Urine colour as a rapid assessment indicator in evaluating the prevalence of Schistosoma haematobium infection in two endemic areas of Benue State-Nigeria.

摘要

Schistosomiasis is a formidable public health problem, especially in sub-Saharan Africa where the majority of cases reside. In the context of having interest upon chemotherapy control, rapid, cheap and fast diagnostic tools and assay play an important role in assessing where treatment methods should be concentrated. We examined whether urine colour observation was correlated with intensity of infection in urinary schistosomiasis as measured by the gold-standard parasitological diagnosis. Using this tool and other proven field diagnostic (reagent strips), we examined 750 urine samples collected from school children and communities in two endemic areas of Benue State-Nigeria. Our findings demonstrate that urine colour observation was significantly associated with infection intensity (r = 0.72, p<.01). Given that parasitological examination is laborious, we showed that urine colour observation was significantly correlated with the indirect diagnosis method, Proteinuria (r = 0.75, p<.01) and Haematuria (0.52, p<.01) widely used at the present time. We suggest that urine colour observation may be useful for diagnostic purposes, and for monitoring and evaluating treatment programs over time. Furthermore, we recommend that additional research should be done to further elucidate the relationship between this technique and other diagnostic methods. Introduction Schistosomiasis is the most prevalent parasitic infection in the world after malaria, with nearly 200 people infected, and 650 million currently at risk in the 76 countries where the disease is endemic 1 . Of those, 20 million are believed to suffer from serious clinical disease, and 120 million are symptomatic 2 . Despite past successes and renewed interest in the control of schistosomiasis within the last decade, the absolute number of people infected with the disease has increased in the last 50 years 3 , with approximately 85% of cases currently living in sub-Saharan Africa.Identification of cases or communities for treatment with Schistosoma haematobium infection is usually based on microscopic detection of eggs in urine. The prevalence of an infection in a particular population varies directly with the sensitivity of the diagnostic techniques used. This dictates the need for a simple, fast, cheap and reliable diagnostic method for the detection of infected persons. The rapid diagnostic technique recommended by the National Expert Committee on the Control of Schistosomiasis (NECCS) is the indirect reagent strip technique for schistosomiasis 4 . Proteinuria and haematuria are recognized clinical features of S.haematobium infection 5 . Many epidemiological studies have been conducted to investigate the characteristics of these methods to measure urinary schistosomiasis; this usually involved comparing the outcomes with intensity of infection.In this study, we objected at comparing the merits of urine colour observation with other diagnostic techniques in order to justify the choice of the technique with those of reagent strips and egg count method, and if this could be used as a rapid screening technique for the assessment of urinary schistosomiasis in endemic areas. Materials and Methods Study AreaThe study was carried out in Buruku and Katsina-Ala Local Government Areas of Benue State-Nigeria between November 2008 and March 2009. The selection of the areas was based on reports from local hospitals, clinics and health centers where cases of urinary schistosomiasis were reported. Agriculture and fishing are the major occupations and sources of economic survival in the area.Study population and Samples collectionPrior to the commencement of the research, ethical approval was sought from the Local Government chairmen and Local Government Education Authorities of both areas. Parents of the school children were duly informed on the significance of the study.Urine samples were collected from communities (250), primary school children (250) and secondary school children (250). Abou