Long-term suppression of adult bladder morbidity and severe hydronephrosis following selective population chemotherapy for Schistosoma haematobium.
Repeated selective population chemotherapy of school age children reduces infection and morbidity associated with Schistosoma haematobium infection. To examine the long-term effect of this treatment on susceptibility to re-infection and late disease, a cohort of Kenyans (n = 194) were re-examined for infection and urinary tract morbidity 7-13 years after they underwent annual ultrasonography and treatment for an average of 5 years beginning in 1984 as children. Controls were previously untreated age-matched individuals residing in the same or adjacent villages. The overall prevalence and intensity of infection were equivalent between the 2 groups. In contrast, the prevalence of bladder wall pathology was 11-fold lower in previously treated (1.5%) versus untreated subjects (17%). Severe hydronephrosis was completely reversed. These data demonstrate that treatment significantly reduced urinary tract morbidity despite re-infection, and suggest that the important risk factors for urinary tract morbidity in adulthood are cumulative intensity and duration of infection during early adolescence.
Subramanian
A K
AK
Department of Medicine, University Hospitals of Cleveland and Case Western Reserve University, Ohio 44106-4983, USA.
Mungai
P
P
Ouma
J H
JH
Magak
P
P
King
C H
CH
Mahmoud
A A
AA
King
C L
CL
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000818:Animals; D015331:Cohort Studies; D005500:Follow-Up Studies; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging* / Q000469:parasitology*; D007630:Kenya / Q000453:epidemiology; D016555:Matched-Pair Analysis; D010270:Parasite Egg Count; D012307:Risk Factors; D012548:Schistosoma haematobium / Q000254:growth & development*; D012553:Schistosomiasis haematobia / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000469:parasitology; D012556:Schistosomicides / Q000627:therapeutic use*; D014463:Ultrasonography; D001743:Urinary Bladder / Q000000981:diagnostic imaging*; D001745:Urinary Bladder Diseases / Q000000981:diagnostic imaging / Q000469:parasitology* / Q000473:pathology / Q000517:prevention & control; D014556:Urine / Q000469:parasitology
D012556:Schistosomicides