The Basel ultrasonography protocol for assessing hepatosplenic pathologies in Asian schistosomiasis: report of a WHO expert meeting
Richter, Joachim, Neumayr, Andreas, Garba-Djirmay, Amadou, Ohmae, Hiroshi, Aniceto, Ralph, Zhou, Xiao Nong, Xu, Jing, Guo, Zhaoyu, Ning, An, Kamau, Edward Mberu, Tamarozzi, Francesca, Wu, Hannah Wei, King, Charles, Vennervald, Birgitte Jyding, Chami, Goylette F., Utzinger, Jürg, and Hatz, Christoph (2025) The Basel ultrasonography protocol for assessing hepatosplenic pathologies in Asian schistosomiasis: report of a WHO expert meeting. Infectious Diseases of Poverty, 14 (1). 83.
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Abstract
Asian hepatointestinal schistosomiasis due to Schistosomajaponicum 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.
| Item ID: | 87754 |
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| Item Type: | Article (Research - C1) |
| ISSN: | 2049-9957 |
| Keywords: | Esophageal varices, Hepatosplenic schistosomiasis, Interseptal fibrosis, Liver fibrosis, Point-of-care ultrasound, Portal fibrosis, Portal hypertension, Schistosomajaponicum, Schistosomamekongi, Ultrasonography |
| Copyright Information: | © The Author(s) 2025. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
| Date Deposited: | 12 Feb 2026 07:47 |
| FoR Codes: | 42 HEALTH SCIENCES > 4202 Epidemiology > 420207 Major global burdens of disease @ 100% |
| SEO Codes: | 20 HEALTH > 2004 Public health (excl. specific population health) > 200404 Disease distribution and transmission (incl. surveillance and response) @ 100% |
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