title: Schistosoma haematobium infection and asymptomatic bacteriuria in young South African females.
abstract: Schistosoma haematobium eggs can induce lesions in the urinary and genital tract epithelia, as eggs pass through or get trapped in the tissue. Local inflammatory reactions induced by S. haematobium eggs might affect the ability of bacteria to establish mucosal super-infection foci. S. haematobium infection and asymptomatic bacteriuria can both portray haematuria, proteinuria and leukocyturia. This shared set of proxy diagnostic markers could fuel routine misdiagnosis in S. haematobium endemic areas. Furthermore, S. haematobium infected individuals might be at a higher risk of contracting bacterial urinary tract infections, which could manifest either as symptomatic or asymptomatic bacteriuria. The aim of the current study was to explore whether schistosomal lesions are susceptible to super-infection by bacteria measured as asymptomatic bacteriuria. S. haematobium infection was determined by microscopy of urine samples. Furthermore, urine samples were tested with dipslides for asymptomatic bacteriuria and with dipsticks for haematuria, proteinuria and leukocytes. We found no association between asymptomatic bacteriuria and S. haematobium infection in a sample of 1040 female primary and high school students from a schistosomiasis endemic area in KwaZulu-Natal, South Africa. Furthermore, it was demonstrated that asymptomatic bacteriuria is not a bias for use of micro-haematuria as a proxy diagnostic measure for S. haematobium infection in this population.
authors.affiliation: Section for Parasitology and Aquatic Diseases, Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. Electronic address: amok@sund.ku.dk.
authors.forename: Anna Overgaard
authors.initials: AO
authors.lastname: Kildemoes
authors.affiliation: Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases, Oslo University Hospital Ullevaal, Oslo, Norway.
authors.forename: Eyrun Floerecke
authors.initials: EF
authors.lastname: Kjetland
authors.affiliation: Department of Public Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Siphosenkosi Gift
authors.initials: SG
authors.lastname: Zulu
authors.affiliation: Department of Public Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Myra
authors.initials: M
authors.lastname: Taylor
authors.affiliation: Section for Parasitology and Aquatic Diseases, Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Birgitte Jyding
authors.initials: BJ
authors.lastname: Vennervald
mesh_terms: D000293:Adolescent; D000818:Animals; D058345:Asymptomatic Infections / Q000453:epidemiology*; D001437:Bacteriuria / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D003141:Communicable Diseases; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D005260:Female; D006417:Hematuria / Q000453:epidemiology*; D006801:Humans; D010270:Parasite Egg Count; D012306:Risk; D012548:Schistosoma haematobium / Q000302:isolation & purification; D012553:Schistosomiasis haematobia / Q000175:diagnosis / Q000453:epidemiology*; D013019:South Africa / Q000453:epidemiology; D013334:Students; D016482:Urinalysis; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000453:epidemiology; D055815:Young Adult
keywords: Asymptomatic bacteriuria; Diagnostics; Haematuria; Schistosoma haematobium; Urogenital schistosomiasis