Abstract:
In a cross-sectional survey, 304 subjects whose sputum and faeces tested positive for paragonimus out of a total of 1125 from Amagunze, Lokpanta and Oduma which are areas known for the parasite endemicity in Southeast Nigeria were enlisted into the study. The liver, spleen, and kidney of these subjects were sonographically examined in order to characterize the sonographic features specific for paragonimus in these organs. A total number of 456 subjects were also enlisted as control. Characterization was based on echotexture scoring on a 4 point likert scale of normal, dark (echopoor), coarse and echogenic texture and presence of cysts, which were validated by three independent experts. The organ dimensions were also included as criteria for the characterization. Three hundred crabs collected from these locations were also examined using standard method for the burden of the parasite. Using SPSS version 16.0, ANOVA and students t-test were done on the length of the liver, spleen and kidneys with age and sex as factors and to determine difference of continuous variables between two independent groups. Out of the 300 crabs examined, only 25 (8.3%) were positive mainly for paragonimus uterobilateralis and the burden ranged from 1-75 per crab. Two hundred and twenty four (224) 73.7% out of 304 subjects showed presence of paragonimus in the sputum while only N=80 (26.3%) had the parasite in the stool. The male – female ratio of the infected subjects were 168:136. The echotextural characterization show that N=25 were echopoor (dark), 20 had liver cyst and 7 had coarse echotexture. The mean organ dimensions of the liver, spleen and kidneys in infected subjects were; 13.8 + 1.03cm, 11.57 + 2.11cm and 9.6 + 1.27cm respectively. The mean organ dimensions of the liver, spleen and kidneys for the control subjects were; 12.56 + 1.66cm, 10.83 + 2.05cm and 9.65 + 1.66cm respectively. No significant differences were demonstrated in the organ dimensions between the infected and control (p > 0.05). The sonographic features observed in this study include, hepatosplenomegaly, pleural effusion, dark echotexture, coarse and echogenic texture and liver cyst.
