Abstract: Objective    To understand the epidemic and clinical characteristics of newly discovered advanced schistosomiasis for evidence to formulate scientific measures against this entity. Methods     The data, including the basic information, inpatient medical records, imaging and laboratory findings were collected from and analyzed in the newly discovered advanced schistosomiasis cases reported in Nanling County from 2016 to 2020. Results     Totally, 49 new cases of advanced schistosomiasis were found in Nanling County between 2016 and 2020, distributed in 4 townships, including 34 cases in Yijiang Town, 13 in Jishan Town, 1 in Xuzhen Town and another 1 in Jiafa Town. Average age of the 49 patients was (59.11±11.66) years. Twenty-six of them were males, and 23 females. The occupations were associated with farmers in 22, migrant workers in 17 and domestic workers in 8. By clinical typing, 31 cases were of splenomegaly, 16 of ascites and 2 of colonic proliferation. The average time was 19.2 years from the initial diagnosis to the first conclusion of advanced schistosomiasis, and the average treatment session was 4.22. B-ultrasound revealed that splenomegaly occurred in 31 of the 49 cases of the advanced schistosomiasis. Fourteen patients underwent splenectomy, and 4 were of normal spleen. The mean count of platelets and leukocytes was significantly lower in patients with splenomegaly than in those undergone splenectomy(t =[-]5.552,[-]4.958; both P<0.05). In the 49 patients, 27 had a history of type B or/and C infection. Twenty four had history of hepatitis B infection, 6 had history of hepatitis C infection. Serum albumin level was significantly lower in patients with hepatitis B and/or C infection history than those without infection history (t=2.702, P<0.05). Conclusion     Survey on the advanced schistosomiasis should be strengthened in the key population living in the crucial areas of schistosomiasis control so that the potential advanced infection can be timely identified and undergone anti-fibrosis therapy in early stage to slow down the disease progression. Additionally, prevention or anti hepatitis treatment is recommended.

Key words: Advanced schistosomiasis, Hepatic fibrosis, Splenectomy, Combined hepatitis