Quantitative assessment of eosinophiluria in Schistosoma haematobium infections: a new marker of infection and bladder morbidity.
Eosinophiluria, as quantified by measuring eosinophil cationic protein (ECP) in urinary extracts, microhematuria, egg excretion, and ultrasound-detectable bladder pathology were recorded in Schistosoma haematobium-infected Tanzanian school children at a baseline survey and during an 18-month post-treatment follow-up study. Significant correlations were seen between urinary ECP levels, intensity of infection, and bladder pathology. Treatment resulted in a marked reduction in prevalence and intensity of infection, in a delayed and less marked reduction in ECP levels, and in a resolution of pathology. The overall diagnostic efficiency of the ECP test (cut-off value for the ECP > or =5 ng/ml) in relation to infection was comparable with that of egg count and microhematuria, but with a better sensitivity than a single egg count. In relation to bladder pathology, the diagnostic performance of the ECP test (cut-off value for the ECP > or =25 ng/ml) exceeded that of a single egg count. In addition, the ECP was better in discriminating between different grades of bladder pathology. The present study points to the ECP as a useful marker of both S. haematobium infection and of associated bladder morbidity reflecting the inflammatory status of the bladder wall.
Reimert
C M
CM
Laboratory of Medical Allergology, National University Hospital, Copenhagen, Denmark.
Mshinda
H M
HM
Hatz
C F
CF
Kombe
Y
Y
Nkulila
T
T
Poulsen
L K
LK
Christensen
N O
NO
Vennervald
B J
BJ
D000293:Adolescent; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D001798:Blood Proteins / Q000652:urine*; D002648:Child; D015331:Cohort Studies; D004797:Enzyme-Linked Immunosorbent Assay; D047091:Eosinophil Granule Proteins; D004804:Eosinophils / Q000737:chemistry; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018836:Inflammation Mediators / Q000652:urine*; D008297:Male; D009017:Morbidity; D010270:Parasite Egg Count; D011223:Praziquantel / Q000627:therapeutic use; D011237:Predictive Value of Tests; D012260:Ribonucleases; D012548:Schistosoma haematobium / Q000472:pathogenicity*; D012553:Schistosomiasis haematobia / Q000175:diagnosis* / Q000188:drug therapy / Q000652:urine; D018709:Statistics, Nonparametric; D013636:Tanzania; D014463:Ultrasonography; D001743:Urinary Bladder / Q000000981:diagnostic imaging / Q000469:parasitology / Q000473:pathology; D001745:Urinary Bladder Diseases / Q000175:diagnosis* / Q000469:parasitology / Q000473:pathology; D014556:Urine / Q000737:chemistry / Q000166:cytology / Q000469:parasitology
D000871:Anthelmintics; D001798:Blood Proteins; D047091:Eosinophil Granule Proteins; D018836:Inflammation Mediators; D011223:Praziquantel; D012260:Ribonucleases