American Journal of Clinical Medicine Research
ISSN (Print): 2328-4005 ISSN (Online): 2328-403X Website: http://www.sciepub.com/journal/ajcmr Editor-in-chief: Dario Galante
Open Access
Journal Browser
Go
American Journal of Clinical Medicine Research. 2021, 9(1), 6-9
DOI: 10.12691/ajcmr-9-1-2
Open AccessArticle

Sonographic Manifestation of Urinary Bilharziasis in School Children in Rahad, Sudan

Alsawi Y.A. Yusuf1, and Ahmad A. Agab Eldour1

1Department of Radiology, University of Kordofan, ElObeid, Sudan

Pub. Date: December 25, 2020

Cite this paper:
Alsawi Y.A. Yusuf and Ahmad A. Agab Eldour. Sonographic Manifestation of Urinary Bilharziasis in School Children in Rahad, Sudan. American Journal of Clinical Medicine Research. 2021; 9(1):6-9. doi: 10.12691/ajcmr-9-1-2

Abstract

Background: Urinary bilharziasis is endemic to more than 70 countries, mostly in sub-saharan Africa, including Sudan. It poses a significant burden in terms of morbidity, economic and public health consequences. The disease is usually diagnosed clinically and by urine examination. Imaging plays an important role in demonstrating morbid anatomy and complications. Rahad town is located near a small fresh-water lake and is known for high prevalence of the disease. Objective: The aim of this study was to investigate the sonographic manifestations of urinary bilharziasis among school children in Rahad town in North Kordofan state, Sudan. Methods: Seventy-five school children, who complain of burning micturition, red urine and/or urgency were included in the study. At least 10 ml urine were collected from each child in a sterile, tightly closed container. Ultrasound scanning of the abdomen was carried out by a radiologist, using a 3.5 MHz abdominal probe and a portable ultrasound scanner. The liver, spleen, kidneys, ureters and urinary bladder were scanned and documented. The urine was examined by a senior pathologist, who recorded the finding of microscopic hematuria and/or bilharzial ova in each sample. Data were analyzed using a statistical package (PSPP) to calculate frequencies and mean values. Results: The study included 75 children in classes 1-4. Mean age was 9.36 years, range 7-14 years. Males were 59 (78.67%). More than one quarter (n= 20, 26.7%) have positive urine for S. hematobium ova. More than half (n= 42, 56%) have positive sonographic findings in the urinary bladder, including a third (n= 27, 36%) with bladder mucosal polyps. Only one child (1.3%) had dilated ureter and renal collecting system. Conclusion: Sonographic manifestations of urinary bilharziasis among school children in Rahad are mainly found in the urinary bladder, seen as wall thickening and irregularity, polyp formation and occasionally, calcification. Ultrasound could be used for mass screening and further follow up of urinary bilharziasis in children, as it can detect lesions even in patients with negative urine test for schistosomal ova.

Keywords:
urinary bilharziasis ultrasound schistosomiasis

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]  Global Health Estimates 2015: Deaths by Cause, Age, Sex, by Country and by Region, 2000-2015. Geneva, World Health Organization; 2016.http://www.who.int/healthinfo/global_burden_disease/estimates/en/index1.html.
 
[2]  Fenwick A, Webster JP, Bosque-Oliva E, Blair L. The Schistosomiasis Control Initiative (SCI): rationale, development and implementation from 2002-2008. Parasitology 2009; 136(13): 1719-1730.
 
[3]  Prevention and control of schistosomiasis and soil-transmitted helminthiasis http://apps.who.int/iris/bitstream/10665/42588/1/WHO_TRS_912.pdf. Geneva, World Health Organization: 2002. Accessed June 23, 2018.
 
[4]  Bruun B, Aagaard-Hansen J. The social context of schistosomiasis and its control: an introduction and annotated bibliography. UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases. WHO 2008. ISBN 978 92 4 159718 0.
 
[5]  Prevalence of Urinary Bilharziasis in North Kordofan. Unpublished report by the Ministry of Health, North Kordofan State, Sudan. 2012.
 
[6]  Elmadani AE, Hamdoun AO, Monis A, Karamino NE, Gasmelseed N. Ultrasound findings in urinary shistosomaisis infection in school children in the Gezira State Central Sudan. Saudi J Kidney Dis Transpl. 2013; 24(1): 162-7.
 
[7]  Nmorsi OP, Ukwandu NC, Ogoinja S, Blackie HO, Odike MA. Urinary tract pathology in Schistosoma haematobium infected rural Nigerians. Southeast Asian J Trop Med Public Health. 2007; 38(1): 32-7.
 
[8]  Salas-Coronas J1, Vázquez-Villegas J, Villarejo-Ordóñez A, et al. Radiological findings in patients with imported schistosomiasis. Enferm Infecc Microbiol Clin. 2013; 31(4): 205-9.
 
[9]  Hatz CFR. The use of ultrasound in schistosomiasis. Advances in Parasitology. 2001; 48: 225-284.
 
[10]  King CL, Malhotra I, Peter Mungai P, et al. Schistosoma haematobium–Induced Urinary Tract Morbidity Correlates with Increased Tumor Necrosis Factor–α and Diminished Interleukin-10 Production. The Journal of Infectious Diseases 2001; 184(9): 1176-1182.
 
[11]  Strahan R, McAdam D, Schneider ME. Sonographic response in the liver and urinary bladder of children 14 months after treatment for schistosomiasis. Trop Doct. 2013; 43(2): 71-4.
 
[12]  Richter J. Evolution of schistosomiasis-induced pathology after therapy and interruption of exposure to schistosomes: a review of ultrasonographic studies. Acta Tropica 2000; 77(1): 111-131.
 
[13]  Salah MA, Böszörményi-Nagy G, Al Absi M, et al. Ultrasonographic urinary tract abnormalities in Schistosoma haematobium infection. Int Urol Nephrol. 1999; 31(2): 163-72.
 
[14]  Ekwunife CA, Okafor FC, Nwaorgu OC. Ultrasonographic screening of urinary schistosomiasis infected patients in Agulu community, Anambra state, southeast Nigeria. International Archives of Medicine 2009; 2:34.
 
[15]  Leutscher PD, Reimert CM, Vennervald BJ, et al. Morbidity assessment in urinary schistosomiasis infection through ultrasonography and measurement of eosinophil cationic protein (ECP) in urine. Trop Med Int Health. 2000; 5(2): 88-93.
 
[16]  Brouwer KC, Munatsi A, Ndhlovu PD, et al. Urinary schistosomiasis in Zimbabwean school children: predictors of morbidity. Afr Health Sci. 2004; 4(2): 115-8.
 
[17]  King CH, Keating CE, Muruka JF, et al. Urinary tract morbidity in schistosomiasis haematobia: associations with age and intensity of infection in an endemic area of Coast Province, Kenya. Am J Trop Med Hyg. 1988; 39(4): 361-8.
 
[18]  Koukounari A, Sacko M, Keita AD, et al. Assessment of ultrasound morbidity indicators of schistosomiasis in the context of large-scale programs illustrated with experience from Malian children. Am J Trop Med Hyg. 2006; 75(6): 1042-1052.
 
[19]  Akpata R, Neumayr A, Holtfreter MC, et al. The WHO ultrasonography protocol for assessing morbidity due to Schistosoma haematobium. Acceptance and evolution over 14 years. A systematic review. Parasitology Research 2015; 114(4): 1279-1289.
 
[20]  Honeycutt J, Hammam O, Fu CL, Hsieh MH. Controversies and challenges in research on urogenital schistosomiasis-associated bladder cancer. Trends Parasitol. 2014; 30(7): 324-32.
 
[21]  Honeycutt J, Hammam O, Hsieh MH. Schistosoma haematobium egg-induced bladder urothelial abnormalities dependent on p53 are modulated by host sex. Exp Parasitol. 2015; 158: 55-60.
 
[22]  Dematei A, Fernandes R, Soares R, et al. Angiogenesis in Schistosoma haematobium-associated urinary bladder cancer. APMIS. 2017; 125(12): 1056-1062.
 
[23]  Rollison D. A wake up call for urinary schistosomiasis: reconciling research effort with public health importance. Parasitology 2009; 136(12): 1593-1610.
 
[24]  Bonnard P, Boutouaba S, Diakhate I, Seck M, Dompnier JP, Riveau G. Learning curve of vesico-urinary ultrasonography in Schistosoma haematobium infection with WHO practical guide: a “simple to learn” examination. Am J Trop Med Hyg. 2011; 85(6): 1071-4.
 
[25]  Homeida M, Ahmed S, Dafalla A, et al. Morbidity Associated with Schistosoma Mansoni Infection as Determined by Ultrasound: A Study in Gezira, Sudan. Am J Trop Med Hyg 1988; 39(2): 196-201.
 
[26]  King CH. Toward the Elimination of Schistosomiasis. N Engl J Med 2009; 360: 106-109.