The unacknowledged impact of urinary schistosomiasis in children: 5 cases from Kumasi, Ghana

Abstract

SUMMARYUrinary schistosomiasis is a parasitic disease caused by Shistosoma haematobium. It is prevalent in several parts of Africa particularly in areas where there are large water bodies. In most affected communities, the condition is often accepted as normal since to them, all growing children pass blood in their urine and "grow out of it". Mass treatment of school children has been a regular exercise often undertaken by stake holders to decrease the disease burden and reduce transmission in selected communities.Urinary schistosomiasis can have devastating impact on the urinary tract which is often unacknowledged and unevaluated. Such omission could have implication for progressive renal damage which, if not detected and treated, could lead to end stage renal failure and death.We present five (5) cases of urinary schistosomiasis with severe obstructive uropathy seen at the paediatric nephrology/urology units of Komfo Anokye Teaching Hospital, Ghana. All five cases had some degree of anaemia and hypertension. Two of the five cases presented with end stage renal failure and died subsequently whilst two underwent successful surgery. One made a spontaneous recovery from the urinary obstruction though still has significant renal impairment.This potential devastating effect of urinary schistosomiasis on the kidneys calls for thorough evaluation and assessment of each confirmed case to include blood pressure measurement, full blood count, and ultrasonography of the urinary system. Mass screening programmes should be combined with portable ultrasonography of the kidneys, ureters and bladder.

Prevalence and correlates of urogenital schistosomiasis in school going children in Maramba compound of Livingstone District, Zambia

“…Urogenital schistosomiasis can have unacknowledged devastating impact on the urinary tract that could have implication for progressive renal damage which, if not detected and treated, could lead to end stage renal failure and death (21). Looking at the recreational swimming in school going children as a potent medium for the spread of disease that is usually asymptomatic (3), periodic screening are warranted to protect the lives of children and adolescents in communities.…”

Sonographic early findings in a case of bladder schistosomiasis

“…The disease is widely diffused in areas in which there are large bodies of water for irrigation, particularly where dams have been constructed. A prevalence rate of 12.4% has been reported in some endemic regions in Ghana [12]. Several species of Schistosoma have been detected and classified among others: S. mansoni, S. japonicum, S. mekongi, S. eagle, S. haematobium, S. intercalatum, and S. mattheii.…”

The parasitology of female genital schistosomiasis

“…The diseases caused by S. haematobium (urinary and genital schistosomiasis) are endemic in 54 African and Mediterranean countries and contribute significantly to the 235 million cases of schistosomiasis annually reported worldwide ( Ahmed, 2020 ; WHO, 2022 ). Infections are recorded in both adults and children of both sexes and complications such as bladder cancer and renal failure are observed in chronic infections involving the urinary tract ( Barsoum, 2013 ; Antwi et al., 2014 ), while complications like infertility, ectopic pregnancy, miscarriages, and increased risk of HIV infections are observed in chronic infections involving the genital tract especially among females ( Feldmeier et al., 1994 ; WHO, 2009 ; Nour, 2010 ; Downs et al., 2011 ; Gyapong & Theobald, 2015 ).…”