Quantitative assessment of eosinophiluria in Schistosoma haematobium infections: a new marker of infection and bladder morbidity.

Abstract

Abstract. Eosinophiluria, as quantified by measuring eosinophil cationic protein (ECP) in urinary extracts, microhematuria, egg excretion, and ultrasound-detectable bladder pathology were recorded in Schistosoma haematobium-infected Tanzanian school children at a baseline survey and during an 18-month post-treatment followup study. Significant correlations were seen between urinary ECP levels, intensity of infection, and bladder pathology. Treatment resulted in a marked reduction in prevalence and intensity of infection, in a delayed and less marked reduction in ECP levels, and in a resolution of pathology. The overall diagnostic efficiency of the ECP test (cut-off value for the ECP Ն5 ng/ml) in relation to infection was comparable with that of egg count and microhematuria, but with a better sensitivity than a single egg count. In relation to bladder pathology, the diagnostic performance of the ECP test (cut-off value for the ECP Ն25 ng/ml) exceeded that of a single egg count. In addition, the ECP was better in discriminating between different grades of bladder pathology. The present study points to the ECP as a useful marker of both S. haematobium infection and of associated bladder morbidity reflecting the inflammatory status of the bladder wall.

Relationship between eosinophil cationic protein and infection intensity in a schistosomiasis endemic community in Ghana

“…This is similar to results reported elsewhere. 8 Frequency of contact was, however, found to be insignificantly associated with mean ECP levels (P=0.74) ( Figure 1C). Additionally, association between ECP and sex was insignificant (P=0.33) ( Figure 5B).…”

“…For instance, separate studies in Zanzibar and the People's Republic of China reported low sensitivity of the Kato-Katz technique, which only improved with increasing number of samples. 4,5 Other studies have reported the collection of between two and four urine samples on consecutive days in efforts to improve the accuracy of measurement of S. haematobium infection prevalence [6][7][8] and infection intensity by egg count. 9 Therefore, complementing current microscopic methods with immunological techniques could significantly improve accurate one-time infection detection and intensity determination of the parasite in single samples.…”

“…8 The eosinophil cationic protein (ECP) is one such immunomolecule released during innate immune responses; it is a highly basic and potent cytotoxic single-chain, zinc-containing protein of strong proinflammatory activity, 10 detectible in blood, stool, and urine, 11,12 and with a half-life of 45 minutes in circulation. 13 Penetration of the human skin by the cercaria is done with the aid of secreted proteases and immunomodulators.…”

Recent advances in schistosomiasis

“…Schistosome-induced morbidity does not always correlate with intensity of infection, and the dynamics of both its development and resolution are highly variable. Quantitative assessment of eosinophiluria in S. haematobium infection has been reported to have a better sensitivity than does a single egg count, with regard to bladder pathology [33]. A comparison of eosinophilic cationic protein (ECP) in urinary extracts, microhematuria, egg excretion, and ultrasonographically detected bladder pathology showed that the ECP was a cost-effective diagnostic tool in discriminating different grades of bladder pathology.…”

Schistosomiasis - An Unusual Cause of Ureteral Obstruction: A Case History and Perspective

“…21 Urinary eosinophil cationic protein has been shown to correlate well with the extent of bladder pathology in S. haematobium infections. 74 Immunodiagnostic assays have been developed to detect circulating antibodies to semi-purified or fractionated antigens [75][76][77][78][79][80][81] and parasite circulating antigens in different host body fluids. [82][83][84][85][86][87][88] Falcon assay screening test (FAST)-ELISA and immunoblot assays for specific antibodies to S. mansoni and S. haematobium adult worm microsomal antigens are highly specific for both species.…”