Hemastix® is a useful diagnostic tool for urinary schistosomiasis control programs
Original article
French MD (2007) School-based control of urinary schistosomiasis on Zanzibar, Tanzania: monitoring micro-haematuria with reagent strips as a rapid urological assessment. J Pediatr Urol 3: 364–368 Article
Urinary schistosomiasis is particularly prevalent among schoolchildren in sub-Saharan Africa. The infection is a common cause of hematuria, and disease sequelae include bladder damage and kidney dysfunction. Rapid and accurate diagnoses are crucial to measure the effectiveness of control programs for this infection. French et al., therefore, evaluated Hemastix® (Bayer, Elkart, IN)—diagnostic reagent strips that detect microhematuria—during a 3-year period of a control program aimed at schoolchildren on Zanzibar, Tanzania.
A subset of schoolchildren among the 135,000 who were administered praziquantel for schistosomiasis and albendazole for soil-transmitted helminthiasis were surveyed at treatment baseline in 2004 (n = 2,002), and at annual follow-up with re-treatment in 2005 (n = 3,278) and in 2006 (n = 3,993). The urine samples of the children surveyed were graded for microhematuria by use of Hemastix®, and parasite burden was assessed microscopically by the egg-count method.
Hemastix® scored highly for sensitivity, specificity, positive predictive value and negative predictive value for the whole 3-year period, even as prevalence and parasitic burden decreased as a result of chemotherapy; the scores for girls, however, were not quite as good as those for boys, probably because menstrual blood was a confounder. The method was diagnostically superior to patient-reported blood in the urine and pain upon urination.
The authors recommend Hemastix® for use in future control programs because it is rapid, cost-effective, and its ease of use could increase screening coverage.
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Subject areas under which this article appears: Infections, inflammation and prostatitis