Ultrasonography of ureteric abnormalities induced by Schistosoma haematobium infection before and after praziquantel treatment.
OBJECTIVE
To describe the ultrasonographic appearance of ureteric lesions due to Schistosoma haematobium infection and to report prevalence rates of such lesions in endemic communities in Mali before and after praziquantel treatment.


METHODS
The total population (n = 961) of three S. haematobium-endemic villages in Mali was examined ultrasonographically to detect urinary tract morbidity. Urine was tested for S. haematobium ova and for haematuria. An identical follow-up study was performed 1 year after mass treatment with praziquantel.


RESULTS
Prevalence rates of S. haematobium infection in the three villages were 53%, 72% and 73%. Ultrasonography revealed dilatation of the ureters in 143 subjects (15%). In 20 of these, mainly children and adolescents, thickening and irregularities of the ureteric wall with distal ureter obstruction were directly visualized on ultrasonography. Within the bladder of two others, an intraluminal structure of ureterocele-like appearance was seen. None of these alterations has been previously described as an ultrasonographic feature of schistosomal uropathy. Active S. haematobium infection and microhaematuria were found in 21 and 20 of these 22 subjects respectively. Significant renal obstruction was present in 10 of them. One year after treatment, an entirely normal urinary tract was found in 85% of 104 re-examined individuals who had had ureter dilatation. Ureteric wall thickening or ureterocele-like lesions had disappeared in 95% of subjects.


CONCLUSIONS
The role of ultrasound in the evaluation of schistosomal uropathy is confirmed. Ureteric wall abnormalities causing strictures and ureterocele-like lesions of the ostium must be regarded as further ultrasonographic features of this condition. The study documents the excellent reversibility of ureteric abnormalities after antischistosomal treatment in children and adolescents, thus emphasizing the need for early and efficient medical treatment of the infection.
Kardorff
R
R
Department of Paediatrics, Medizinische Hochschule Hannover, Germany.
Traoré
M
M
Doehring-Schwerdtfeger
E
E
Vester
U
U
Ehrich
J H
JH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D002648:Child; D002675:Child, Preschool; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007682:Kidney Pelvis / Q000000981:diagnostic imaging / Q000469:parasitology; D008297:Male; D008302:Mali / Q000453:epidemiology; D008875:Middle Aged; D011223:Praziquantel / Q000627:therapeutic use*; D012548:Schistosoma haematobium / Q000302:isolation & purification; D012553:Schistosomiasis haematobia / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000453:epidemiology; D014463:Ultrasonography; D014515:Ureteral Diseases / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000469:parasitology
D011223:Praziquantel