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.

Epidemiological Survey on Schistosomiasis and Intestinal Helminthiasis among Village Residents of the Rural River Basin Area in White Nile State, Sudan

There have been some reports on schistosomiasis of school children in Sudan’s Nile River basin area; however, information about the infection status of Schistosoma species and intestinal helminths among village residents of this area is very limited. Urine and stool samples were collected from the 1,138 residents of the Al Hidaib and Khour Ajwal villages of White Nile State, Sudan in 2014. The prevalence of overall schistosomiasis and intestinal helminthiasis was 36.3% and 7.7%, respectively. Egg positive rates were 35.6% for Schistosoma haematobium, 2.6% for S. mansoni, and 1.4% were mixed. The prevalence of schistosomiasis was significantly higher in men (45.6%) than in women (32.0%), in Khou Ajwal villagers (39.4%) than in Al Hidaib villagers (19.2%), and for age groups ≤15 years old (51.5%) than for age groups >15 years old (13.2%). The average number of eggs per 10 ml urine (EP10) of S. haematobium infections was 18.9, with 22.2 eggs in men vs 17.0 in women and 20.4 in Khou Ajwal villagers vs 8.1 in Al Hidaib villagers. In addition to S. mansoni eggs, 4 different species of intestinal helminths were found in the stool, including Hymenolepis nana (6.6%) and H. diminuta (1.0%). Collectively, urinary schistosomiasis is still prevalent among village residents in Sudan’s White Nile River basin and was especially high in men, children ≤15 years, and in the village without a clean water system. H. nana was the most frequently detected intestinal helminths in the 2 villages.

Comparison of ELISA and Urine Microscopy for Diagnosis of Schistosoma haematobium Infection

BACKGROUND: Schistosoma haematobium which causes urogenital schistosomiasis (UGS) is highly prevalent in African countries. Urine microscopy (UM) is the first-line diagnostic method of UGS. Enzyme-linked immunosorbent assay (ELISA) is a common method for screening many parasite infections primarily or alternatively. The present study established an in-house diagnostic system by ELISA and evaluated its diagnostic efficacy in comparison with UM for screening UGS in White Nile State, Republic of Sudan, 2011–2013. METHODS: A total of 490 participants were screened by UM or ELISA, and 149 by both. The in-house ELISA system was established employing soluble egg antigen of S. haematobium and the cut-off absorbance was set at 0.270. RESULTS: Of the 149 subjects, 58 participants (38.9%) were positive by UM, 119 (79.9%) were positive by ELISA and 82 (55.0%) showed consistently positive or negative results by both methods. The diagnostic sensitivity of ELISA was 94.8% and specificity was 29.7% based on UM results. The ELISA positive serum samples also cross-reacted with egg antigens of Schistosoma mansoni and Schistosoma japonicum. CONCLUSION: We have established in-house ELISA for screening serum immunoglobulin (Ig) G antibodies by employing soluble egg antigen of S. haematobium for diagnosis of UGS with 94.8% sensitivity and 29.7% specificity. The ELISA system can supplement the conventional diagnosis by UM.

Environmental factors influencing the distribution and prevalence of Schistosoma haematobium in school attenders of ILembe and uThungulu Health Districts, KwaZulu-Natal Province, South Africa

Schistosoma haematobium infection is reported to facilitate the development of urogenital diseases. Its symptoms include haematuria, dysuria and tiredness, and it may cause cognitive decline in children. The prevalence of S. haematobium infection needs to be known in endemic areas and a mass treatment programme against the disease implemented. The aim of this study was to investigate the prevalence and intensity of S. haematobium infection in ILembe and uThungulu health districts, using the major symptom, haematuria, as an indicator. A total of 6 265 urine samples, from 96 rural schools, was collected for analysis using dipsticks. The prevalence of haematuria in the ILembe health district was 37% (95% CI, 35­39%) for boys and 39% (95% CI, 37­41%) for girls. The prevalence of haematuria in the uThungulu health district was 56% (95% CI, 53­59%) and 53% (95% CI, 50­56%) for girls and boys, respectively. Light-intensity infection was the most common infection level in both health districts. A negative relationship was observed between prevalence and altitude (r = −0.262, p = 0.009); whereas, we found a slight, though significant, positive association with mid-summer temperatures (r = 0.234, p = 0.021). Associations between prevalence and distance of school to the nearest river were non-significant

High Genetic Variability of Schistosoma haematobium in Mali and Nigeria

Schistosoma haematobium is one of the most prevalent parasitic flatworms, infecting over 112 million people in Africa. However, little is known about the genetic diversity of natural S. haematobium populations from the human host because of the inaccessible location of adult worms in the host. We used 4 microsatellite loci to genotype individually pooled S. haematobium eggs directly from each patient sampled at 4 endemic locations in Africa. We found that the average allele number of individuals from Mali was significantly higher than that from Nigeria. In addition, no significant difference in allelic composition was detected among the populations within Nigeria; however, the allelic composition was significantly different between Mali and Nigeria populations. This study demonstrated a high level of genetic variability of S. haematobium in the populations from Mali and Nigeria, the 2 major African endemic countries, suggesting that geographical population differentiation may occur in the regions.

High Genetic Variability of Schistosoma haematobium in Mali and Nigeria

Schistosoma haematobium is one of the most prevalent parasitic flatworms, infecting over 112 million people in Africa. However, little is known about the genetic diversity of natural S. haematobium populations from the human host because of the inaccessible location of adult worms in the host. We used 4 microsatellite loci to genotype individually pooled S. haematobium eggs directly from each patient sampled at 4 endemic locations in Africa. We found that the average allele number of individuals from Mali was significantly higher than that from Nigeria. In addition, no significant difference in allelic composition was detected among the populations within Nigeria; however, the allelic composition was significantly different between Mali and Nigeria populations. This study demonstrated a high level of genetic variability of S. haematobium in the populations from Mali and Nigeria, the 2 major African endemic countries, suggesting that geographical population differentiation may occur in the regions.

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.

Dicrocoelium Dendriticum infection in a patient with chronic Schistosomiasis Haematobium

Infection with Dicrocoelium dendriticum in humans is seldom to be reported in Egypt. This liver fluke, which commonly infects ruminants, has a complex life cycle with two intermediate hosts; the land snail and the ant. Human infection occurs by accidental ingestion of the second intermediate host. The present reported a patient suffered from recurrent acute chole-cystitis with chronic urinary schistosomiasis whose Kato stool examination showed Dicroceolium dendriticum eggs. He was successfully treated with Mirazid

The effect of hookworm infection and urinary scistosomiasis on blood hemoglobiin concentration of schoolchildren living in northern Mozambique / Infecções por ancilostomídeos e Schistosoma haematobium e sua correlação com a concentração sanguínea de hemoglobina em crianças moçambicanas

This study aims to assess the association between schistosomiasis and hookworm infection with hemoglobin levels of schoolchildren in northern Mozambique. Through a cross-sectional survey, 1,015 children from five to 12 years old in the provinces of Nampula, Cabo Delgado and Niassa were studied. Hookworm infection and urinary schistosomiasis were diagnosed, through Ritchie and filtration methods, with a prevalence of 31.3% and 59.1%, respectively. Hemoglobin levels were obtained with a portable photometer (Hemocue®). The average hemoglobin concentration was 10.8 ± 1.42 g/dL, and 62.1% of the children presented levels below 11.5 g/dL, of which 11.8% of the total number of children had hemoglobin levels below 9 g/dL. A multiple linear regression analysis demonstrated negative interactions between hemoglobin levels and ancylostomiasis, this being restricted to the province of Cabo Delgado (β = -0.55; p < 0.001) where an independent interaction between hemoglobin levels and urinary schistosomiasis was also observed (β = -0.35; p = 0.016). The logistical regression model indicated that hookworm infection represents a predictor of mild (OR = 1.87; 95% CI = 1.17-3.00) and moderate/severe anemia (OR = 2.71; 95% CI = 1.50 - 4.89). We concluded that, in the province of Cabo Delgado, hookworm and Schistosoma haematobium infections negatively influence hemoglobin levels in schoolchildren. Periodical deworming should be considered in the region. Health education and improvements in sanitary infrastructure could achieve long-term and sustainable reductions in soil-transmitted helminthiases and schistosomiasis prevalence rates.

Este estudo tem como objetivo avaliar a relação entre a ancilostomíase e a esquistossomíase urinária com as concentrações sanguíneas de hemoglobina em crianças escolares no norte de Moçambique. Em estudo transversal, 1.015 crianças com idade entre cinco e 12 anos foram incluídas, nas Províncias de Nampula, Cabo Delgado e Niassa. A ancilostomíase e a esquistossomíase urinária foram diagnosticadas através das técnicas de Ritchie e de filtração da urina, respectivamente; prevalências de 31,3% e 59,1% foram observadas. As concentrações sanguíneas de hemoglobina foram obtidas com um fotômetro portátil (Hemocue). A concentração média de hemoglobina foi 10,8 ± 1.42 g/dL, 62,1% das crianças apresentaram concentração abaixo de 11,5 g/dL e 11,8% apresentaram nível abaixo de 9 g/dL. A regressão linear múltipla demonstrou interações negativas entre os níveis de hemoglobina e i) a infecção por ancilostomídeos (β = -0,55; p < 0,001) e ii) a esquistossomíase urinária (β = -0,35; p = 0,016), ambas associações restritas à Província de Cabo Delgado. Também em Cabo Delgado, o modelo de regressão logística demonstrou que a infecção por ancilostomídeos representa um preditor de anemia leve (OR = 1,87; 95% CI = 1,17-3,00) e anemia moderada/grave (OR = 2,71; 95% CI = 1,50 - 4,89). O estudo conclui que em Cabo Delgado, Moçambique, as infecções por ancilostomídeos e Schistosoma haematobium estão significativamente associadas a uma menor concentração sanguínea de hemoglobina em crianças em idade escolar. A administração periódica de anti-helmínticos deve ser feita regularmente. Melhorias na infraestrutura sanitária das regiões estudadas são as medidas mais eficazes para controle destas parasitoses.

Rapid diagnosis of schistosomiasis in Yemen using a simple questionnaire and urine reagent strips

Schistosomiasis ranks second to malaria in terms of socioeconomic and public health importance in Yemen. This study assessed the validity of a morbidity questionnaire and urine reagent strips as a rapid tool for screening schoolchildren for urinary schistosomiasis as compared with the presence of eggs in urine as the gold-standard parasitological diagnosis. The study examined urine samples and interviewed 696 children [mean age 12.5 years] attending a primary-preparatory school in south Yemen. Urinary schistosomiasis was confirmed in 126 [18.1%] children. Diagnostic performance was poor for 2 items in the morbidity questionnaire [self-reported history of previous infection and self-reported history of antischistosomal treatment]. However, self-reported dysuria, self-reported haematuria in the questionnaire and microhaematuria by reagent strips [alone or with macrohaematuria] revealed good diagnostic performance. The results indicated that reagent strips are a valid method for detection of microhaematuria for identifying individuals and communities infected with Schistosoma haematobium

Urinary schistosomiasis and malaria associated anemia in Ethiopia

<p><b>OBJECTIVE</b>To assess the prevalence of anemia in children with urinary schistosomiasis, malaria and concurrent infections by the two diseases.</p><p><b>METHODS</b>Urine and blood samples were collected from 387 children (216 males and 171 females) to examine urinary schistosomiasis and malaria and to determine hemoglobin concentration at Hassoba and Hassoba Buri village in Amibara woreda, Afar region, Ethiopia.</p><p><b>RESULTS</b>The overall prevalence of urinary schistosomiasis and Plasmodium falciparum malaria was 24.54% and 6.20% respectively. Only 2.84% of children carried concurrent infections of both parasites. There was high percentage of anemic patients (81.81%) in the coinfected cases than in either malaria (33.3%) or schistosomiasis (38.94%) cases. There was significantly low mean hemoglobin concentration in concurrently infected children than non-infected and single infected (P<0.05). The mean hemoglobin concentration between Plasmodium falciparum and S. haematobium infected children showed no significant difference (P>0.05). The level of hemoglobin was negatively correlated with the number of S. haematobium eggs/10 mL urine (r=-0.6) and malaria parasitemia (r=-0.53).</p><p><b>CONCLUSIONS</b>The study showed that anemia is higher in concurrently infected children than non-infected and single infected. Furthermore, level of hemoglobin was negatively correlated with the number of S. haematobium eggs and malaria parsitemia. Therefore, examination of hemoglobin status in patients co-infected with malaria and schistosomiasis is important to reduce the risk of anemia and to improve health of the community.</p>

Novel therapeutic and prevention approaches for schistosomiasis: review

Schistosomiasis is a debilitating disease affecting approximately 600 million people in 74 developing countries, with 800 million, mostly children at risk. To circumvent the threat of having praziquantel [PZQ] as the only drug used for treatment, several PZQ derivatives were synthesized, and drugs destined for other parasites were used with success. A plethora of plant-derived oils and extracts were found to effectively kill juvenile and adult schistosomes, yet none was progressed to pre- and clinical studies except an oleo-gum resin extracted from the stem of Commiphora molmol, myrrh, which action was challenged in several trials. We have proposed an essential fatty acid, a component of our diet and cells, the polyunsaturated fatty acid arachidonic acid [ARA] as a remedy for schistosomiasis, due to its ability to activate the parasite tegument-bound neutral sphingomyelinase, with subsequent hydrolysis of the apical lipid bilayer sphingomyelin molecules, allowing access of specific antibody molecules, and eventual worm attrition. This concept was convincingly supported using larval and adult Schistosoma mansoni and Schistosoma haematobium worms in in vitro experiments, and in vivo studies in inbred mice and outbred hamsters. Even if ARA proves to be an entirely effective and safe therapy for schistosomiasis, it will not prevent reinfection, and accordingly, the need for developing an effective vaccine remains an urgent priority. Our studies have supported the status of S. mansoni calpain, glutathione-S-transferase, aldolase, triose phosphate isomerase, glyceraldehyde 3-phosphate dehydrogenase, enolase, and 2-cys peroxiredoxin as vaccine candidates, as they are larval excreted-secreted products and, contrary to the surface membrane molecules, are entirely accessible to the host immune system effector elements. We have proposed that the use of these molecules, in conjunction with Th2 cytokines-inducing adjuvants for recruiting and activating eosinophils and basophils, will likely lead to development and implementation of a sterilizing vaccine in a near future

Impact of Praziquantel Mass Drug Administration Campaign on Prevalence and Intensity of Schistosoma haemamtobium Check for this Species in other Resources among Schoolchildren in Bahi District; Tanzania

As part of the Tanzania National Schistosomiasis Control Programme; Bahi district in central Tanzania; received two annual rounds of praziquantel mass drug administration (MDA) to control urinary schistosomiasis in schoolchildren. The objectives of this study were to assess the impact of the two rounds of MDA on prevalence and intensity of Schistosoma haemamtobium and the impact of MDA campaigns on knowledge of urinary schistosomiasis; safe water use and contact with potentially unsafe water bodies. A quantitative crosssectional study was carried out among schoolchildren in March and April; 2013. A structured questionnaire was used to collect information on MDA uptake; knowledge of schistosomiasis; sources of water for domestic and other uses. Urine samples were collected from each pupil to examine prevalence and intensity of S. haematobium. Transmission of schistosomiasis was assessed by sampling Bulinus spp snails for cercarial shedding. Uptake of MDA was 39.5 in 2011 and 43.6 in 2012. Prevalence of S. haematobium significantly dropped by 50.0 from 26 in 2011 to 15 in 2012 (p = 0.000). Prevalence of S. haematobium was significantly low in MDA participating (3.1) than non-participating (28.5) schoolchildren (p = 0.000). MDA campaigns had significant impact on knowledge of the disease (p = 0.02) and borderline impact on safe water use (p = 0.04) but had no impact on avoidance of contact with unsafe water bodies (p = 0.06). Bulinus spp. snails were found shedding schistosome cercariae indicating environmental contamination with viable S. haematobium eggs. In conclusion; though MDA significantly reduced prevalence of S. haematobium; uptake was below 50.0 and below the World Health Assembly resolution 54.19 target of 75.0 for 2010. Non-participation in MDA was the likely source of S. haematobium eggs in the environment hence the observed 15.0 prevalence of S. haematobium infection; and cercarial shedding Bulinus spp. snails indicating continuity of transmission hence the need for further health promotion campaigns

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.

Comparative analysis of urinary schistosomiasis among primary school children and rural farmers in Obollo-Eke, Enugu State, Nigeria: implications for control

OBJECTIVE@#To determine the prevalence, sex-age related intensity of urinary schistosomiasis and to compare such parameters among rural school children and rural farmers in selected communities in Obollo-Eke located in Southeast, Nigeria.@*METHODS@#A cross-sectional survey involving 1 337 school children and farmers was conducted in Obollo-Eke community between September 2006 and July 2007. Demographic data of subjects was collected using a questionnaire prepared for this purpose. Urine samples were collected and examined for haematuria and ova of Schistosoma haematobium (S. haematobium) using Medi-test Combi 9 and sedimentation technique respectively.@*RESULTS@#The prevalence of urinary schistosomiasis based on microscopic examination of the urine sediment for the ova of S. haematobium was 17.5% while the prevalence of haematuria was 15.6%. Infection intensity varied from light to heavy. In general, the prevalence was higher among males (20.8%) than females (14.6%; P>0.05) and was slightly higher among primary school children (18.0%; n=762) than farmers (16.9%; n=575; P>0.05). The age-specific prevalence of schistosomiasis among the study subjects ranged from 8.3% to 21.2% in 0-5 years and 11-15 years age groups respectively.@*CONCLUSIONS@#Haematuria and mean egg/10 mL urine (r = 0.95; P<0.01) showed that both procedures are reliable for the diagnosis of the disease and can be used to ascertain the prevalence of the disease in any community. The comparative analysis of urinary bilharziasis among primary school children and rural farmers demonstrated that the infection is moderately high in these two risk population groups at Obollo-Eke. A robust intervention strategy is clearly needed.

Detection of schistosomiasis antibodies in urine patients as a promising diagnostic maker

OBJECTIVE@#To determine secreted antischistosoma antibodies in urine and to discern the epidemiological situation of schistosomiasis in the agricultural field labourers'camps city in the Gezira State-central Sudan.@*METHODS@#Total of 66 urine and 66 serum paired samples were collected from those who confirmed parasitologically positive and negative with schistosomiasis from the two camps. Samples were tested using ELISA technique to measure and compare the immunoglobulin G (IgG) levels in serum and urine samples of schistosomiasis patients.@*RESULTS@#The overall prevalence of S. mansoni and S. haematobium was 53.8% and 15.4%, while the intensity were (2.04 GMEC) and (0.9 GMEC) respectively. The relative percentage of positive IgG individulas in urine was 92.40% where as 96.97% in serum. Statistically no significant difference between the IgG levels in serum and urine samples was observed.@*CONCLUSIONS@#This study shows that the detection of secreted IgG antibodies in urine can substitute serum for diagnosis of schistosomiasis.

ultrasound findings of complications of Schistosoma haematobuim

Ultrasound had been utilized for detection of infections and evaluation of mass chemotherapy programs for Schistosoma mansoni, with few studies concentrating on S. haematobium. The objectives were to determine the frequency of ultrasound findings of complications of Schistosoma haematobium in infected patients in El Kiryab and El Rahad area. 83 urine samples were selected from El Kiryab Agricultural Scheme, Khartoum State, and 80 ones from the El Rahad area, Kordofan State, 20 patients were sporadic cases from Khartoum East of Blue Nile, while 50 samples were taken as a control group. Urine microscopic examination and ultrasound was used to scan for residual effects of Schistosoma haematobium. The frequency of positive microscopic findings of S. haematobium was 63.9% and 62% in El Kiryab and El Rahad areas respectively. The frequency of the urinary bladder changes were wall thinking 85.5%; wall fibrosis in 29%; calcification in 87.4%; Polyps in 72% and ureteric dilatation in 41.7% of the scanned candidates

Schistosomiasis and Water-Related Practices in School Girls in Rural KwaZulu-Natal; South Africa

There is increasing evidence of an association between female genital Schistosoma haematobium infection and HIV. In KwaZulu-Natal; we aimed to explore girls' water contact practice and to determine whether a study exclusively on girls would be manageable and welcomed. Three primary schools that had participated in a parasite control programme eight years prior were approached. Subject to consent; girls aged 9 to 12 years were interviewed on water-body contact; symptoms and household composition. Urine samples were analysed for S. haematobium infection eggs. Good dialogue was achieved in all schools and 95consented to participation; 43had an S. haematobium infection; geometric mean intensity 10.5 ova per 10 ml urine. Only 12had ever been treated for S. haematobium. Water-body contact was significantly associated with S. haematobium (OR 2.8; 95CI 1.3-5.9; p= 0.008); however; S. haematobium was also found in 20of girls who claimed to never have had water-body contact. Sixty-four percent thought they had no choice but to use unprotected water; 21had no mother in the household; and being an orphan increased the risk of having S. haematobium. The community welcomed the study. Prevalence levels in South Africa are so high that some communities are eligible for WHO-recommended regular mass treatment

Height as a Surrogate for Bodyweight for Estimating the Dosage of Praziquantel and Artesunate in theTreatment of Urinary Schistosomiasis in School-Age Children

World Health Organization recommends mass treatment of all school children in areas where the prevalence of schistosomiasis is greater than 50. Praziquantel and artesunate are reported to display broad-spectrum antischistosomal activities. Since the susceptibilities of the different stages of schistosomes to the two drugs are distinctively different; it has been established that the use of these two drugs in combination will be beneficial for the treatment of urinary schistosomiasis. Dosage is determined by weight; which can be difficult to determine in field conditions. The use of calibrated height meter with height-based dosage calibration will make the work less cumbersome in field settings. Data on age; weight; and height from 264 school children who were screened and found to be infected with Schistosoma haematobium; diagnosed by the presence of the ova in their urine; were used to predict an alternative to bodyweight and thus the dosage of praziquantel and artesunate required to treat this disease. A very strong positive correlation (r = 0.8) was obtained for the height of treated children measured against weight while a moderately positive correlation coefficient (r = 0.6) was obtained for weight against age measurements; depicting that height can be used in lieu of weight for correct dose determination. A height meter calibrated with the equivalent number of tablets of praziquantel and artesunate could thus be used as a simple measurement to determine the dosage of praziquantel and artesunate needed to treat children in the field. This calibrated height will expedite treating large population of children in mass treatment campaigns in an endemic community