Esquistosomiasis vesical urinaria: caso anatomoclínico diagnosticado en Chile / Urinary bladder schistosomiasis: a case report diagnosed in Chile

Resumen La esquistomiasis urinaria es producida por Schistosoma haematobium. Es una enfermedad endémica en muchas regiones del mundo, no existente en Chile. Se presenta el caso de un hombre joven que viajó a Malawi, en África meridional, y que a su regreso al país, años después, presentó un síndrome miccional con hematuria macroscópica. La biopsia de vejiga mostró una cistitis granulomatosa y eosinofílica con huevos de Schistosoma haematobium.

Urinary schistosomiasis is produced by Schistosoma haematobium. It is an endemic disease in many regions of the world, non-existent in Chile. We report a case of a young man who traveled to Malawi, in southern Africa, and who returned to Chile. Few years later, he presented a urinary syndrome with macroscopic hematuria. The bladder biopsy showed a granulomatous and eosinophilic cystitis with eggs of Schistosoma haematobium.

Genetic Diversity of Schistosoma haematobium Eggs Isolated from Human Urine in Sudan

The genetic diversity of Schistosoma haematobium remains largely unstudied in comparison to that of Schistosoma mansoni. To characterize the extent of genetic diversity in S. haematobium among its definitive host (humans), we collected S. haematobium eggs from the urine of 73 infected schoolchildren at 5 primary schools in White Nile State, Sudan, and then performed a randomly amplified polymorphic DNA marker ITS2 by PCR-RFLP analysis. Among 73 S. haematobium egg-positive cases, 13 were selected based on the presence of the S. haematobium satellite markers A4 and B2 in their genomic DNA, and used for RFLP analysis. The 13 samples were subjected to an RFLP analysis of the S. haematobium ITS2 region; however, there was no variation in size among the fragments. Compared to the ITS2 sequences obtained for S. haematobium from Kenya, the nucleotide sequences of the ITS2 regions of S. haematobium from 4 areas in Sudan were consistent with those from Kenya (> 99%). In this study, we demonstrate for the first time that most of the S. haematobium population in Sudan consists of a pan-African S. haematobium genotype; however, we also report the discovery of Kenyan strain inflow into White Nile, Sudan.

Bilharzial endocervical polyp.

Schistosomiasis still represents a major threat to women's health in many developing countries. The frequency in developed countries is increasing among immigrants and tourists who have a history of freshwater exposure in endemic areas. This is a case of 43-year-old immunocompetent Egyptian woman presented by abnormal vaginal bleeding. The gynecological examination revealed an endocervical polyp measuring 3 x 2 x 1 cm. Polypectomy was done. Histopathological examination revealed several granulomas containing viable eggs of Schistosoma hematobium. Schistosomiasis is rarely presented with endocervical polyp. In developing countries, schistosomiasis may be considered in differential diagnosis of patient with endocervical polyp.

A simple approach improving the performance of urine reagent strips for rapid diagnosis of urinary schistosomiasis in Nigerian schoolchildren

In Nigeria, schistosomiasis, caused predominantly by the species Schistosoma haematobium, is highly endemic in resource-poor communities. We performed a school-based survey in two rural communities in Osun State (Southwestern Nigeria) and assessed macrohaematuria, microhaematuria and proteinuria as indirect indicators for the presence of disease. Urine samples were inspected macroscopically for haematuria and screened for microhaematuria and proteinuria using urine reagent strips. The microscopic examination of schistosome eggs was used as the gold standard for diagnosis. In total, 447 schoolchildren were included in this study and had a 51 percent prevalence of urinary schistosomiasis. The sensitivity of microhaematuria (68 percent) and proteinuria (53 percent) for infection with S. haematobium was relatively low. In patients with a heavy infection (>500 eggs/10 mL), the sensitivity of microhaematuria was high (95 percent). When the presence of macrohaematuria and the concomitant presence of microhaematuria and proteinuria were combined, it revealed a sensitivity of 63 percent, a specificity of 93 percent and a positive predictive value of 91 percent. Macrohaematuria also showed high specificity (96 percent) and a positive predictive value of 92 percent, while sensitivity was < 50 percent. These data show that combining urine reagent strip tests (presence of proteinuria and microhaematuria) and information on macrohaematuria increased the accuracy of the rapid diagnosis of urinary schistosomiasis in an endemic rural West African setting. This simple approach can be used to increase the quality of monitoring of schistosomiasis in schoolchildren.

Two practical and cost effective methods for urinary schistosomiasis screening in Yemeni Schoolchildren

The study was conducted to estimate and compare the validity and performance of two screening methods for urinary schistosomiasis: the interview - reporting blood in urine - and detecting microhematuria by reagent strip. In year 2003, 515 schoolchildren from five schools in Abyan and Taiz governorates in Yemen, were interviewed by healthworker for hematuria, and then urine samples were collected and tested for microhematuria by urine strip and for the presence and count of Schistosoma hematobium by filtration method. Validity and performance indicators were estimated and compared for the two methods using the filtration method as the reference -standard - test. The mean age of the schoolchildren was 10.7 +/- 2.5 years. Boys represented 65% of the sample. The prevalence of the infection as determined by filtration, interview and reagent strip methods was 21.4%, 22.15, and 30.9%, respectively. Sensitivity, specificity, PPV, NPV of the urine strip was higher than the same indicators for the interview method. Combining the results of both screening methods increased all validity and performance indicators. A statistically significant [P<0.001] association was found between urine strip positivity level and infection intensity. The urine strip had higher validity and performance indicators than the interview method. For its low-cost, simple and rapid application, we recommend using it for screening infected schoolchildren in area endemic with S.hematobium in combination with the interview method to enhance its performance

Clinical and laboratorial evaluation of urinary schistosomiasis in Brazilians after staying in Mozambique

Nós examinamos 87 brasileiros de um grupo de 132 que, entre julho e novembro de 1994, participaram de um missão de paz em Moçambique. Eles serviram em uma área endêmica de esquistossomose haematóbica e nadaram no rio Licungo em períodos de lazer. A idade aritmética deles era 31 anos e todos eram do gênero masculino. O exame de urina revelou que 30 (34,5%) eliminavam ovos de S. haematobium e 55 (63,2%) tinham sorologia positiva pelo teste enzyme-linked immunoelectrotransfer blot com antígeno microsomal purificado de vermes adultos de S. haematobium. Eosinofilia foi encontrada em 30 (34,5%), haematuria em 26(29,9%), disúria em 32(36,8%) e dor lombar em 36(41,4%). Todos que eliminavam ovos pela urina tiveram sorologia positiva. Entre os 25 pacientes com sorologia positiva e sem ovos de S. haematobium no exame de urina, 13 eram sintomáticos e 12 assintomáticos. O tratamento pelo Prazinquantel nos 30 pacientes com urina positiva para ovos de S. haematobium apresentou 70% de cura parasitológica.

Cystoscopy in the diagnosis and follow-up of urinary schistosomiasis in Brazilian soldiers returning from Mozambique, Africa

A avaliação de esquistossomose urinária em indivíduos procedentes de áreas endêmicas, freqüentemente requer recursos diagnósticos não usados nas áreas de exposição, para determinar as complicações ou estabelecer um critério de cura mais preciso. A cistoscopia e o exame de urina de 24 horas foram realizados, após tratamentos com praziquantel na dose de 40 mg/kg de peso, dose única, em 25 militares brasileiros que participaram de uma Missão de Paz pela ONU em Moçambique no ano de 1994. A idade média dos indivíduos foi de 29 anos e todos apresentavam exame parasitológico de urina positivo. As alterações detectadas pela cistoscopia foram hiperemia e granulomas na submucosa vesical em 59.1% dos indivíduos e somente granulomas em 40.9%. A biópsia vesical revelou granulomas em todos os pacientes e ovos viáveis em 77.3%, mesmo após um período durante o qual os pacientes não mais eliminavam ovos pela urina. Após o tratamento, a cistoscopia seguida por biópsia e avaliação histopatológica, realizada em áreas onde a evolução da doença pode ser monitorada melhor, demonstrou ser um critério mais seguro de cura parasitológica.

Hematuria and Dysuria in the Self-Diagnosis of Urinary Schistosomiasis among School-Children in Northern Cameroon

The present study was designed to assess the value of self reported hematuria and dysuria in the diagnosis of urinary schistosomiasis at the individual level. A sample of 964 school children of grade 5 and 6 from 15 schools of the French speaking educational system in the Sudano-sahelian zone of northern Cameroon were submitted to a questionnaire related to hematuria and dysuria; and provided a urine sample each. The urine samples were processed using the dip stick and sedimentation methods; and the degree of microhematuria and oviuria determined. In all 964 questionnaires were collected; 843 urine samples examined for microhematuria and 871 for oviuria. The percentage of children reporting hematuria increased with the degree of microhematuria and the intensity of infection. Among the various indicators of urinary schistosome infection; microhematuria had the highest sensitivity (76); followed by self reported hematuria or dysuria (65); and dysuria (52). The specificity was highest for self reported hematuria; and lowest for self reported hematuria or dysuria. The efficiency of self reported hematuria or dysuria increased with the intensity of infection and was highest (100) for heavy infections ( 400 eggs/ml g urine). We advocate the use of self reported hematuria or dysuria for the assessment of S. haematobium at the individual level

Esquistosomiasis urinaria, a propósito de un caso importado en el Ecuador

Reportamos aquí un caso confirmado parasitológicamente de esquistosomiasis urinaria, causado por Schistosoma haematobium, en un hombre inglés de 29 años que posiblemente adquireió el parásito durante sus viajes a Egipto o Malawi hace tres meses. Hasta donde conocemos este es el primer caso confirmado en el país. Su importancia radica en el hecho de que el Ecuador es un país ecológicamente megadiverso por lo tanto turístico, rico en flora y fauna, siendo posible la introducción de enfermedades transmitidas por vectores desde otras altitudes. Además, este caso alerta la posibilidad de diagnósticos y manejos de patologías exóticas no conocidas en el Ecuador.

Epidemiology and immunodiagnosis of schistosomiasis haematobium in low endemic area in Egypt

A survey was performed in Behbeet Village in Giza Governorate including 370 individuals [172 males and 198 females] representing 10% of the house holds. Clinical, stool, urine and serological tests accompanied by a questionnaire were applied to all participants to find out the prevalence, intensity of infection of S. Hematobium, underlying sociodemographic factors, morbidity indicators and the awareness and treatment status among the infected population. It was revealed that the overall prevalence of S. Hematobium based on the detection of eggs in urine was 18.1%, while the prevalence of antibodies to S. Hematobium species specific microsomal antigen was 57.6% detected by enzyme-linked immuno-transfer blot [EITB]. The highest age specific prevalence and intensity of infection were detected among school children in the early teenage. Males were at a higher risk of contracting infection than females with a sex ratio of 2.5: 1. Occupational and recreational water contact were significantly more frequent among the egg positives than the negative ones. Present history of hematuria and microhematuria detected by reagent strips had the strongest association with S. Hematobium infection followed by leucocyturia and dysuria

HLA in schistosoma haematobium [Sh]: a special pattern in cancer bladder and hepatosplenomegaly

Estimation of HLA [ABC] antigen frequency was done in 65 patients with various manifestations of SH, in a trial to a possible association of these genetic markers and disease susceptibility to SH and/or in the development of various complications of the disease. It was concluded that, the close association between HLA antigens and S. hematobium infestation can provide some evidence that susceptibility or resistance to schistosomiasis is determined by genetic factors. Susceptibility of individuals may be based on the presence of A11, B21 contributes to resistance to infection. Individuals possessing A30, Cw4 may be prone to the development of the hepatosplenic form of the disease while A30, B35 and CwS more prone to the development of malignant bladder

Um antígeno espécie e estágio-específico para o schistosoma haematobium. Identificaçäo através de anticorpos monoclonais a partir de imunizaçäo de camundongos Balb/C com antígenos ovulares solúveis / Species-specific-antigens for schistosoma-haematobium: Identification by monoclonal antibodies produced of Balb/C mice immunized with soluble egg antigens

No presente estudo, relata-se a identificaçäo e caracterizaçäo imunoquímica parcial de antígenos específicos do Schistosoma haematobium reconhecidos através de anticorpos monoclonais murinos. Os anticorpos monoclonais foram produzidos em camundongos Balb/C imunizados com antígenos ovulares solúveis por via intraperitonial. Este trabalho contribui para a identificaçäo de antigenos do S. haematobium que säo espécie-específicos e que tambem só foram detectados nos ovos dos parasitas, sendo também estágio-específicos. A comparaçäo da sequência parcial de aminoácidos de dois peptídeos tripticos de banda antigenica reconhecida pelo anticorpo monoclonal 2D14E8 em membrana de nitrocelulose com outras sequências de proteínas conhecidas revelou, nos dois peptídeos, uma homologia com a proteína "heat-shock" ou proteína de estresse 70 presente em várias espécies animais, incluindo o homem e o S. mansoni

Estudio de la schistosomiasis en pacientes cubanos ingresados en el Instituto de Medicina Tropical "Pedro Kourí" / Study of schistosomiasis in Cuban patients hospitalized in the \"Pedro Kourí\" Tropical Medicine Institute

Se estudiaron 50 pacientes cubanos con diagnóstico de Schistosomiasis haematobium. Se llegó a la confirmación de esta enfermedad mediante la utilización de la técnica de la ninhidrina. La hematuria y la disuria ocuparon los primeros lugares entre los síntomas y signos; la eosinofilias se encontró en el 84 % de los pacientes, la cistoscopia demostró ser de gran valor en el diagnóstico y seguimiento

Aplicación del método de plasma-trombina al diagnóstico de enfermedades parasitarias / The use of the plasma-thrombin method for diagnosing parasitic diseases

For cases of parasitic diseases have been diagnosed by preparing samples with the plasma-thrombin cell block techinique. This method has been previously applied for the cytological detection of cancer. The authors want to emphasize that by applyng this method to samples obtained from parasitized organs, it is posible to diagnose easily the disease as well as to study, by means of pseudotissural preparations, the tissues response to the parasite and, with follow up samples, the progression of the disease itself.

Esquistosomiasis a S. haematobium: manifestaciones clínicas y hallazgos endoscópicos en pacientes cubanos y extranjeros / Schistosomiasis by S. haematobium: clinical manifestations and endoscopic findings in cuban and foreing patients

Se realiza un estudio de 30 pacientes cubanos y 30 pacientes extranjeros con esquistosomiasis haematobium. Se menciona que los síntomas de la enfermedad son escasos y en ambos grupos predominan la hematuria, disuria y el dolor en bajo vientre, por lo que pueden descubrirse pacientes asintomáticos y llama la atención la pobreza de hallazgos positivos en ambos grupos. Se señala que predominan los elementos de infección reciente en pacientes cubanos, lo que se evidencia en los resultados de la cistoscopia y en las características de los huevos emitidos por la orina. Se observa que en ambos grupos de pacientes hay leucocituria y hematuria, pero la intensidad de ambos es moderada, así como que la anemia no es un elemento importante como parte del cuadro y en ambos grupos existe eosinofilia