Morbidity assessment in urinary schistosomiasis infection through ultrasonography and measurement of eosinophil cationic protein (ECP) in urine

• Published in: Tropical medicine & international health Vol. 5; no. 2; pp. 88 - 93
• Main Authors: Leutscher, Peter D. C., Reimert, Claus M., Vennervald, Birgitte J., Ravaoalimalala, Voahangy E., Ramarokoto, Charles E., Serieye, Jean, Raobelison, Ando, Rasendramino, Mamy, Christensen, Niels O., Esterre, Philippe
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.02.2000; Blackwell Science
• Subjects: Adolescent; Adult; Biological and medical sciences; Biomarkers - urine; Blood Proteins - urine; Child; Diseases caused by trematodes; eosinophil cationic protein; Eosinophil Granule Proteins; Female; Helminthic diseases; Hematuria - diagnosis; Humans; Infectious diseases; Madagascar; Male; Medical sciences; morbidity; Parasite Egg Count; Parasitic diseases; Ribonucleases; Schistosoma haematobium; Schistosomiases; Schistosomiasis haematobia - diagnosis; Schistosomiasis haematobia - diagnostic imaging; Schistosomiasis haematobia - epidemiology; Schistosomiasis haematobia - urine; Tropical medicine; Ultrasonography; Urinary Tract - diagnostic imaging; Malagasy Republic; Africa; Human; Urine; Schistosoma haematobium; Trematode disease; Plathelmintha; Parasitosis; Urinary tract; Helminthiasis; Epidemiology; Trematoda; Morbidity; Arterial disease; Infection; Schistosomiasis; Echography; Helmintha; Invertebrata; Eosinophil cationic protein
• ISSN: 1360-2276; 1365-3156
• DOI: 10.1046/j.1365-3156.2000.00522.x

Summary In a Schistosoma haematobium‐endemic village in western Madagascar we evaluated ultrasonography and Eosinophil Cationic Protein (ECP) in urine as means to detect the associated urinary tract pathology. 192 individuals were matched according to age and sex, and grouped into infected persons with bladder and, if present, kidney pathology (n= 96); infected persons without pathology (n= 48) and noninfected persons without pathology (n= 48). The median urinary egg count was significantly higher in individuals with ultrasonographically detectable urinary tract pathology (115 eggs/10 ml urine) than in infected persons without (45 eggs/10 ml of urine). At 136 ng/ml, the median ECP level was significantly higher in the 144 infected individuals than in the 48 noninfected persons (0.35 ng/ml). Egg excretion correlated positively with ECP level. The median ECP level was significantly higher in the group with ultrasonographically detectable urinary tract pathology than in the group without (183 ng/ml vs. 67 ng/ml). The results suggest that minor degrees of pathology, particularly at an early stage of infection with S. haematobium, might be overlooked by ultrasonography despite the presence of marked inflammation, as indicated by markedly increased urinary ECP levels in infected individuals without ultrasonographically detectable urinary tract pathology. ECP may therefore provide important information on the evolution of S. haematobium‐associated urinary tract morbidity.