A fourteen-year follow-up of ultrasound-detected urinary tract pathology associated with urogenital schistosomiasis in women living in the Msambweni region of coastal Kenya

Joekes, Elizabeth, McMonnies, Kate, Blanshard, Andrew, Mutuku, Francis, Ireri, Edmund, Mungai, Peter, Stothard, Russell ORCID: https://orcid.org/0000-0002-9370-3420 and Bustinduy, Amaya L (2023) 'A fourteen-year follow-up of ultrasound-detected urinary tract pathology associated with urogenital schistosomiasis in women living in the Msambweni region of coastal Kenya'. Transactions of The Royal Society of Tropical Medicine and Hygiene, Vol 117, Issue 9, pp. 637-644.

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Abstract

Background
Complications of urogenital schistosomiasis include acute inflammatory and chronic fibrotic changes within the urogenital tract. Disease burden of this neglected tropical disease is often underestimated, as only active, urine egg-patent Schistosoma infection is formally considered. Previous studies have focussed on short-term effects of praziquantel treatment on urinary tract pathology, demonstrating that acute inflammation is reversible. However, the reversibility of chronic changes is less well studied.

Methods
Our study compared, at two time points 14 y apart, urine egg-patent infection and urinary tract pathology in a cohort of women living in a highly endemic area having intermittent praziquantel treatment(s). In 2014 we matched 93 women to their findings in a previous study in 2000.

Results
Between 2000 and 2014 the rate of egg-patent infection decreased from 34% (95% confidence interval [CI] 25 to 44) to 9% (95% CI 3 to 14). However, urinary tract pathology increased from 15% (95% CI 8 to 22) to 19% (95% CI 11 to 27), with the greatest increase seen in bladder thickening and shape abnormality.

Conclusions
Despite praziquantel treatment, fibrosis from chronic schistosomiasis outlasts the presence of active infection, continuing to cause lasting morbidity. We suggest that future efforts to eliminate persistent morbidity attributable to schistosomiasis should include intensified disease management.

Item Type:	Article
Subjects:	WC Communicable Diseases > Tropical and Parasitic Diseases > WC 680 Tropical diseases (General) WN Radiology. Diagnostic imaging > WN 20 Research (General)
Faculty: Department:	Biological Sciences > Department of Tropical Disease Biology Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1093/trstmh/trad020
Depositing User:	Clare Bennett
Date Deposited:	29 Jun 2023 14:34
Last Modified:	12 Apr 2024 03:12
URI:	https://archive.lstmed.ac.uk/id/eprint/22193

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