Evaluation of Urine Reagent Strip as a Tool for Routine Diagnosis of Maternal Urogenital Schistosomiasis at Antenatal Clinic Visit in Munyenge, South West Region, Cameroon.

Godlove Bunda Wepnje,Leopold Gustave Lehman,Helen Kuokuo Kimbi,Judith Kuoh Anchang-Kimbi

doi:10.1155/2019/2972630

Godlove Bunda Wepnje, Leopold Gustave Lehman + Show 2 more

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https://doi.org/10.1155/2019/2972630

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Abstract

Urine reagent strip used in detecting microhaematuria has been recommended in pregnancy for diagnosis of urogenital schistosomiasis (UGS) during routine antenatal care (ANC). This study evaluated its sensitivity, specificity, and predictive values in the diagnosis of maternal UGS using filtration method as a reference test. We also assessed the variation in its performance in the diagnosis of UGS using multiple-sample collection. A total of 93 pregnant women reporting for first ANC clinic visit at any of the three functional health care centres (Munyenge Integrated Health Centre, Banga Annex Health Centre, and Trans African Health Centre) were enrolled and followed up for three consecutive monthly visits. Urine samples were observed microscopically for S. haematobium egg using urine filtration and screened for microhaematuria and proteinuria using urine reagent strips. Twenty-two (23.7%) out of the 93 women were diagnosed for UGS, all of whom showed S. haematobium egg excretion during all three visits. There was a significant difference (p < 0.001) between the prevalence of S. haematobium infection and the prevalence of microhaematuria. The intensity of infection was significantly higher in microhaematuria-positive women compared with microhaematuria-negative cases. Sensitivity of reagent strip ranged from 54.5 to 59.1%, while specificity was above 98.0% (range: 98.6–100%). The measure of agreement between urine filtration and reagent strip method was substantial (0.61–0.8) irrespective of different sampling periods. Urine reagent strip is a moderately sensitive method in the detection of UGS and will most likely identify women with high egg load burden. Proper diagnosis of schistosomiasis during pregnancy is recommended.

Highlights

Maternal schistosomiasis is a public health concern in endemic countries of sub-Saharan Africa where successful and sustainable control programmes are lacking [1,2,3,4,5]
It is estimated that approximately 10 million women annually have the infection during pregnancy [6] where maternal urogenital schistosomiasis (UGS) is associated with serious adverse effects on pregnancy such as preterm labour, low birth weight, and maternal anaemia [3, 4, 7]
Munyenge is mesoendemic for S. haematobium infection [23]. is work was a prospective cohort study and part of a larger epidemiological study on maternal urogenital schistosomiasis conducted between November 2016 and January 2018 [5]

Summary

Introduction

Maternal schistosomiasis is a public health concern in endemic countries of sub-Saharan Africa where successful and sustainable control programmes are lacking [1,2,3,4,5]. Praziquantel is widely acknowledged as the most important, rapid, and cost-effective method of reducing morbidity due to schistosome infections among risk groups [9]. Management of infected pregnant women through treatment with praziquantel is recommended by WHO, but many endemic countries are reluctant to adopt this policy because of the lack of sufficient safety data [6, 10]. Findings from controlled trial studies continue to support the expansion treatment policies to include pregnant women [10, 11]. Studies in Cameroon have shown that the use BioMed Research International of pipe-borne water eliminates infection [5], but it is not sustainable as pregnant women in endemic areas still make contact with water through domestic and bathing activities [4, 5]

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