title: Bacteriuria and urinary schistosomiasis in primary school children in rural communities in Enugu State, Nigeria, 2012.
abstract: BACKGROUND
  According to a study conducted in1989, Enugu State has an estimated urinary schistosomiasis prevalence of 79%. Recently, studies have implicated bacteriuria co-infection in bladder cancer. These bacteria accelerate the multi-stage process of bladder carcinogenesis. Knowledge about the prevalence of this co-infection is not available in Enugu and the information provided by the 1989 study is too old to be used for current decision making.
  
  
  METHODS
  We carried out a cross-sectional survey of primary school children aged 5-15 years, who were randomly selected through a multi stage sampling method using guidelines recommended by WHO for schistosomiasis surveys. An interviewer administered questionnaire was used to collect data on demography, socioeconomic variables and clinical presentations. Urine samples were collected between 10.00am and 2.00pm. Each sample was divided into two: (A) for prevalence and intensity using syringe filtration technique and (B) for culture. Intensity was categorized as heavy (>50ova/10mls urine) and light (<50ova/10mls urine). Significant bacteriuria was bacteria count ≥ 105 colony forming units/ml of urine.
  
  
  RESULTS
  Of the 842 pupils, 50.6% were females. The prevalence of urinary schistosomiasis was 34.1%. Infection rate was higher(52.8%) among 13-15 years(Prevalence Ratio = 2.45, 95% Confidence Interval 1.63-3.69). Heavy infections wad 62.7% and egg count/10mls urine ranged from 21-1138. Significant bacteriuria among pupils with urinary schistosomiasis was 53.7% compared to 3.6% in the uninfected(PR = 30.8,95% CI 18.91- 52.09). The commonest implicated organism was Escherchia coli.
  
  
  CONCLUSIONS
  We found high prevalence of bacteriuria co-infection among children with urinary schistosomiasis in Enugu State. This underscores the need for concurrent antibiotics administration and follow-up to avert later complications.
authors.affiliation: Nigeria Field Epidemiology and Laboratory Training Programme (NFELTP), Abuja, Nigeria.
authors.forename: Okechukwu Paulinus
authors.initials: OP
authors.lastname: Ossai
authors.affiliation: Nigeria Field Epidemiology and Laboratory Training Programme (NFELTP), Abuja, Nigeria.
authors.forename: Raymond
authors.initials: R
authors.lastname: Dankoli
authors.affiliation: Nigeria Field Epidemiology and Laboratory Training Programme (NFELTP), Abuja, Nigeria.
authors.forename: Chimezie
authors.initials: C
authors.lastname: Nwodo
authors.affiliation: Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria.
authors.forename: Dahiru
authors.initials: D
authors.lastname: Tukur
authors.affiliation: Global Public Health Solutions, Atlanta, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Nsubuga
authors.affiliation: Department of Community Medicine, University of Nigeria, Nsukka, Nigeria.
authors.forename: Daniel
authors.initials: D
authors.lastname: Ogbuabor
authors.affiliation: Department of Community Medicine, University of Nigeria, Nsukka, Nigeria.
authors.forename: Osaeloka
authors.initials: O
authors.lastname: Ekwueme
authors.affiliation: Department of Community Medicine, University of Nigeria, Nsukka, Nigeria.
authors.forename: Godwin
authors.initials: G
authors.lastname: Abonyi
authors.affiliation: Department of Paediatrics, University of Nevada School of Medicine, USA.
authors.forename: Echezona
authors.initials: E
authors.lastname: Ezeanolue
authors.affiliation: Nigeria Field Epidemiology and Laboratory Training Programme (NFELTP), Abuja, Nigeria.
authors.forename: Patrick
authors.initials: P
authors.lastname: Nguku
authors.affiliation: Department of Community Medicine, University of Nigeria, Nsukka, Nigeria.
authors.forename: Douglas
authors.initials: D
authors.lastname: Nwagbo
authors.affiliation: Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria.
authors.forename: Suleiman
authors.initials: S
authors.lastname: Idris
authors.affiliation: Ministry of Health, Enugu State, Southeast, Nigeria.
authors.forename: George
authors.initials: G
authors.lastname: Eze
mesh_terms: D000293:Adolescent; D001437:Bacteriuria / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009549:Nigeria / Q000453:epidemiology; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data; D012494:Sampling Studies; D012553:Schistosomiasis haematobia / Q000453:epidemiology*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
keywords: Bacteriuria; Enugu State; co-infection; urinary schistosomiasis