Female genital schistosomiasis: prevalence disease associated morbidity and intensity of infection as detected by soluble egg antigen in urine

ABSTRACT

This study was done to assess the prevalence and morbidity pattern of S. haematobium infection in women of reproductive age [15 - 45 years] in schistosomiasis endemic area. One hundered and eighty women involved in this study and grouped as follows group I women with proven femal genital schistosomiasis [FGS] [n = 80], group II endemic referents [n = 80] and group III women living in schistosomiasis-free area [n= 20] serve as controls. Full history, general gynaecological and parasitological examinations were done to every women, a s and wich ELISA was carried to detect soluble egg antigen [SEA] in urine of all cases.Evaluation of the applicability of this assay as a diagnostic and morbidity indicator was done. revealed that significantly more FGS reported a history of spontaneous abortion [P < 0.01], complaints of irregular menstruation [P < 0.001], pelvic pain [P < 0.01] vaginal discharge [P < 0.0001], dysuria [P < 0.01] and haematuria [P < 0.0001] than in the referents. Biopsies were taken from the cervix of 80 women with macroscopical lesions and from them 24 cases, S. haematobium eggs were found by histological sectioning [30%]. In the control group [referents] no eggs were detected in the cervical biopsies of 10 of them [50%]. Infections with C and ida albicans, Trichomonas vaginalis were found in similar frequencies in all groups. Ecographic abnormalities of the urinary tract were present in 24% and 0% of the infected women and referents respectively. These findings were accompanied by an elevated frequency of haematuria [55.6% versus 10%] and proteinuria [70% versus 20%] in the FGS and referent groups. Our study indicates that S. haematobium infection in women may not only cause symptoms in the urinary tract but also frequently in the lower reproductive tract [LRT]. SEA levels in urine of S haematobium infected women significantly correlated with egg counts and with clinical findings [P < 0.001]. In addition lower genital tract pathology as determined by cervical smear and biopsy significantly correlated with the SEA levels in urine