Association between Intensity of Dead and Live Schistosoma Eggs and Urinary Tract Morbidity in School Children and Adults in Itilima District, Tanzania

Abstract

Urinary schistosomiasis caused by Schistosoma haematobium has been associated with urinary tract morbidity in areas where the disease is endemic. However, knowledge of the impact of the parasite’s dead and live eggs on the pathogenesis of urinary tract morbidity is scanty. This study examined the relationship between intensity of dead and live S.haematobium eggs and development of urinary tract morbidity among school children and adults in Itilima District, Tanzania. This was a cross- sectional study where a total of 682 urine samples were examined for S. haematobium infection. Dead and live S. haematobium eggs were identified using vital stains (1% neutral red and 0.4% trypan blue). Haematuria was examined using urinalysis reagent strip and its presence confirmed microscopically following standard procedures. These analyses were followed by ultrasound examination to determine the association between intensity of dead and live S. haematobium eggs with urinary tract morbidity. 112 urine samples were examined for dead and live S. haematobium eggs. The prevalence of dead and live S. haematobium eggs was 12.5% (14/112) and 77.7% (87/112) respectively. The prevalence of bladder wall thickening was 67.7% (44/112) and this was significantly associated with low intensities of dead S. haematobium eggs (χ² = 9.652, p = 0.047). Haematuria was microscopically confirmed in 80.4% of infected participants and its severity increased significantly with an increase in the intensity of live S. haematobium eggs (χ² = 0.367, p = 0.024), suggesting the presence of active transmission of the parasite in Itilima District. Control intervention through health education are necessary to enhance public wellbeing in Itilima District.