Chemical Reagent Strips Research Articles

Assessment of urine metabolite biomarkers for the detection of S. haematobium infection in pre-school aged children in a rural community in Zimbabwe

BackgroundEarly diagnosis of urogenital schistosomiasis is key to its control and elimination. The current gold standard microscopic examination techniques lack sensitivity in detecting light Schistosomiasis infections in pre-school aged children thus it is urgent to develop diagnostic tools that may be integrated into control programs. In this study, we evaluated the diagnostic performance of urine metabolite biomarkers using a chemical reagent strip in the detection of S. haematobium infection in pre-school aged children. MethodsA case-control study was conducted involving 82 pre-school aged children that were age and sex matched. Urine samples were collected for 3 consecutive days and were evaluated using urine filtration gold techniques as the gold standard method. The samples were simultaneously measured for metabolite biomarkers specifically haematuria, proteins, ketones, nitrites, glucose, bilirubin and urobilinogen using chemical reagent strips. Pearson correlation test was used to measure the relationship between S. haematobium infection and the urine metabolite biomarkers. ResultsThe diagnostic performance of urine biomarkers were correlated with the microscopic examination urine filtration technique. Haematuria (r = 0.592, p = 0.0001) and proteinuria (r = 0.448, p = 0.0001) were correlated to S. haematobium infection. Negative correlations with p > 0.05 were recorded for ketones and urobilinogen. Highest sensitivity was 65.9 % (CI, 49.4 - 79.9) for haematuria whilst protein (albumin) biomarker had a lower specificity value of 43.9 % (28.5 – 60.3). Inversely, highest sensitivity was 87.8 % (73.8 – 95.9) for proteinuria whilst haematuria had a lower sensitivity value of 82.9 % (67.9 – 92.8). The positive predictive values ranged from 57.7 % (41.6 – 72.2) to 79.4 % (65.5 - 88.7) whereas negative predictive values ranged from 70.8 % (60.8 – 79.2) to 52.0 % (48.7 – 55.3). With respect to diagnostic efficiency, haematuria had a fair diagnostic performance with an area under the curve of 0.76 followed by proteinuria with proteinuria whilst the remaining metabolites fail discriminating ability with an area under the curve of <0.5. ConclusionAlthough haematuria and protein biomarkers in urine are moderately sensitive and specific, they are important morbidity indicators of urogenital schistosomiasis in pre-school aged that may be utilised during screening in schistosomiasis control programs. We recommend comprehensive analysis of biomarkers using metabolomics techniques to identify novel urine biomarkers.

Prevalence, Peculiarities and Patterns of Urogenital Schistosomiasis and Hematuria in Owena Reservoir Area, Ondo East Local Government Area, Ondo State, Nigeria

Background: Schistosomiasis, Leprosy, Leishmaniasis, Malaria, Trypanosomiasis and Filariasis are the six major tropical diseases, specially targeted for control by the Special Program for Research and Training on Tropical Diseases of the United Nations Development Programme (UNDP), World Bank and World Health Organization. Out of the above six diseases, schistosomiasis is the second most important tropical diseases, second only to malaria. The distribution of schistosomiasis cuts across 76 countries in Africa, Latin America and Asia. Schistosoma hematobium endemicity cuts across 54 countries. Aim: To study the prevalence, peculiarities and patterns of urogenital schistosomiasis and hematuria in Owena Reservoir Area for an effective, affordable and sustainable schistosomiasis control in the area. Materials and methods: Owena Reservoir Area consists of Owena, Kajola and Baiken communities. A school-based cross-sectional technique was used for urine collection and quantification of Schistosoma hematobium eggs which involved 624 pupils in March 2014 and 591 pupils in April 2015. Risk factors, socio-demographic variables were collected using questionnaires. Urine samples were examined for Schistosoma hematobium eggs using sedimentation by gravity cum centrifugation. The urine samples obtained from the pupils were divided into two separate 30ml universal sterling plastic bottles with conical bottom. The first of the two 30ml universal sterling plastic bottles were examined for Schistosoma hematobium eggs using sedimentation by gravity cum centrifugation. The second of the two 30ml universal sterling plastic bottles were assessed for gross hematuria through visual observation of bloody urine while non-bloody samples were examined for micro-hematuria using one strip of commercially prepared chemical reagent strips COMBUR-9 prepared and marketed by Acun Laboratory USA which was dipped into each urine sample and the color change was matched with standard by the side of the container of the reagent strips. Results: Out of the 624 pupils examined in March 2014, 256 (41.0%) were positive for Schistosoma hematobium eggs in urine, while in April 2015, 381 (64.5%) out of 591 were positive. Prevalence of hematuria in the three communities shows that in Owena community the age group 21 – 30 had the highest prevalence (49.2%); in Kajola, the age group 5-10 had the highest prevalence (46.2%); while in Baiken community, the age group 5-10 had the highest prevalence (55.5%) – with 95% Confidence Interval in all cases. Conclusion: Macrohematuria was identified as a sensitive and specific diagnostic technique for identifying people infected with Schistosoma hematobium in the three communities. This parameter may be recommended as a cost saving diagnostic approach during future control efforts, with reference to the April 2015 peculiarities and patterns of infection shown by this study.

Evaluation of a novel Nano diagnostic assay for Assessing the Prevalence of Schistosoma haematobium Infection in Areas at Risk in Upper Egypt

Abstract Background Urogenital schistosomiasis caused by Schistosoma heamatobium is one of the major public health problems worldwide. It is thought that despite extensive efforts and integrated control programs implicated over the last few decades, the global disease burden of schistosomiasis remains unacceptably high. This persistence of the disease may be due to in part the lack of accurate diagnostic tools for case detection and community screening in endemic areas. Aim of the work The present work aims to develop a novel nano-diagnostic assay using gold nanoparticles (nanomagnetic beads based- ELISA) which can utilize larger surface area, achieving a higher sensitivity for detection of urinary schistosomal egg antigen (SEA) in urine of human schistosomiasis haematobium and comparing it with the traditional sandwich ELISA and direct microscopic examination of urine sediments together with indirect screening by chemical reagent strips for microhaematiria and proteinuria for assessing prevalence of urinary schistosomiasis in some villages in Beni-Suef governorate. Subjects and methods A cross sectional study was conducted on 290 students (192 male and 98 female) selected randomly from Primary and Preparatory schools in four villages in Beni-Suef governorate; The participating children were aged 8–15 years old. A simple questionnaire was designed based on the key indicators of urinary schistosomiasis then, terminal urine samples were collected between 10 am and 2 pm in clean container from each participant to be screened by chemical reagent strips (Combi 10) and examined by urine microscopy and sandwich ELISA techniques (traditional and IMB) for S. haematobium detection. Soluble egg antigen (SEA) was used to produce specific polyclonal antibodies (pAbs) which were then used as a primary capture in the sandwich ELISA techniques. The anti-SEA pAbs were labeled with horse-radish peroxidase (HRP) and used as a secondary capture. Results Out of the 290 participants, 39 children (13.4%) were positive by UM, 53 were positive by traditional sandwich ELISA, with diagnostic sensitivity (87.2%) and specificity (92.4%) and 50 were positive by IMB-sandwich ELISA with diagnostic sensitivity (94.9%) and specificity (95.2%)based on UM results. Micro-haematuria and proteinuria were assessed by chemical reagent strips which gave sensitivity of 29.5%, specificity of 90.8% for micro-haematuria alone, sensitivity of 18.4%, specificity of 92.4% for proteinuria alone, while sensitivity of 35.9%, specificity of 94.9% for combined micro-haematuria and proteinuria which indicated a highly significant association with S. haematobium infection (p value&amp;lt;0.001). Conclusion Combination of both clinical and epidemiological data in addition to sensitive diagnostic tools is essential for diagnosis. The present study as with other studies revealed that, IMB-ELISA based on gold nanoparticles provides more rapid and sensitive detection for SEA in urine samples of patient with active schistosomiasis. Simplicity and fast detection (10 min) are its main advantages. Moreover, its high sensitivity and specificity ensure its application with greater precision and rapid detection. Also, in addition, the prevalence of urinary schistosomiasis in these regions is considered relatively high requiring rapid implementation of control programs to decrease the prevalence and improve the community's health status.

Evaluation of a developed IMB based-ELISA in diagnosis of urinary schistosomiasis in areas at risk in Upper Egypt

Background: Nanotechnology enables researchers to boost accuracy of the existing diagnostic techniques.Immunomagnetic beads (IMB) based-ELISA was utilized to diagnose several parasitic diseases;schistosomiasis mansoni and japonicum, toxoplasmosis and neurocysticercosis.Objectives: The present work aims to develop and evaluate a novel nano-diagnostic assay using goldnanoparticles (AuNPs) in ELISA (IMB based-ELISA) for the diagnosis of urinary schistosomiasis.Subjects and Methods: IMB based-ELISA assay was developed by preparation of polycolonal antibodies(pAbs) against Schistosoma soluble egg antigen (SEA). The developed novel assay was evaluated in urinesamples of 290 schoolchildren collected from primary and preparatory schools in four villages in Beni-Suefgovernorate, Egypt. Urine samples were screened by chemical reagent strips (Combi 10) and examined byurine microscopy (UM). The conventional ELISA technique was used to evaluate the efficacy of IMB based-ELISA using UM as the gold standard method for diagnosis of urinary schistosomiasis.Results: The novel IMB based-ELISA assay succeeded to diagnose 50 out of 290 schoolchildren (17.2%).In comparison with other methods, results showed that 39/290 (13.4%) were positive by UM and53/290 (18.3%) by conventional ELISA. A sensitivity, specificity and diagnostic accuracy of the evaluatedELISA assay using UM as the gold standard method were 94.87%, 95.22% and 94.48% respectively. Itwas observed that Combi-10 gave sensitivity and specificity of 35.9% and 94.9% respectively for microhaematuriaand proteinuria.Conclusion: IMB-ELISA based on AuNPs provides a more rapid as well as sensitive detection of SEA in urinesamples of patients with active schistosomiasis. Its high sensitivity and specificity ensure its applicationin field studies. Additionally, urinary schistosomiasis proved highly prevalent in schoolchildren living inBeni-Suef villages.

Epidemiological Assessment of Urinary Schistosomiasis among School-aged Children in Selected Local Government Areas in Gwandu Emirate of Kebbi State, Nigeria

Urinary schistosomiasis remains a public health problem in the tropics. The study examines the prevalence of urinary schistosomiasis among school-aged children in Bunza, Koko and Aliero Local Government Areas (LGAs) in Gwandu Emirate of Kebbi State, Nigeria. Four hundred and seventy-four (474) urine samples were examined for ova of Schistosoma haematobium using sedimentation technique and chemical reagent strip for haematobium detection. The overall prevalence of S. haematobium recorded was 126 (26.58%). The distribution of infection by location revealed that Bunza had highest infection (35.1%), followed by Koko (28.00%) and Aliero (17.1%). Bunza showed Odd ratio (OR) of 2.02 and 95% CI (1.33 – 3.08) with statistical significance of P &lt; 0.0014 which indicates that location plays a significant factor in prevalence of infection. The prevalence of infection in relation to gender showed that males had the highest percentage 37.13%, Chi-square revealed that there was difference between the males and female infection rate (P &lt; 0.0001) while 16.03% was observed among the females. The age bracket 9 – 12 years old 47.05% were the most affected with the infection, while children 5 – 8 years bracket with 15.08% had the least infection rate. Chi-square shows that there was difference between the ages and infection rate of (P&lt;0.0001). Blood in urine (haematuria) was significantly associated with infection rate. Water-contact activities recorded revealed that there was association between water contact and infection rate (P-value &lt; 0.0001). With the high prevalence of infection in the study areas, there should be a concerted effort by stakeholders in the state, not just to establish a comprehensive data on the prevalence of the infection, but also to take decisive action in its control.

Urinary schistosomiasis among primary school pupils in selected communities of Abua/Odual Local Government Area, Rivers State, Nigeria

The aim of the study was to determine urinary schistosomiasis in primary school pupils in some selected communities in Abua/Odual Local Government Area of Rivers State, Nigeria, the risk factors of schistosomiasis with the view of suggesting control measures suitable to reduce infectivity and morbidity. Urine samples were collected and investigated using centrifugation and sedimentation techniques for the presence ofS. heamatobium eggs. Also, the urine was examined using the chemical reagent strip, Medi-test Combi-9 for the presence of haematuria and proteinuria in the urine. Of 140 urine samples collected and examined, haematuria and proteinuria shows prevalence of 61 (43.6%) and 94 (67.1%) respectively, and an overall prevalence of S. haematobium infection of 25% was recorded. Males (51.9%) had higher infection rate than females (17.4%). Children within age 10-13 years had the highest occurrence (55.4%), due to frequent visit in the water bodies to swim, paddle, play in the mud, fish, wash, fetch water from the infected water while the least was recorded among children within age 3-5 seen as infant whose parents restrict from visiting the river often. Emago-Kugbo recorded the highest infection with (32.3%), but the least was recorded in Akani-Kugbo with (15%). Statistical analysis showed that the infection varied significantly among sexes, age at p&gt;0.05, community infection was equally significant at 0.05. The result of this study has shown the presence of urinary schistosomiasis in the Kugbo Clan, though prevalence was below 50%. The childrenhave no knowledge about schistosomiasis infection in the area. Also the presence of snail species especially the Bulinus globosus and increase contact with fresh water were taught to be responsible for the occurrence of the infection in the Kugbo Area. The results show that the communities around the Kugbo Clan are prevalent with schistosomiasis and that there is immediate attention for mass drug distribution of praziquantel and public health education in curbing the disease in the study-area.&#x0D; Keywords: Urinary schistosomiasis; primary school pupils; Abua/Odual LGA; Rivers State; Nigeria.

Changes in the results of the multi reagents strips in a single lot: A comparative study

Topic: Changes in the results of the multi reagents strips in a single lot.AIM: To verify whether the multi reagent strips show changes in results of pH and specific gravity.Introduction: Urine chemical reagent Strips are square measure firm plastic strips onto that many separate reagent areas are affixed. The test is for the detection of one or more lot of the subsequent analytes in urine: Leukocytes, Glucose, organic compound ketone (Acetoacetic acid), Bilirubin, Blood, specific gravity, Protein, Nitrite, Urobilinogen and pH. Urine undergoes several changes throughout states of malady or body pathology before blood composition is altered to a major extent. Urinalysis may be a helpful procedure as an indicator of health or malady as such may be a part of routine health screening.Materials and Methods: Sample size: 100 multi reagent strips were taken from a single lot. The test is for the detection of one or more lot of the subsequent analytes in urine: Leukocytes, Glucose, organic compound ketone (Acetoacetic acid), Bilirubin, Blood, specific gravity, Protein, Nitrite, Urobilinogen and pH.The strips were verified for any changes by dipping it in an artificially prepared single urine sample, analyzed as per the user’s manual and results were analyzed.Result: The average pH value is 7.0, in this slot of 100 strips had variations ranging between 6.19 and 7.82. Whereas specific gravity the average value is 1.01, in this slot of 100 strips had variations ranging between 1.006 and 1.016.Conclusion: When manually analyzed it shows difference and variations in each strip in a single lot for pH and specific gravity of 5.8% and 2.6% respectively. Therefore, it is applicable for manual urine analysis method.

Efficacy of Chemical Reagent Strip in the Diagnosis of Urinary Schistosomiasis in Ikota, Ifedore Local Government Area, Ondo State, Nigeria

Urinary schistosomiasis is a parasitic disease caused by Schistosoma haematobium which affects the bladder and as such is a major source of morbidity and mortality in Africa and Sub-Sahara Africa. This study was conducted to determine the efficiency and efficacy of chemical reagent strip in the diagnosis of urinary schistosomiasis among pupils in Ikota, Ifedore Local Government Area of Ondo state. The pupils’ data were obtained using pretested, well-structured questionnaire while the samples were analyzed in the laboratory using sedimentation method and chemical reagent dipstick (Combi-9) was used to examine the microhaematuria and proteinuria. Of the one hundred and fifty (150) individuals that were sampled, 76 (50.66%) pupils were males and 74 (49.33%) were females. The prevalence of infection of S. haematobium in the area was 36 (24.0%). There was no significant difference (p >0.05) in prevalence relating to sex and age. Analysis on microhaematuria and proteinuria shows that 30 (20.0%) were positive for microhaematuria and 76 (50.67%) for proteinuria. The sensitivities of the urinary symptoms were 50.0% for proteinuria and 83.33% for microhaematuria and specificity was 62.3% for proteinuria and 100.00% for microhaematuria respectively. This chemical reagent strip combine with gold standard method of diagnosis will increase the accuracy and give good predictive value.

Urinary Bladder Thickness, Tumor Antigen, and Lower Urinary Tract Symptoms in a Low Schistosoma Haematobium-Endemic Rural Community of Nigeria

Objective: Bladder tumor antigen (BTA) is a common biomarker for urothelial carcinoma while bladder wall thickening (BWT) is a sign of urinary bladder irritation which suggests cystitis or early-stage bladder cancer pathology, most especially in the absence of bladder outlet obstruction. The aim of this study was to find the incidence of urinary bladder thickness and evaluate the relationship between BTA and BWT in a low schistosomiasis-endemic Nigerian village. Materials and Methods: The study was descriptive and cross-sectional. Freshly passed mid-day urine samples of 56 individuals were screened using chemical reagent strips and then diagnosed microscopically for Schistosoma haematobium. Subsequent follow-up involving ultrasound examination was carried out on distended bladder. The lower urinary tract symptoms (LUTS) were also recorded. Urinary BTA analysis was carried out on the urine samples using enzyme-linked immunosorbent assay. Results: The prevalence of urogenital schistosomiasis in the area was 3.6%. The overall prevalence of human BTA and BWT in the individuals was 44.6 and 35.7%, respectively. The LUTS were associated with BWT (P = 0.004; odds ratio = 6.0; 95% confidence interval = 1.8–20.3). BTA, BWT, and LUTS were not sex and age dependent (P &gt; 0.05). In addition, there was no association between urinary BTA, BWT, and LUTS (P &gt; 0.05). The sensitivity of BWT and LUTS (60.0%) was improved than when either was used to diagnose BTA. Conclusion: The high occurrence of BTA and BWT in the individuals suggests that they may be prone to urothelial carcinoma and urinary bladder irritation, respectively. The role of urogenital schistosomiasis in urinary BTA levels needs to be further explored.

The Validity of Haematuria and Proteinuria by chemical reagent strip for diagnosis of Schistosoma haematobium infection

The Validity of Haematuria and Proteinuria by chemical reagent strip for diagnosis of Schistosoma haematobium infection

Maternal urogenital schistosomiasis; monitoring disease morbidity by simple reagent strips.

BackgroundUrine analysis is one of the recommended antenatal guidelines for early diagnosis of pregnancy-associated complications. While in practice, urine analysis by dipstick had been used to provide useful information on other urinary tract infections, its applications for early detection of urogenital schistosomiasis in pregnant women is often times not given due attention in most endemic areas. Our study therefore assessed the performance of some common urinalysis parameters in the diagnosis of maternal urogenital schistosomiasis in endemic rural communities of Nigeria.Methodology/Principal findingsThe cross-sectional epidemiologic survey of urogenital schistosomiasis was conducted among pregnant women in Yewa North Local Government, Ogun State, Nigeria. The women were microscopically examined for infection with Schistosoma haematobium, visually observed for macrohematuria, and screened for microhematuria and proteinuria using standard urine chemical reagent strips. Of 261 volunteered participants, 19.9% tested positive for S. haematobium infection. The proportion of microhematuria (23.8%) was significantly higher than that of macrohematuria (3.8%) and proteinuria (16.8%) (P<0.05). Microhematuria with sensitivity (82.7%) and specificity (89.0%) was the best diagnostic indicator of urogenital schistosomiasis. Macrohematuria with the least sensitivity (11.8%) was however the most specific (98.1%) for diagnosing urogenital schistosomiasis in pregnant women. Maximum microhematuria sensitivity (100.0%) was observed in women between 15–19 years but sensitivity was consistently low in older age groups. Maximum sensitivity, specificity and predictive values (100.0%) were recorded for microhematuria in first trimester women. Diagnostic efficiency of proteinuria and macrohematuria was also better in the first trimester women except the 25.0% specificity recorded for proteinuria. The overall diagnostic performance of microhematuria and proteinuria was better in secundigravidae.Conclusions/SignificanceMicrohematuria can be used for early detection of urogenital schistosomiasis in endemic areas especially in younger women. However because microhematuria is a condition that occurs during pregnancy and in several other diseases, it is necessary to compliment the diagnosis with other diagnostic tools such as microscopy and serology. Treatment with praziquantel is recommended for the women in their late trimesters after follow up test in order to avert associated adverse pregnancy outcomes.

VARIABILITY OF URINE PARAMETERS IN CHILDREN INFECTED WITH SCHISTOSOMA HAEMATOBIUM IN UKAWU COMMUNITY, ONICHA LOCAL GOVERNMENT AREA, EBONYI STATE, NIGERIA.

Background:Schistosomiasis, a chronic, debilitating and neglected tropical and sub-tropical water-borne ailment, is highly endemic in Nigeria, especially among primary school children in rural communities. The study on the variability of urine parameters in children infected with Schistosomahaematobium in Ukawu community, Onicha Local Government Area of Ebonyi State, was undertaken.Materials and Methods:Urine samples were aseptically collected from 400 primary school children in the community and analysed using chemical reagent strips and sedimentation techniques.Results:The study revealed an overall prevalence of 27% as 108 pupils out of 400 were infected with S. haematobium in the area. Proteinuria, haematuria and leucocyturia were observed to occur in 67.0%, 79.0% and 74.9% respectively. Males had higher infections and higher occurrences of proteinuria, haematuria and leucocyturia (72.5%, 88.2% and 82.4% respectively). There was no significant difference with respect to sex (P<0.05). Children within ages 12-15 years had the highest prevalence of S. haematobium (35.5%) while those within the ages of 4-7 had the least prevalence (11.4%). The difference in the rate of infection between the different age groups was significant, statistically (P>0.05). Children within ages 12-15 had the highest occurrence of proteinuria, haematuria and leucocyturia while children within ages 4-7 had the least occurrence of the three urine parameters. All the pupils excreting above 40 egg/10ml of urine had proteinuria, haematuria and leucocyturia.Conclusion:The study revealed that the community studied is endemic with Schistosoma haematobium infections and the level of the urine parameters increased with the intensity of infection. Prompt case detection and treatment, good personal hygiene, eradication of snail hosts, public enlightenment and proper waste disposal are hereby recommended.

A cross-sectional study on urogenital schistosomiasis in children; haematuria and proteinuria as diagnostic indicators in an endemic rural area of Nigeria.

Rapid and accurate diagnosis is necessary for the management of schistosomiasis in endemic areas. To assess the burden of urogenital schistosomiasis and the diagnostic efficiency of morbidity indicators of the disease in an endemic rural community of Nigeria. A cross-sectional school-based study was conducted. Urine samples of 487 pupils were screened microscopically for S. haematobium and tested for haematuria and proteinuria using chemical reagent strips. The prevalence and intensity of infection were 57.1% and 45.0 eggs/10 mL urine respectively. Prevalence of infection in male (54.1%) and female (60.3%) individuals showed no significant variation (P>0.05). However, prevalence of infection was age dependent with those in age groups 3-5 and 12-14 years having the least and highest prevalence of infection respectively (P<0.05). Microhaematuria and proteinuria varied significantly with ages of the pupils with least (14.0, 40.0%) and highest (60.0, 80.0%) prevalence recorded in age groups 3-5 and 15-19 years respectively (P<0.05). Proteinuria showed higher sensitivity (80.3%) compared to microhaematuria (73.3%). Schistosomiasis is highly endemic in the study area and the use of microhaematuria and proteinuria for mapping the infected population prior treatment could be adopted.

Urogenital schistosomiasis and urological assessment of hematuria in preschool-aged children in rural communities of Nigeria

ObjectiveThe study evaluates the prevalence of urogenital schistosomiasis and diagnostic performance of chemical reagent strips used for disease diagnosis in preschool-aged children (≤5 years) in Nigeria rural communities. Patients and methodsUrine samples from 419 children were observed microscopically for Schistosoma haematobium and screened for hematuria using standard urine chemical reagent strips. ResultsPrevalence and intensity of infection were 9.8% and 14.4 eggs/10 ml of urine, respectively. Prevalence of infection was similar in girls (10%) and boys (9.6%) (p > 0.05). The intensity of infection was higher in boys (17.1 eggs/10 ml of urine) than in girls (12.8 eggs/10 ml of urine); however, this was not gender dependent (p > 0.05). The occurrence of hematuria was not associated with gender (p > 0.05), but was associated with prevalence of infection (p < 0.05). ConclusionInfection with S. haematobium occurs early in life in the communities and although intensity of infection is low, it could have serious implications in disease transmission. Hematuria, although moderately sensitive to infection, is an important morbidity indicator of urogenital schistosomiasis in the study population.

Diagnostic accuracy of different urine dipsticks to detect urinary schistosomiasis: a comparative study in five endemic communities in Osun and Ogun States, Nigeria

The diagnostic accuracy of urine dipsticks was investigated using two different brands in five endemic communities of south-western Nigeria. The BM-5L test was used in 1992 to screen 566 subjects in two communities in Ogun State, while 1457 subjects in three other communities in Osun State were screened with the Combur-9 test in 2006. Haematuria gave a higher prevalence of infection than proteinuria irrespective of which strip brand was used (e.g. BM-5L test: 58.3 and 36.2%; Combur-9 test: 46.5 and 41.9%, respectively). Compared with egg microscopy (gold standard), haematuria identified over 90% of egg-positive samples using either the BM-5L test in 1992 or the Combur-9 test in 2006. The corresponding values for proteinuria were 58% using the BM-5L test and 82% using the Combur-9 test. Sensitivity of haematuria to infection was higher using the BM-5L test (92.4-93.5%) than Combur-9 (58.6-73.3%), while sensitivity of proteinuria to infection was higher using Combur-9 (55.5-80.4%) than BM-5L test (26.0-58.3%). However, both strip brands have comparable specificity for haematuria (BM-5L test, 88.3-99.5%; Combur-9, 88.9-100%) and proteinuria (BM-5L test, 94.4-100%; Combur-9, 98.7-100%) to infection. Based on these results we conclude that neither brand nor manufacturer has a significance effect on the performance of chemical reagent strips. However, the diagnostic value of both haematuria and proteinuria varied according to the positivity level adopted, intensity of infection and age, but was not affected by sex and village of residence.

Is diabetes a disease for general practice?

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Cost-effectiveness of screening methods for urinary schistosomiasis in a school-based control programme in Ibadan, Nigeria

To carry out a comparative cost-effectiveness analysis of screening methods for urinary schistosomiasis; terminal haematuria, unqualified haematuria, dysuria, visual urine examination and chemical reagent strip technique, in a school-based control programme. Estimation of costs and determination of cost-effect ratios of the screening methods applied in a school-based screening and treatment programme, from the perspective of a programme manager. A junior secondary school in Ibadan, Nigeria. Cost per number of cases correctly diagnosed. Unqualified haematuria was found to be the most cost-effective method costing N51.06 (US$ 2.16) to diagnose a case correctly, followed by terminal haematuria N58.91 (US$ 2.50) and dysuria N84.24 (US$ 3.57). Despite the relatively high input costs of chemical reagent strip technique over visual urine examination (N22.12 (US$ 0.94) per student vs. N6.44 (US$ 0.27) per student), it was found to be more cost effective costing N304.56 (US$ 12.91) to diagnose a case correctly than visual examination of urine cost of N317.58 (US$ 13.46) per correct case diagnosed. From the viewpoint of a programme manager, interview method of screening by asking for blood in the urine remains the most efficient means of screening for urinary schistosomiasis in school-based control programmes in our environment.

Age and gender effects in self‐reported urinary schistosomiasis in Tanzania

To characterize age-gender prevalence profiles of urinary schistosomiasis according to the questionnaire responses, compare the profiles to field survey data from selected regions, and determine if the profiles varied spatially throughout Tanzania. In 2004, a national school-based questionnaire survey for self-reported schistosomiasis and blood in urine (BIU) was conducted in all regions of mainland Tanzania, to assist targeted mass distribution of praziquantel. Field survey data were collected in six north-western and five coastal regions using microscopic examination of urine samples for the presence of Schistosoma haematobium eggs and assessment of micro-haematuria with chemical reagent strips. Bayesian logistic regression models were created to calculate age-gender profiles adjusted for demographic and ecological covariates and spatial correlation in the questionnaire data. Separate odds ratios (OR) for age-gender effects were calculated in each administrative area. Data were obtained from > 2.5 million schoolchildren. Boys had higher prevalence of self-reported schistosomiasis and BIU than girls. In boys, prevalence according to the questionnaire and field surveys followed similar age profiles. However, in girls, prevalence according to the field surveys increased in older age groups, but flattened out or decreased according to the questionnaire, indicating the latter underestimated prevalence in older girls. In the models, little spatial correlation was evident in the OR for the age-gender effects, suggesting that these did not vary spatially. Age-gender patterns of urinary schistosomiasis were consistent in different geographical areas of Tanzania. Because the questionnaire underestimated prevalence in older girls, we propose that upward calibration of observed prevalence is done for older females only.

Urinary schistosomiasis epidemiological survey of urinary schistosomiasis among children in selected schools: A preliminary study in Minna, Nigeria

The study was carried out in Minna Metropolis, between August and December, 2005, with a total of 387 school children interviewed and 217 urine samples analysed. This research employs the use of questionnaires, validation of questionnaires by urinalysis and the microscopic examination of the urine samples. The research is aimed at appreciating prevalent level of urinary schistosomiasis in Minna metropolis. The overall prevalence of urinary schistosomiasis, as confirmed by the presence of egg of Schistosoma haematobium was 12.9%, reported blood in the urine 34.4%, microhaematuria 52.5%, protenuria 32.7% and red blood cells 24.6%. The frequency of gross haematuria, and the degree of microhaematuria and proteinuria detectable by chemical reagent strips was observed to correlate with intensity of infection. The urinary schistosomiasis prevalence, confirmed by urine microscopy, of 12.9% in the selected school children within Minna, in spite its urban status, suggests that Minna is an endemic area, and the state requires an effective urinary schistosomiasis control programme. A major concern which represents a serious issue in the study includes the very poor level of awareness about the possible cause of urinary schistosomiasis or reported blood in the urine, as only 0.78% of the children have knowledge about the infection and 12% of the children that reported having blood in their urine have visited a health center.

Long-term outcome of hematuria home screening for bladder cancer in men: Messing EM, Madeb R, Young T, Gilchrist KW, Bram L, Greenberg EB, Wegenke JD, Stephenson L, Gee J, Feng C, Department of Urology, University of Rochester, Rochester, NY

The objectives of this study were to determine whether bladder cancer (BC) screening in healthy men could lead to earlier detection and reduced BC mortality compared with unscreened men and to determine long-term outcomes of a geographically defined, unscreened population with newly diagnosed BC. In 1987 and from 1998 to 1992, 1,575 men ages 50 years and older who were solicited from well patient rosters in clinics in and around Madison, Wisconsin, tested their urine repetitively with a chemical reagent strip for hemoglobin. Participants who had positive test results underwent standard urologic evaluation. BC grades and stages and the outcomes of men with BC detected by screening were compared with the grades, stages, and outcomes of 87% of men ages 50 years and older with newly diagnosed BC who were reported to the Wisconsin Tumor Registry in 1988 (n = 509 men). Two hundred fifty-eight screening participants (16.4%) were evaluated for hematuria, and 21 participants (8.1%) were diagnosed with BC. Proportions of low-grade (Grade 1 and 2) superficial (Stage Ta and T1) versus high-grade (Grade 3) superficial or invasive (Stage > or = T2) cancers in screened men (52.4% vs. 47.7%) and in men from the tumor registry (60.3% vs. 39.7%) were similar (P = .50). The proportion of high-grade superficial or invasive BCs that were invasive were lower in screened men (10%) than in unscreened men (60%; P = .002). At 14 years of follow-up, no men with screen-detected BC had died of BC, whereas 20.4% of men with unscreened BC had died of BC (P = .02). Screening effected the early detection of BC and may reduce mortality from BC compared with BC that is diagnosed at standard clinical presentation.