore, a WHO-chiared expert meeting took place in Basel, Switzerland in September 2024 with the aim to establish a standardized ultrasound protocol for reporting the pathology caused by S. japonicum and S. mekongi. The proposed protocol is described in this article. Graphical Abstract |
| format | Article |
| id | doaj-art-ec45c0dd6ea64e40bf22fe2ca2072e57 |
| institution | Kabale University |
| issn | 2049-9957 |
| language | English |
| publishDate | 2025-08-01 |
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| series | Infectious Diseases of Poverty |
| spelling | doaj-art-ec45c0dd6ea64e40bf22fe2ca2072e572025-08-20T03:43:34ZengBMCInfectious Diseases of Poverty2049-99572025-08-0114111010.1186/s40249-025-01349-xThe Basel ultrasonography protocol for assessing hepatosplenic pathologies in Asian schistosomiasis: report of a WHO expert meetingJoachim Richter0Andreas Neumayr1Amadou Garba-Djirmay2Hiroshi Ohmae3Ralph Aniceto4Xiao-Nong Zhou5Jing Xu6Zhaoyu Guo7An Ning8Edward Mberu Kamau9Francesca Tamarozzi10Hannah Wei Wu11Charles King12Birgitte Jyding Vennervald13Goylette F. Chami14Jürg Utzinger15Christoph Hatz16Swiss Tropical and Public Health Institute BaselSwiss Tropical and Public Health Institute BaselWorld Health OrganizationDepartment of Parasitology, National Institute of Infectious DiseasesDepartment of Immunology, Research Institute of Tropical MedicineNational Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases ResearchNational Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases ResearchNational Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases ResearchJiangxi Provincial Institute of Parasitic DiseasesWorld Health OrganizationDepartment of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di ValpolicellaCenter for International Health Research, Rhode Island HospitalCenter for Global Health and Diseases, Case Western Reserve UniversitySection for Parasitology and Aquatic Pathobiology, Faculty of Health and Medical Sciences, University of CopenhagenBig Data Institute, Nuffield Department of Population Health, University of OxfordSwiss Tropical and Public Health Institute BaselSwiss Tropical and Public Health Institute BaselAbstract Asian hepatointestinal schistosomiasis due to Schistosoma japonicum is prevalent in the Philippines and in Indonesia, while it is close to elimination in China. The second Asian schistosome, S. mekongi, is found in Cambodia and Laos. The main pathology caused by both species is liver fibrosis, which can cause significant morbidity and mortality, mainly due to portal hypertension leading to bleeding from esophageal varices. Ultrasonography was introduced several decades ago as a safe, fast, non-invasive, and relatively inexpensive technique for assessing chronic schistosomiasis-related hepatic pathology in the clinical and field settings. A standardized ultrasound protocol had been established by experts at a WHO-chaired meeting in Cairo, Egypt, in 1990. The peculiarities of sonomorphologic abnormalities caused by S. japonicum and S. mekongi were not sufficiently covered in the Cairo protocol and not addressed at all in the subsequent WHO chaired meeting in Niamey 1996. At a follow-up WHO-chaired meeting in Phnom Pehnh, Cambodia, in 2002, an attempt was made to develop a protocol for Asian schistosomiasis, but a protocol resulting from this meeting has never been published. Although several studies investigated the use of ultrasonography to assess S. japonicum- and S. mekongi-related sonomorphological morbidity across endemic areas the lack of a standardized protocol hampered the characterization of sonomorphologic abnormalities with regard to progression, reversibility, prognosis, and correlation to morbidity. In addition, the comparison of data from different endemic areas and populations remained difficult. Therefore, a WHO-chiared expert meeting took place in Basel, Switzerland in September 2024 with the aim to establish a standardized ultrasound protocol for reporting the pathology caused by S. japonicum and S. mekongi. The proposed protocol is described in this article. Graphical Abstracthttps://doi.org/10.1186/s40249-025-01349-xSchistosoma japonicumSchistosoma mekongiHepatosplenic schistosomiasisUltrasonographyPoint-of-care ultrasoundLiver fibrosis |
| spellingShingle | Joachim Richter Andreas Neumayr Amadou Garba-Djirmay Hiroshi Ohmae Ralph Aniceto Xiao-Nong Zhou Jing Xu Zhaoyu Guo An Ning Edward Mberu Kamau Francesca Tamarozzi Hannah Wei Wu Charles King Birgitte Jyding Vennervald Goylette F. Chami Jürg Utzinger Christoph Hatz The Basel ultrasonography protocol for assessing hepatosplenic pathologies in Asian schistosomiasis: report of a WHO expert meeting Infectious Diseases of Poverty Schistosoma japonicum Schistosoma mekongi Hepatosplenic schistosomiasis Ultrasonography Point-of-care ultrasound Liver fibrosis |
| title | The Basel ultrasonography protocol for assessing hepatosplenic pathologies in Asian schistosomiasis: report of a WHO expert meeting |
| title_full | The Basel ultrasonography protocol for assessing hepatosplenic pathologies in Asian schistosomiasis: report of a WHO expert meeting |
| title_fullStr | The Basel ultrasonography protocol for assessing hepatosplenic pathologies in Asian schistosomiasis: report of a WHO expert meeting |
| title_full_unstemmed | The Basel ultrasonography protocol for assessing hepatosplenic pathologies in Asian schistosomiasis: report of a WHO expert meeting |
| title_short | The Basel ultrasonography protocol for assessing hepatosplenic pathologies in Asian schistosomiasis: report of a WHO expert meeting |
| title_sort | basel ultrasonography protocol for assessing hepatosplenic pathologies in asian schistosomiasis report of a who expert meeting |
| topic | Schistosoma japonicum Schistosoma mekongi Hepatosplenic schistosomiasis Ultrasonography Point-of-care ultrasound Liver fibrosis |
| url | https://doi.org/10.1186/s40249-025-01349-x |
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