Abstract
ABSTRACT.This study determined the contribution of a mobile health (M-health) system to the treatment of Schistosoma haematobium in a region of Chad where S. haematobium is endemic. M-health involves the use of a mobile phone for health care. The study compared the prevalence of schistosomiasis in an area with an M-health system, newly installed in 2014, with an area without an adequate health infrastructure. Data were gathered after the M-health system had been running for 3 years. We took urine samples from children age 1 to 15 years, for a total of 200 children in a village in the M-health area and 200 in a village in a non-M-health area. Urine was checked for urinary schistosomiasis by using dipsticks for microhematuria and, in cases of positive dipstick results, microscopy was used to detect eggs. Comparison between the areas allowed us to assess the effectiveness of the installed M-health system after 3 years of operation. Based on dipstick outcomes, the non-M-health area had an infection rate of 51.5% compared with 29% in the M-health area. Microscopy results in non-M-health and M-health were 27.5% and 21%, respectively. The dipstick result difference between M-health and non-M-health areas was statistically significant. Dipsticks were more reliable than microscopy for the detection of schistosomiasis, especially in areas without qualified personnel. Based on these results, M-health proved its ability to reduce the infection rate of urogenital schistosomiasis, and the implementation of M-health shows great promise in areas where this disease is endemic and where no mass drug administration is provided.
Highlights
Bilharziasis, or schistosomiasis, is a parasitic disease caused by trematodes, which are hematophagous flatworms of separate genders
Clinical signs may vary from hematuria with few extra complaints, to severe forms of irritative bladder complaints and obstruction of the upper urinary tract caused by fibrosis of the ureters
200 children from an M-health village and 200 children from a non-M-health village were screened for urinary schistosomiasis to compare the prevalence of schistosomiasis in the two locations
Summary
Bilharziasis, or schistosomiasis, is a parasitic disease caused by trematodes, which are hematophagous flatworms of separate genders. Adult flatworms live in the circulatory system of mammals and evolve during the larval stage in freshwater mollusks.[1] In cases of Schistosoma haematobium, the female worm produces eggs that penetrate the urinary bladder, producing symptoms of a lower urinary tract disease. Clinical signs may vary from hematuria with few extra complaints, to severe forms of irritative bladder complaints and obstruction of the upper urinary tract caused by fibrosis of the ureters. The most commonly used tests to diagnose the disease are detection of hematuria by urine test strips and direct detection of eggs using a microscope for a centrifuged or filtered urine sample.[2]
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