Ultrasound findings in urinary shistosomaisis infection in school children in the Gezira state central Sudan

Abstract

To evaluate the ultrasound findings of urinary schistosomiasis in Quran school (Khalwas) children in Gezira State Sudan, we studied all the students from two schools. A total of 103 boys were tested for urinary schistosomiasis using the urine filtration method. Schistosoma haematobium (S. haematobium) eggs were counted. Ultrasound was performed for all the positive subjects. Seventy-three (71%) subjects were positive for S. haematobium. The mean age was 11.3 ± 2.9 years. Sixty-six (90.4%) subjects showed urinary tract abnormalities. The findings revealed the following degrees of wall thickening: 53.0% mild, 18.2% moderate and 21.2% severe. Urinary bladder polyp(s) were noted in 43.3% (single) and 40.9% (multiple) of the subjects, and calcification of the bladder wall was observed in 7.6% subjects. Ureteric dilatation was noted in 38/73 (52.0%), while hydronephrosis was detected in 19/73 (26.3%). The vast majority of urinary tract schistomiasis lesions were in the urinary bladder. Ultrasound is a useful tool for identifying the morbidity of S. haematobium in endemic areas.

A 14-year follow-up of ultrasound-detected urinary tract pathology associated with urogenital schistosomiasis in women living in the Msambweni region of coastal Kenya

“…In these cases, the active infection is often not detected on urine microscopy of a single urine specimen, as the diagnostic yield is reduced in lower intensity infections. 38 It has also been shown previously that the excreted egg count in urine does not necessarily correlate with fibrotic pathology among adults, 35,39,40 and that the likelihood of pathology can be related to an excessive (unmodulated) immune response rather than to the number of excreted eggs per se. 41,42 This suggests that in our study's population of adult women there is ongoing morbidity despite no detectable active infection.…”

“…34 Bladder wall thickening was the most common form of pathology found on ultrasound, which replicates the findings of earlier ultrasound studies of urogenital schistosomiasis pathology in other endemic areas. [35][36][37] Interestingly, we found more urinary tract pathology than egg-patent infection among adult women in both villages.…”