RESUMO
Assessment of the burden of disease and techniques for clinical diagnosis could ultimately help in schistosomiasis control. This study assessed the impact of exercises and water intake on ova recovery during laboratory diagnosis and schistosomiasis-associated urinary symptoms and quality of life (QOL) among inhabitants of Dendo, an endemic community in Ghana. The clinical findings and responses of 400 randomly selected participants were used for the study. The International Prostate Symptoms Score (I-PSS) was used to collect information on participants' self-reported urinary symptoms and QOL. Finally, urine samples were collected on two consecutive days, initially without exercise and water intake and then after exercise and water intake, and about 10 ml of it were microscopically examined for the presence and quantification of ova. The data collected from the study were analyzed using IBM SPSS. Schistosoma haematobium egg recovery increased significantly (p < 0.001) from 206 (51.5%) to 220 (55.0%) after exercise and water intake with the highest increase being observed among participants less than 20 years (53.3% to 57.1% after exercise and water intake). As high as 90.3% and 56.8% of Schistosoma-positive participants reported IPSS>7 (symptomatic voiding disorders) and QOL≥4 (mostly dissatisfied or unhappy QOL) respectively. The commonest voiding symptoms reported were nocturia (98.9%) and incomplete emptying (79.6%). Positive correlations between egg count, IPSS score, and QOL were observed. This study provides important evidence for the inclusion of exercise and water intake in the microscopic diagnosis of Schistosoma haematobium and reveals that schistosomiasis significantly impacts the affected individuals' urinary health and overall quality of life.
RESUMO
Background: In recent times, cervical dysbiosis which mostly causes and aggravates infections is highlighted for its role in immune modulation in cervical dysplasia, which promotes the shifting of Th1 phenotype immunity to Th2 phenotype immunity. This study therefore estimated and compared the levels of circulatory IL-4, IL-6, IL-10, TNF-α, and IFN-γ cytokines among adult women identified to have different grades of cervical intraepithelial neoplasia (CIN) and with cervicovaginal infection. Methods: A total of 157 participants were recruited from the Akyemansa District of Ghana, and cervical swabs and blood samples were taken. The Pap smear test, microbiological culture, and ELISA were employed for cytology analysis, bacteria isolation, and identification and estimation of IL-4, IL-6, IL-10, TNF-α, and IFN-γ cytokines, respectively. Results: Overall, 14/157 (8.9%) had CIN with 7.6% having CIN 1 and 1.3% having CIN 2. The main predictor for CIN was age above 46 years (OR 11.16, 95% CI: 2.4-51.8). Bacterial vaginosis (p = 0.003) and Candida infection (p = 0.012) were significantly higher in CIN. Again, Staphylococcus aureus (60% vs. 17.6%, p = 0.005), Citrobacter sp. (40.0% vs. 13.2%, p = 0.017), and Morganella morganii (40.0% vs. 4.4%, p = 0.002) isolates were significantly higher in CIN-positive participants. IL-10 and TNF-α concentrations were elevated in participants with CIN 1+ (TNF-α NIL vs. CIN 1+ only, p < 0.05) while IL-6 was decreased among participants with CIN 1+. In the presence of vaginal infection, TNF-α decreased among CIN 1+ participants while IL-10 remained elevated. Conclusion: The findings of this study suggest that cervical dysbiosis causes immune suppression, which creates a suitable microenvironment for the development of CIN.
