Evaluation of an Ultrasonographic Score for Urinary Bladder Morbidity in Schistosoma haematobium Infection

Medhat, Ahmed; Zarzour, Ali; Nafeh, Mohamed; Shata, Tarek; Sweifie, Y.; Attia, Marwa M.; Helmy, Ashraf A; Shehata, Mohammed; Zaki, Saad; Mikhail, Nabiel; Ibrahim, S. A.; King, Charles H.; Strickland, G. Thomas

doi:10.4269/ajtmh.1997.57.16

Cited by 20 publications

(18 citation statements)

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“…Again, younger age was associated with faster clearance of bladder and upper urinary tract lesions. Similar posttreatment improvements in urinary bladder and kidney morbidity scores in children were reported by Medhat and others 33 in Egypt and Hatz and others 35 in Tanzania. In a study by Delegue and others 34 in Senegal, in which 24% of the subjects were over the age of 25, urinary tract lesions were said to regress significantly in the cohort at large 4 months after PZQ therapy, but an age-specific breakdown of outcomes was not given.…”

Section: Discussionsupporting

confidence: 84%

“…16,[29][30][31][32][33][34][35][36][37][38] However, these studies have been primarily focused on responses among children and not adults. Doehring and others documented improvement of bladder lesions associated with schistosomiasis among children within 2 months, 29 and found reversibility of urinary tract obstructive findings within 1 year after treatment.…”

Section: Discussionmentioning

confidence: 99%

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Case–Control Study of Posttreatment Regression of Urinary Tract Morbidity Among Adults in Schistosoma haematobium–Endemic Communities in Kwale County, Kenya

Magak

Chang-Cojulun

Kadzo

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. Previous population-based studies have examined treatment impact on Schistosoma-associated urinary tract disease among children, but much less is known about longer-term treatment benefits for affected adult populations in areas where risk of recurrent infection is high. In communities in Msambweni, along the Kenya coast, we identified, using a portable ultrasound, 77 adults (aged 17-85) with moderate-to-severe obstructive uropathy or bladder disease due to Schistosoma haematobium. Treatment response was assessed by repeat ultrasound 1-2 years after praziquantel (PZQ) therapy and compared with interval changes among age-and sex-matched infected/treated control subjects who did not have urinary tract abnormalities at the time of initial examination. Of the 77 affected adults, 62 (81%) had improvement in bladder and/or kidney scores after treatment, 14 (18%) had no change, and one (1.3%) had progression of disease. Of the 77 controls, 75 (97%) remained disease free by ultrasound, while two (3%) had apparent progression with abnormal findings on follow-up examination. We conclude that PZQ therapy for S. haematobium is effective in significantly reducing urinary tract morbidity from urogenital schistosomiasis among adult age groups, and affected adults stand to benefit from inclusion in mass treatment campaigns.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Case–Control Study of Posttreatment Regression of Urinary Tract Morbidity Among Adults in Schistosoma haematobium–Endemic Communities in Kwale County, Kenya

Magak

Chang-Cojulun

Kadzo

et al. 2015

The American Society of Tropical Medicine and Hygiene

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“…This was unexpected as S. haematobium infection has consistently been reported as an independent risk factor for urinary tract morbidity [43], [44], [64]–[71]. The fact that S. haematobium was only introduced in this region approximately 6 years prior to this study [72], may explain the relatively low severity of urinary tract morbidity in this community and the consequent absence of a spatial pattern.…”

Section: Discussionmentioning

confidence: 78%

“…To assess the presence or absence of S. haematobium -specific urinary tract morbidity, the urinary bladder score was determined [42]. A score of ≥1 was considered as S. haematobium -specific bladder morbidity in accordance with previous studies [31], [43], [44]. The severity of morbidity was represented by the liver image pattern score for S. mansoni - and by the upper urinary tract score for S. haematobium -specific morbidity [42].…”

Section: Methodsmentioning

confidence: 99%

Micro-Geographical Heterogeneity in Schistosoma mansoni and S. haematobium Infection and Morbidity in a Co-Endemic Community in Northern Senegal

et al. 2013

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Background Schistosoma mansoni and S. haematobium are co-endemic in many areas in Africa. Yet, little is known about the micro-geographical distribution of these two infections or associated disease within such foci. Such knowledge could give important insights into the drivers of infection and disease and as such better tailor schistosomiasis control and elimination efforts.MethodologyIn a co-endemic farming community in northern Senegal (346 children (0–19 y) and 253 adults (20–85 y); n = 599 in total), we studied the spatial distribution of S. mansoni and S. haematobium single and mixed infections (by microscopy), S. mansoni-specific hepatic fibrosis, S. haematobium-specific urinary tract morbidity (by ultrasound) and water contact behavior (by questionnaire). The Kulldorff's scan statistic was used to detect spatial clusters of infection and morbidity, adjusted for the spatial distribution of gender and age.Principal Findings Schistosoma mansoni and S. haematobium infection densities clustered in different sections of the community (p = 0.002 and p = 0.023, respectively), possibly related to heterogeneities in the use of different water contact sites. While the distribution of urinary tract morbidity was homogeneous, a strong geospatial cluster was found for severe hepatic fibrosis (p = 0.001). Particularly those people living adjacent to the most frequently used water contact site were more at risk for more advanced morbidity (RR = 6.3; p = 0.043).Conclusions/Significance Schistosoma infection and associated disease showed important micro-geographical heterogeneities with divergent patterns for S. mansoni and S. haematobium in this Senegalese community. Further in depth investigations are needed to confirm and explain our observations. The present study indicates that local geospatial patterns should be taken into account in both research and control of schistosomiasis. The observed extreme focality of schistosomiasis even at community level, suggests that current strategies may not suffice to move from morbidity control to elimination of schistosomiasis, and calls for less uniform measures at a finer scale.

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“…Both readings were blinded to the previous readings and the patient's current and previous infection status. The scoring of the severity of bladder-wall morbidity was slightly modified on the basis of a classification described elsewhere [21,22] and similar to that of King et al [6] and was scored on the basis of the extent of bladder-wall pathology: grade 0, bladder-wall thickness !5 mm; grade 1, bladder-wall thickness 5-7 mm or any areas of bladderwall irregularity; grade 2, maximum bladder-wall thickening of 8-9 mm with у2 areas of involvement; grade 3, maximum bladder-wall thickening of у10 mm with у1 areas of involvement or any polyp, mass, or tumor. Grade 1 hydroureter was defined on the basis of World Health Organization (WHO) criteria, in which dilation of the ureter can be visualized (e.g., !1 cm) either in the proximal portion or in the distal third.…”

Section: Subjects Materials and Methodsmentioning

confidence: 99%

Increased Ratio of Tumor Necrosis Factor–α to Interleukin‐10 Production Is Associated withSchistosoma haematobium–Induced Urinary‐Tract Morbidity

Wamachi

Mayadev

Mungai³

et al. 2004

J INFECT DIS

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Bladder and kidney disease, which affect approximately 25%-30% of subjects infected with Schistosoma haematobium, are mediated by T cell-dependent granulomatous responses to schistosome eggs. To determine why only some infected subjects develop disease, we examined the hypothesis that infected Kenyan subjects with ultrasound-detected urinary-tract morbidity (n=49) had dysregulated cytokine production leading to enhanced granulomatous responses, compared with subjects of similar age and intensity of infection without morbidity (n=100). Peripheral blood mononuclear cells from subjects with morbidity produced 8-fold greater levels of egg antigen-driven tumor necrosis factor (TNF)-alpha and had a 99-fold greater mean TNF-alpha:interleukin (IL)-10 ratio, compared with subjects without disease. No differences in cytokine response to non-egg-derived schistosome antigens were observed between groups. Subjects with morbidity had increased TNF-alpha production in response to endotoxin, suggesting an innate hyperresponsiveness. These results indicate that increased TNF-alpha production, relative to that of IL-10, is associated with developing bladder-wall morbidity with S. haematobium infection.

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Evaluation of an Ultrasonographic Score for Urinary Bladder Morbidity in Schistosoma haematobium Infection

Cited by 20 publications

References 0 publications

Case–Control Study of Posttreatment Regression of Urinary Tract Morbidity Among Adults in Schistosoma haematobium–Endemic Communities in Kwale County, Kenya

Case–Control Study of Posttreatment Regression of Urinary Tract Morbidity Among Adults in Schistosoma haematobium–Endemic Communities in Kwale County, Kenya

Micro-Geographical Heterogeneity in Schistosoma mansoni and S. haematobium Infection and Morbidity in a Co-Endemic Community in Northern Senegal

Increased Ratio of Tumor Necrosis Factor–α to Interleukin‐10 Production Is Associated withSchistosoma haematobium–Induced Urinary‐Tract Morbidity

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