Diagnosis of Urinary Schistosomiasis by using Chemical Analysis of Urine from School Children of Taibat Alahamda Khartoum Sudan

Abstract

The aim of this study was to investigate the prevalence of urinary schistosomiasis among school children attending the primary school of Taibat Alahamda village, Khartoum North, Sudan. According to some previous reports and the studies of the Federal Ministry of Health, Taibat Alahamda was considered to be an endemic area of schistosomiasis in Khartoum North locality. Therefore, Taibat Alahamda primary school for boys was selected for this study. The first clinical laboratory sign to be investigated was to identify school children suffering from haematiuria in order to be diagnosed and treated. Some essential chemical changes observed in the urine collected from the pupils were thoroughly examined which might lead to the possible diagnosis of urinary schistosomiasis among the school children. Eight hundred thirty eight (838) pupils were examined, 47 were found to be infected with Schistosoma haematobium. This constituted a prevalence rate of 5.6%. The study also revealed that the age of the pupils examined was a critical factor in contracting the disease, as most of the children infected with S.haematobium were above 10 years of age. When biochemical analysis was performed for all urine samples collected, protein level was shown to be an important indicator for infection with S.haematobium. The results showed that 95.75% of positive cases were infected with S.haematobium. However, only around 4.25% cases were co-infected with both S.haematobium and S.mansoni and not a single case was infected with S. mansoni alone. Significant amount of red blood cells and pus cells were detected in the urine samples examined. Also, microscopic examination of urine samples revealed that 5.48% of infected pupils were suffering from pyuria, while 6.68% had haematouria. Other biochemical parameters of urine investigated, such as glucose, ketone bodies, urobilinogin and bile pigments, were shown to be of no clinical significance .This was possibly, due to the fact that such parameters were not directly related to the disease and, consequently, were not affected by the pathogenesis of S.haematobium. When some infected children were treated, praziquantel was shown to be the drug of choice. This was observed by the fact that most of the treated pupils 70.2% responded well to the oral single dose of praziquantel. However, when a second dose of the drug was administered one month later, 100% of the pupils responded to the treatment. Interestingly, children with mixed infection of S.haematobium and S.mansoni, did not respond at all to the first dose, and only weakly to the double doses of the drug, a matter that should be thoroughly investigated in the future.