Cystoscopy in the diagnosis and follow-up of urinary schistosomiasis in Brazilian soldiers returning from Mozambique, Africa

Abstract

SUMMARYThe assessment of urinary schistosomiasis in individuals coming from endemic areas often requires diagnostic resources not used in areas of exposure in order to determine complications or to establish more precise criteria of cure. Cystoscopy and 24-hour urine examination were performed, after treatments with praziquantel 40 mg/kg body weight, single dose, on 25 Brazilian military men who were part of a United Nations peace mission to Mozambique in 1994. The median age of the individuals was 29 years and all presented a positive urine parasitological exam. The alterations detected by cystoscopy were hyperemia and granulomas in the vesical submucosa in 59.1% of the individuals and only granulomas in 40.9%. A vesical biopsy revealed granulomas in all patients and viable eggs in 77.3% even after a period during which the patients no longer excreted eggs in urine. Cystoscopy after treatment, followed by biopsy and histopathological evaluation, performed in areas where the evolution of the disease can be better monitored, was found to be a safe criterion of parasitological cure.

The WHO ultrasonography protocol for assessing hepatic morbidity due to Schistosoma mansoni. Acceptance and evolution over 12 years

“…By the modifications of the Niamey protocol as proposed above, the assessment of the regression and subsequent reappearance of lesions in constantly exposed individuals might be evaluated more properly. A cystoscopy study on Brazilian soldiers returning from a peace keeping mission in Mozambique revealed that even after two rounds of adequate praziquantel therapy, 36% of soldiers who were no more excreting ova in the urine still had viable ova in the 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 bladder mucosa (Silva et al 2006), an important issue also for travel medicine, considering the potential of schistosomiasis to induce bladder cancer (Mostafa, et al 1999, Amonkar et al 2001). Unfortunately; this study missed the opportunity to evaluate ultrasonography in this respect.…”

Prevalence of Schistosoma haematobium parasitism in rural population of Cubal city, Province of Benguela, Angola

“…On returning from the mission, all participants presented S.haematobium eggs in the parasitological examination of urine and also urinary complications were attributed to the parasite. However, the transmission of this helminth did not occur in the American continent due to the inexistence of the host mollusk intercalated in the trematode life cycle (Silva et al, 2006). Ping et al (2014) and Wang et al (2013) cited that only S. japonicum is endemic.…”

Schistosoma haematobium in China, ex‐Africa: New Populations at Risk?

“…1 Imported cases of schistosomiasis have been reported among tourist travelers, 2 immigrants, 3 expatriates, 4 Peace Corps volunteers, 5 and military personnel 6 with exposures to endemic areas of Africa or Asia.…”