Clinical Nephrology - Epidemiology - Clinical Trials

Kidney International (1997) 52, 478–481; doi:10.1038/ki.1997.356

Urinary tract morbidity due to Schistosoma haematobium infection in Mali

Udo Vester, Rüdiger Kardorff, Mamadou Traoré, Hammar A Traoré, Sahari Fongoro, Claudia Juchem, Doris Franke, Rolf Korte, Bruno Gryseels, Jochen H H Ehrich and Ekkehard Doehring

Department of Pediatric Nephrology and Metabolic Diseases, Medizinische Hochschule, Hannover, Germany; Institut National de Recherche en Santé Publique (INRSP), Bamako, Mali; Gesellschaft für technische Zusammenarbeit (GTZ), Eschborn, Germany; Prins Leopold Instituut voor Tropische Geneeskunde, Antwerpen, Belgium; Department of Pediatric Nephrology, Kinderklinik der Charité, Berlin, and Interdisziplinaeres Therapiezentrum (ITZ), Feldberg, Germany

Correspondence: Dr U Vester, Department of Pediatric Nephrology and Metabolic diseases, Medizinische Hochschule Hannover, 30623 Hannover, Germany.

Received 17 April 1996; Revised 13 January 1997; Accepted 3 March 1997.

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Abstract

Urinary tract morbidity due to Schistosoma haematobium infection in Mali. A total of 824 Malian villagers in a region endemic for Schistosoma (S.) haematobium were examined clinically, parasitologically and by abdominal ultrasound. Systematic schistosomicidal treatment had never been applied to this population. Prevalence of S. haematobium infection ranged from 77% in adolescents to 51% in adults older than 40 years. Intensity of infection was generally mild, 91% of all patients excreting less than 100 ova/10 ml urine. Bladder wall enlargement and irregularities, bladder masses, pseudopolyps and dilation of the upper urinary tract were found ultrasonographically in about one third of infected individuals. Bladder lesions were more frequent in children than in adults and correlated with the intensity of infection in younger age groups only. Hydronephrosis was rare (7 of 824) and never seen in uninfected individuals. Prevalence of urinary tract pathology dropped significantly with age (P < 0.001) and was lowest in patients older than 40 years. Logistical regression identified age and infection as independent parameters affecting the prevalence of urinary tract pathology (P < 0,001). We conclude that Schistosoma haematobium infection causes substantial morbidity in children and younger adults. The reduction of urinary tract morbidity with age despite a considerable prevalence of infection in older age groups suggests spontaneous resolution during adulthood in most cases.

Keywords:

Schistosoma haematobium, urinary tract morbidity, parasite, obstruction

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