Urinary Tract Morbidity in Schistosomiasis Haematobia: Associations with Age and Intensity of Infection in an Endemic Area of Coast Province, Kenya

King, Charles H.; Keating, Catherine E.; Muruka, J; Ouma, John H.; Houser, Harold B.; Siongok, T. K. Arap; Mahmoud, Adel A. F.

doi:10.4269/ajtmh.1988.39.361

Cited by 62 publications

(38 citation statements)

References 9 publications

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“…First, the sensitivity of urine filtration for parasitologic diagnosis is known to be lower in individuals with light intensity infections. 21 Such light infections are more common among adults, 24 making the detection of their active infections less likely. In addition, sensitivity of parasitologic testing may be further limited by chronic scarring of the bladder, (common among older individuals from S. haematobium-endemic areas), 12,28 which may limit the release of eggs into the bladder lumen.…”

Section: Discussionmentioning

confidence: 99%

“…The above findings, coupled with observed age-specific variation in S. haematobium infection intensity, 24 and the known association of chronic forms of urinary tract morbidity with age, 24 prompted further detailed evaluation of age-specific changes in cytologic abnormalities. Results were further analyzed separately by sex to allow for the fact that squamous metaplasia of the trigone is reported to be common (up to 50% prevalence) in some normal adult female populations.…”

Section: Study Participationmentioning

confidence: 99%

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Predisposition to urinary tract epithelial metaplasia in Schistosoma haematobium infection.

Hodder¹,

Mahmoud²,

Sorenson³

et al. 2000

The American Journal of Tropical Medicine and Hygiene

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Abstract. Although there is strong epidemiologic evidence linking Schistosoma haematobium infection with carcinoma of the bladder, the utility of cytologic screening for urinary tract cancer has not been critically evaluated in S. haematobium-endemic populations. The present cross-sectional study examined urine cytology findings among 1,014 residents (ages 1 to 91) of the S. haematobium-endemic Msambweni area of Coast Province, Kenya. Among 705 evaluable cytology specimens, prevalence of inflammation (39%), hyperkeratosis (30%), metaplasia (33%), and frank atypia (0.4%) was notably higher than in previously studied, non-endemic populations. Overall, S. haematobium infection was strongly associated with increased risk for cytologic abnormality (Ͼ 2.8-fold relative risk of metaplasia or hyperkeratosis; P Ͻ 0.001). Age-group analysis confirmed parallel increases in metaplasia and S. haematobium infection prevalence early in life (from age 1 to 15 for both boys and girls). However, above age 20, metaplasia prevalence persisted at 33-45% prevalence despite a decline in infection prevalence and intensity. Prevalence of advanced (moderate or severe) metaplasia showed two age-related peaks: the first at 10-14 years of age (at the time of peak infection), and the second among subjects Ն 60 years old. No cancers were detected in the study population either on cytology or on follow-up ultrasound examination. These data suggest an age-dependent progression of cellular abnormalities in the urinary epithelium that is associated with chronic S. haematobium infection, which becomes independent of concurrent infection intensity as subjects grow older. Implications for cancer screening are discussed.

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Section: Discussionmentioning

confidence: 99%

Section: Study Participationmentioning

confidence: 99%

Predisposition to urinary tract epithelial metaplasia in Schistosoma haematobium infection.

Hodder¹,

Mahmoud²,

Sorenson³

et al. 2000

The American Journal of Tropical Medicine and Hygiene

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“…The results summarized in this paper are taken from previously published reports of the outcomes of the Msambweni Study, performed in the Msambweni area of Kwale District on the south coast of Kenya (King et al 1988a,b, 1990, Muchiri et al 1996, Ouma et al 2005, Satayathum et al 2006). This area is a 25 km 2 , 9-village area which is endemic for urinary schistosomiasis due to S. haematobium, located about 50 km southwest of Mombasa, adjacent to the main Mombasa-Tanzania road.…”

Section: Methodsmentioning

confidence: 99%

Long-term outcomes of school-based treatment for control of urinary schistosomiasis: a review of experience in Coast Province, Kenya

King

2006

Mem. Inst. Oswaldo Cruz

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“…Approximately 200 million people are infected worldwide, with the vast majority residing in sub-Saharan Africa. 1 Urogenital schistosomiasis, which is caused by Schistosoma haematobium, accounts for approximately two-thirds of all cases 2,3 and has a broad range of clinical features, ranging from hematuria and genital ulceration to bladder cancer and infertility. [2][3][4] Rural, impoverished, and marginalized populations are disproportionately affected.…”

mentioning

confidence: 99%

“…1 Urogenital schistosomiasis, which is caused by Schistosoma haematobium, accounts for approximately two-thirds of all cases 2,3 and has a broad range of clinical features, ranging from hematuria and genital ulceration to bladder cancer and infertility. [2][3][4] Rural, impoverished, and marginalized populations are disproportionately affected. 5 The World Health Organization is facilitating mass drug administration (MDA) campaigns for several neglected tropical diseases, including the provision of praziquantel in regions with high burdens of schistosomiasis.…”

mentioning

confidence: 99%

Ultra–Low-Cost Urine Filtration for Schistosoma haematobium Diagnosis: A Proof-of-Concept Study

Ephraim¹,

Duah²,

Andrews³

et al. 2014

The American Society of Tropical Medicine and Hygiene

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Abstract. Simple, efficient, and cost-effective strategies are needed for urine sample preparation in the field diagnosis of infection with Schistosoma haematobium. In this proof-of-concept study, we evaluated inexpensive and widely available paper products (paper towels, school workbook paper, and newspaper) to gravity-filter urine containing 60 eggs/mL of Schistosoma haematobium. Eggs were reliably visualized by light microscopy by using single-ply paper towels as urine filters. This filtration method has broad applicability in clinical and public health settings in resourceconstrained environments.Schistosomiasis is a disease caused by infection with a bloodborne fluke acquired through direct contact with contaminated fresh water. Approximately 200 million people are infected worldwide, with the vast majority residing in sub-Saharan Africa.1 Urogenital schistosomiasis, which is caused by Schistosoma haematobium, accounts for approximately two-thirds of all cases 2,3 and has a broad range of clinical features, ranging from hematuria and genital ulceration to bladder cancer and infertility.2-4 Rural, impoverished, and marginalized populations are disproportionately affected. 5The World Health Organization is facilitating mass drug administration (MDA) campaigns for several neglected tropical diseases, including the provision of praziquantel in regions with high burdens of schistosomiasis.6 Lower prevalences of infection are found in regions that implement MDA campaigns. 7,8 Effective and inexpensive diagnostic tools will be essential for S. haematobium case detection in clinical and public health settings, especially in regions with an infection prevalence below the threshold for MDA campaigns.There are several low-cost diagnostics strategies for schistosomiasis; urine reagent strips evaluating for hematuria are somewhat sensitive but have a wide range in specificity for S. haematobium diagnosis.9-11 Similarly, the urine circulating cathodic antigen test is sensitive for S. mansoni, but lacks sensitivity for S. haematobium.12,13 Urine filtration and light microscopy remain an important diagnostic procedure for detection of S. haematobium infection. However, techniques used for concentration of eggs from urine involve either centrifugation or filtration by using specialized microporous membranes, which are relatively expensive for use in lowincome countries. Simplifying sample preparation in the field before microscopy is vital for efficient and cost-effective diagnostic strategies in resource-constrained settings. The goal of this proof-of-concept study was to evaluate inexpensive, rapid, and effective modes of urine filtration for S. haematobium by using widely available and affordable commercial products, and to compare these approaches with a conventional concentration approach.Ethical approval for this proof-of-concept diagnostic project was granted by the Institutional Review Board of the University of Cape Coast, Cape Coast, Ghana (IRB/UCC) and the Department of Laboratory Technology.Urine samples from 10...

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Urinary Tract Morbidity in Schistosomiasis Haematobia: Associations with Age and Intensity of Infection in an Endemic Area of Coast Province, Kenya

Cited by 62 publications

References 9 publications

Predisposition to urinary tract epithelial metaplasia in Schistosoma haematobium infection.

Predisposition to urinary tract epithelial metaplasia in Schistosoma haematobium infection.

Long-term outcomes of school-based treatment for control of urinary schistosomiasis: a review of experience in Coast Province, Kenya

Ultra–Low-Cost Urine Filtration for Schistosoma haematobium Diagnosis: A Proof-of-Concept Study

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