Abstract
BackgroundDiagnosis of schistosomiasis depends mainly on stool or urine microscopy for Schistosoma egg detection as well as immunoassays. The low sensitivity of these conventional tests makes molecular detection the diagnostic method of choice. The study aimed to detect the molecular prevalence of urine schistosomiasis and evaluate microscopic examination vs. PCR technique for detection of Schistosoma haematobium (S. haematobium) in urine of patients with suggestive symptoms or previous history of urine schistosomiasis coming from endemic regions.ResultsThis cross-sectional study was performed on eighty patients attending the urology clinic of Sohag University Teaching Hospital from August 2016 to July 2018. Socio-demographic data and clinical data were collected. Urine samples from all study individuals were collected and examined microscopically for S. haematobium eggs as well as detection of S. haematobium DNA of using PCR assay. Microscopic examination and PCR were positive among (68.8%) and (87.5%) of cases, respectively. There was 60% agreement between microscopy and molecular assay. Microscopy was a good test to rule in cases of urine schistosomiasis, with 100% specificity and 100% PPV, but was of limited sensitivity (NPV = 40%) and missed 12.5% of positive cases. Among studied patient variables, only hematuria showed association with urine schistosomiasis with statistical significance.ConclusionUrine schistosomiasis was highly prevalent in studied population. Considering the high sensitivity and specificity of PCR, it should be implemented as the test of choice, especially in chronic urinary schistosomiasis with low infection setting. In our study population, patients presenting hematuria were likely to have S. haematobium.
Highlights
Diagnosis of schistosomiasis depends mainly on stool or urine microscopy for Schistosoma egg detec‐ tion as well as immunoassays
Urinary schistosomiasis or bilharziasis caused by Schistosoma haematobium (S. haematobium) is a blood fluke infection that may cause fatal health sequelae, with significant socio-economic consequences in developing countries (King, Dickman & Tisch, 2005)
The current study aimed to assess the true prevalence of S. haematobium in Sohag University Hospital, Governorate of Sohag, using the Polymerase chain reaction (PCR) assay to detect DNA of S. haematobium in urine vs. urine microscopy and to evaluate the diagnostic performance of microscopy and to determine the associated variable that can be a predicator for the occurrence of urinary schistosomiasis. This cross-sectional study was performed for detection of S. haematobium for patients attending the Outpatient Clinic of Sohag University Hospital from August 2016 to July 2018, who had suggestive symptoms, previous history of urine schistosomiasis, or history of contact with water canals, or received Schistosoma treatment and were coming from endemic regions
Summary
Diagnosis of schistosomiasis depends mainly on stool or urine microscopy for Schistosoma egg detec‐ tion as well as immunoassays. Urinary schistosomiasis or bilharziasis caused by Schistosoma haematobium (S. haematobium) is a blood fluke infection that may cause fatal health sequelae, with significant socio-economic consequences in developing countries (King, Dickman & Tisch, 2005). It occurs in many parts of the world, Middle East, Africa, a few countries in West Asia (Iraq, Yemen, KSA) and Corsica, France, where > 600 million individuals live. Immunodiagnostic techniques are easier to carry out and more sensitive than microscopy They are a common epidemiological screening tool in low endemicity setting. Polymerase chain reaction (PCR) techniques, due to their high sensitivity and specificity, were successfully used to detect DNA from many parasites including Schistosoma spp. (Obeng et al, 2008)
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