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The diagnostic value of haematuria and proteinuria in Schistosoma haematobium infection in southern Nigeria

Published online by Cambridge University Press:  05 June 2009

O. C. Nwaorgu
Affiliation:
Department of Parasitology and Entomology, Anambra State University of Technology, PMB 5025 Awka, Anambra State, Nigeria
E. U. Anigbo
Affiliation:
Department of Parasitology and Entomology, Anambra State University of Technology, PMB 5025 Awka, Anambra State, Nigeria

Abstract

Haematuria and proteinuria as detected by chemical reagent strips correlated moderately (r=0·7) with prevalence and intensity of infection with Schistosoma haematobium in an area of Anambra State, Nigeria. Differences attributable to age and sex were also reflected in a similar pattern, all peaks occurring in the 5–14 year age group. The differences observed with varying levels of intensity and haematuria at both 10 and 50 erythrocytes/μl (p<0·001) and proteinuria at 0·3 g/dl (p<0·01) were statistically significant. At a proteinuria level of 1 g/dl, the observed differences were however not statistically significant (p>0·5). The percentage of specimens from children (1–14 years) positive for S. haematobium eggs and with at least traces of haematuria and proteinuria (63·4% and 95%, respectively) was higher than in adults (33·3% and 80·2%, respectively). All individuals with more than 50 eggs/10 ml of urine were correctly identified using both indices either separately or in combination. For egg counts of less than 50 egg/10 ml of urine, false diagnosis occurred in only 5% of all specimens examined. The sensitivity and specificity of haematuria and proteinuria at trace quantities was very high, hut haematuria had a higher predictive value for a positive test (PvPt) and was considered the overall better indicator. A combination of both indices did not significantly increase the PvPt. When trace haematuria and moderate proteinuria were combined, both the sensitivity, specificity and PvPt were all above 90%, giving the best overall values in all the combinations made.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1992

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References

REFERENCES

Briggs, M. M., Chadfield, M., Mummery, D. & Briggs, M. (1971) Screening with reagent strips. British Medical Journal, 3, 433434.CrossRefGoogle ScholarPubMed
Ezzat, E., Osman, R. A., Ahmet, K. Y. & Stoothill, J. F. (1974) The association between Schistosoma haematobium infection and heavy proteinuria. Transactions of the Royal Society of Tropical Medicine and Hygiene, 68, 315317.CrossRefGoogle ScholarPubMed
Farid, Z., Bassily, S., Schulert, A. R., Zeind, A. S., McConnell, E. & Abdel-wahab, M. F. (1968) Urinary blood loss in Schistosoma haematobium infection in Egyptian farmers. Transactions of the Royal Society of Tropical Medicine and Hygiene, 469500.Google ScholarPubMed
Feldmeier, R., Doehring, E. & Dafalla, A. A. (1982) Simultaneous use of a sensitive filtration technique and reagent strips in urinary schistosomiasis. Transactions of the Royal Society of Tropical Medicine and Hygiene, 76, 416421.CrossRefGoogle ScholarPubMed
Greenham, R. & Cameron, A. H. (1980) Schistosoma haematobium and the nephrotic syndrome. Transactions of the Royal Society of Tropical Medicine and Hygiene, 74, 609613.CrossRefGoogle ScholarPubMed
Mott, K. E., Dixon, H., Osei-Tutu, E. & England, E. C. (1983) Relationship between intensity of Schistosoma haematobium infection and clinical haematuria and proteinuria. Lancet, 1, 10051008.CrossRefGoogle Scholar
Mott, K. E., Dixon, H., Osei-Tutu, E. & England, E. C. (1985a) Evaluation of reagent strips in urine tests for detection of Schistosoma haematobium infection: a comparative study in Ghana and Zambia. Bulletin of the World Health Organization, 63, 125133.Google ScholarPubMed
Mott, K. E., Dixon, H., Ossei-Tutu, E., England, E. C., Ekue, K. & Tekle, A. (1985b) Indirect screening for Schistosoma haematobium infection: a comparative study in Ghana and Zambia. Bulletin of the World Health Organization, 63, 135142.Google ScholarPubMed
Murare, H. M. & Taylor, P. (1987) Haematuria and proteinuria during Schistosoma haematobium infection: relationship to intensity of infection and the value of chemical reagent strips for pre and post-treatment diagnosis. Transactions of the Royal Society of Tropical Medicine and Hygiene 81, 426430.CrossRefGoogle ScholarPubMed
Pugh, R. N. H. (1979) Periodicity of output of Schistosoma haematobium eggs in the urine. Annals of Tropical Medicine and Parasitology, 73, 8990.CrossRefGoogle ScholarPubMed
Pugh, R. N. H., Bell, D. R. & Gilles, H. M. (1980) Malumfashi Endemic Diseases Research Project XV. The potential medical importance of bilharzia in Northern Nigeria—a suggested rapid, cheap and effective solution for the control of Schistosoma haematobium infection. Annals of Tropical Medicine and Parasitology, 74, 597618.CrossRefGoogle ScholarPubMed
Taylor, P. (1982) Proteinuria as a simple diagnostic test for urinary schistosomiasis in school children in rural Zimbabwe. Central African Journal of Medicine, 28, 216219.Google Scholar
Wilkins, H. A., Goll, P. H., de C. Marshall, T. F. & Moore, P. J. (1979) The significance of proteinuria and haematuria in Schistosoma haematobium infection. Transactions of the Royal Society of Tropical Medicine and Parasitology, 73, 7480.CrossRefGoogle ScholarPubMed