Urinary schistosomiasis in Zimbabwean school children: predictors of morbidity

  • Kimberly C Brouwer The W. Harry Feinstone Department of Molecular Microbiology & Immunology, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore MD 21205, USA
  • Anderson Munatsi Blair Research Laboratory, Josiah Tongogara Ave./Mazowe Street, P.O. Box CY 573, Causeway, Harare, Zimbabwe
  • Patricia D Ndhlovu Blair Research Laboratory, Josiah Tongogara Ave./Mazowe Street, P.O. Box CY 573, Causeway, Harare, Zimbabwe
  • Yukiko Wagatsuma Present address: Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
  • Clive J Shiff The W. Harry Feinstone Department of Molecular Microbiology & Immunology, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore MD 21205, USA.

Abstract

Background: The morbid effects of urinary bilharziasis are becoming more evident with the advent of sophisticated diagnostics such as ultrasound. However, such diagnosis of Schistosoma haematobium morbidity is often hampered by lack of funds, proper equipment, or training.

Objective: We performed a cross-sectional investigation of schoolchildren in a highly endemic area of east central Zimbabwe in order to assess the utility of a number of simple clinical indicators to predict Schistosoma haematobium morbidity.

Methods: Prevalence and intensity of S. haematobium infection was determined in 551 schoolchildren, with ultrasound examination of the kidneys and bladder performed on 222. The association of a number of demographic, parasitological, and clinical parameters with clinical outcome was evaluated.

Results: Overall, 60% of the children were infected with S. haematobium. Although lacking specificity, proteinuria and parasite eggs count best predicted bladder pathology. Presence of kidney dilation was associated with fatigue and pain upon urination, but these variables were not very sensitive.

Conclusions: None of the variables assessed were ideal predictors of morbidity. However, the results suggest that a combination of inexpensive, simple indicators may allow for improved targeting of S. haematobium treatment to those with severe morbidity and better monitoring of the progress of control campaigns when more expensive diagnostic methods are not available.

African Health Sciences Vol.4(2) 2004: 115-118
Published
2004-11-10
Section
Articles

Journal Identifiers


eISSN: 1680-6905