title: Long-term suppression of adult bladder morbidity and severe hydronephrosis following selective population chemotherapy for Schistosoma haematobium.
abstract: 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.
authors.affiliation: Department of Medicine, University Hospitals of Cleveland and Case Western Reserve University, Ohio 44106-4983, USA.
authors.forename: A K
authors.initials: AK
authors.lastname: Subramanian
authors.forename: P
authors.initials: P
authors.lastname: Mungai
authors.forename: J H
authors.initials: JH
authors.lastname: Ouma
authors.forename: P
authors.initials: P
authors.lastname: Magak
authors.forename: C H
authors.initials: CH
authors.lastname: King
authors.forename: A A
authors.initials: AA
authors.lastname: Mahmoud
authors.forename: C L
authors.initials: CL
authors.lastname: King
mesh_terms: 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
chemical_list: D012556:Schistosomicides