ArticleBMC infectious diseases2014
Oesophageal varices, schistosomiasis, and mortality among patients admitted with haematemesis in Mwanza, Tanzania: a prospective cohort study.
Article in BMC infectious diseases, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.
- Surgical portosystemic shunts versus devascularisation procedures for prevention of variceal rebleeding in people with hepatosplenic schistosomiasis.The Cochrane database of systematic reviews · 2018Pooled it
- Establishing an Endoscopy Unit for Management ofEndoscopy international open · 2026Article
- An actionable roadmap for NTD morbidity, disability, and disfigurement management.PLoS neglected tropical diseases · 2025Article
- Clinical and endoscopic findings of patients presenting with upper gastrointestinal bleeding in Khartoum, Sudan: a cross-sectional study.BMC gastroenterology · 2025Article
- Management Outcomes of Variceal Bleeding in Northern Tanzania: Insights From a Single-Center Retrospective Analysis.JGH open : an open access journal of gastroenterology and hepatology · 2025Article
- Control and elimination of Schistosoma mansoni infection in adult individuals on Ukerewe island, northwestern Tanzania: baseline results before implementation of intervention measures.BMC infectious diseases · 2024Article
- The diagnostic accuracy of triphasic abdominal CT in detecting esophageal varices.BMC medical imaging · 2024Article
- Hepatic schistosomiasis, upper gastrointestinal bleeding, and health related quality of life measurements from the Albert Nile Basin.Journal of patient-reported outcomes · 2021Article
- Praziquantel and Upper Gastrointestinal Bleeding in Hepatic Schistosomiasis: A Quasi-Experimental Study.Drugs - real world outcomes · 2021Article
- Schistosoma mansoni-related periportal fibrosis; can we use APRI and PSDR levels in the real-time selection of patients for targeted endoscopy in a resource-limited setting? A case-control study.BMC gastroenterology · 2021Article
- Patients with severe schistosomiasis mansoni in Ituri Province, Democratic Republic of the Congo.Infectious diseases of poverty · 2021Article
- Prevalence, infection intensity and geographical distribution of schistosomiasis among pre-school and school aged children in villages surrounding Lake Nyasa, Tanzania.Scientific reports · 2021Article
- Morbidity and Mortality Due toTropical medicine and infectious disease · 2020Article
- Schistosomiasis Pulmonary Arterial Hypertension.Frontiers in immunology · 2020Review
- Can Early Diagnosis of Varices, Regular Praziquantel, and Reduction of Hepatitis Coinfection Reduce Mortality among Patients Attended for Periportal Fibrosis in Northwestern Tanzania? A Case-Control Study.Journal of parasitology research · 2020Article
- Profile and outcome of patients with upper gastrointestinal bleeding presenting to urban emergency departments of tertiary hospitals in Tanzania.BMC gastroenterology · 2019Article
- The diagnostic accuracy of routine clinical findings for detection of esophageal varices in rural sub-Saharan Africa where schistosomiasis is endemic.African health sciences · 2019Article
- Risk factors for mortality among patients admitted with upper gastrointestinal bleeding at a tertiary hospital: a prospective cohort study.BMC gastroenterology · 2017Article
- Colorectal cancer in a patient with intestinal schistosomiasis: a case report from Kilimanjaro Christian Medical Center Northern Zone Tanzania.World journal of surgical oncology · 2017Article
- Praziquantel for Schistosomiasis: Single-Drug Metabolism Revisited, Mode of Action, and Resistance.Antimicrobial agents and chemotherapy · 2017Review
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Authors and funding
11 authors at 4 institutions in 3 countries.
Funding
Abstract
backgroundUpper gastrointestinal bleeding (UGIB) is a common cause of hospital admissions worldwide. Aetiologies vary by sociodemographics and geography. Retrospective studies of endoscopies in much of Africa have documented oesophageal varices as a leading cause of UGIB. Prospective studies describing outcomes and associations with clinical factors are lacking.
methodsWe conducted a prospective cohort study at a referral hospital in Mwanza, Tanzania where schistosomiasis is endemic. Adults admitted with haematemesis underwent laboratory workup, schistosomiasis antigen testing and elective endoscopy, and were followed for two months for death or re-bleeding. We assessed predictors of endoscopic findings using logistic regression models, and determined prediction rules that maximised sensitivity and positive predictive value (PPV).
resultsOf 124 enrolled patients, 13 died within two months (10%); active schistosomiasis prevalence was 48%. 64/91(70%) patients had oesophageal varices. We found strong associations between varices and numerous demographic or clinical findings, permitting construction of simple, high-fidelity prediction rules for oesophageal varices applicable even in rural settings. Portal vein diameter ≥ 13 mm or water sourced from the lake yielded sensitivity, specificity, PPV and NPV >90% for oesophageal varices; presence of splenomegaly or water sourced from the lake maintained sensitivity and PPV >90%.
conclusionsOur results guide identification of patients, via ultrasound and clinical examination, likely to have varices for whom referral for endoscopy may be life-saving. Furthermore, they support empiric anti-schistosome treatment for patients with UGIB in schistosome-endemic regions. These interventions have potential to reduce UGIB-related morbidity and mortality in Africa.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.