Schistosomal Pulmonary Arterial Hypertension in East Africa.

Schistosomal cor pulmonale is common in Egypt where schistosomiasis is endemic (Day, 1937; Shaw and Ghareeb, 1938; Bedford, Aidaros, and Girgis, 1946; Erfan et al., 1949; Kenawy, 1950; Girgis, 1952; Farid et al., 1959). It is also well known in South America, particularly in Brazil (Lopes de Faria et al., 1957; Cavalcanti et al., 1962), and in Puerto Rico (Clark and Graef, 1935; Marchand et al., 1957; Rodriguez et al., 1963). Sporadic cases have been described from West Africa (Edington, 1957; Lauckner, Rankin, and Adi, 1961; Ogunlesi, 1962), and one from Southern Rhodesia (Gelfand, 1957). However, it is rare in Central Africa, as is illustrated by the fact that Gelfand in 1950 reported 400 necropsies in Africans suffering from bilharzia without finding a single example of cor pulmonale. In spite of the fact that schistosomiasis is endemic in various parts of East Africa, only one patient has been described (Williams, 1958). This patient was seen in 1953 and had evidence of severe pulmonary arterial hypertension. The cause was unsuspected during life and was only shown to be schistosomal at necropsy. The purpose of this paper is to present 5 further cases, 1 from coastal Kenya and 4 from Uganda. Of these 5, 4 were diagnosed during life.