Diagnostic and clinical aspects of schistosomiasis in 182 patients treated at a Swedish ward for tropical diseases during a 10-year period.

Patients treated for schistosomiasis during a 10-year period at a hospital for infectious diseases in Stockholm were investigated by a retrospective analysis in order to evaluate the diagnostic procedures. 80% of the 182 individuals originated from an endemic area and 78% were men. The mean age was 28 years for men and 27 for women. 137 had no other detectable parasites. 127 were asymptomatic. Haematuria was found in 6/15 patients with S. haematobium. 143 patients had infection with S. mansoni. Pathological findings during physical examinations were rare. 61% of the patients had eosinophilia. IgE was a sensitive marker among the patients with a chronic infection (84%). Analysis of antibodies directed against the somatic structure of the adult worm by use of immunofluorescence (IFL) technique had a sensitivity of 80% among the patients with a chronic infection. The detection of antibodies against the gut-associated antigens in IFL indicated an early infection. An enzyme-linked immunosorbent assay (ELISA), using a crude soluble egg antigen, had a sensitivity of 95% and specificity of 96% and is of important diagnostic value.