title: Case-Control Study of Posttreatment Regression of Urinary Tract Morbidity Among Adults in Schistosoma haematobium-Endemic Communities in Kwale County, Kenya.
abstract: Previous population-based studies have examined treatment impact on Schistosoma-associated urinary tract disease among children, but much less is known about longer-term treatment benefits for affected adult populations in areas where risk of recurrent infection is high. In communities in Msambweni, along the Kenya coast, we identified, using a portable ultrasound, 77 adults (aged 17-85) with moderate-to-severe obstructive uropathy or bladder disease due to Schistosoma haematobium. Treatment response was assessed by repeat ultrasound 1-2 years after praziquantel (PZQ) therapy and compared with interval changes among age- and sex-matched infected/treated control subjects who did not have urinary tract abnormalities at the time of initial examination. Of the 77 affected adults, 62 (81%) had improvement in bladder and/or kidney scores after treatment, 14 (18%) had no change, and one (1.3%) had progression of disease. Of the 77 controls, 75 (97%) remained disease free by ultrasound, while two (3%) had apparent progression with abnormal findings on follow-up examination. We conclude that PZQ therapy for S. haematobium is effective in significantly reducing urinary tract morbidity from urogenital schistosomiasis among adult age groups, and affected adults stand to benefit from inclusion in mass treatment campaigns.
authors.affiliation: Department of Radiology, Kenyatta National Hospital, Nairobi, Kenya; Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Pediatrics, University Hospitals of Cleveland, Cleveland, Ohio; Kenya Medical Research Institute, Nairobi, Kenya; Division of Vector Borne and Neglected Tropical Diseases, Ministry of Public Health and Sanitation, Nairobi, Kenya; Department of Environmental Sciences, Emory University, Atlanta, Georgia.
authors.forename: Philip
authors.initials: P
authors.lastname: Magak
authors.affiliation: Department of Radiology, Kenyatta National Hospital, Nairobi, Kenya; Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Pediatrics, University Hospitals of Cleveland, Cleveland, Ohio; Kenya Medical Research Institute, Nairobi, Kenya; Division of Vector Borne and Neglected Tropical Diseases, Ministry of Public Health and Sanitation, Nairobi, Kenya; Department of Environmental Sciences, Emory University, Atlanta, Georgia.
authors.forename: Alicia
authors.initials: A
authors.lastname: Chang-Cojulun
authors.affiliation: Department of Radiology, Kenyatta National Hospital, Nairobi, Kenya; Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Pediatrics, University Hospitals of Cleveland, Cleveland, Ohio; Kenya Medical Research Institute, Nairobi, Kenya; Division of Vector Borne and Neglected Tropical Diseases, Ministry of Public Health and Sanitation, Nairobi, Kenya; Department of Environmental Sciences, Emory University, Atlanta, Georgia.
authors.forename: Hilda
authors.initials: H
authors.lastname: Kadzo
authors.affiliation: Department of Radiology, Kenyatta National Hospital, Nairobi, Kenya; Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Pediatrics, University Hospitals of Cleveland, Cleveland, Ohio; Kenya Medical Research Institute, Nairobi, Kenya; Division of Vector Borne and Neglected Tropical Diseases, Ministry of Public Health and Sanitation, Nairobi, Kenya; Department of Environmental Sciences, Emory University, Atlanta, Georgia.
authors.forename: Edmund
authors.initials: E
authors.lastname: Ireri
authors.affiliation: Department of Radiology, Kenyatta National Hospital, Nairobi, Kenya; Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Pediatrics, University Hospitals of Cleveland, Cleveland, Ohio; Kenya Medical Research Institute, Nairobi, Kenya; Division of Vector Borne and Neglected Tropical Diseases, Ministry of Public Health and Sanitation, Nairobi, Kenya; Department of Environmental Sciences, Emory University, Atlanta, Georgia.
authors.forename: Eric
authors.initials: E
authors.lastname: Muchiri
authors.affiliation: Department of Radiology, Kenyatta National Hospital, Nairobi, Kenya; Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Pediatrics, University Hospitals of Cleveland, Cleveland, Ohio; Kenya Medical Research Institute, Nairobi, Kenya; Division of Vector Borne and Neglected Tropical Diseases, Ministry of Public Health and Sanitation, Nairobi, Kenya; Department of Environmental Sciences, Emory University, Atlanta, Georgia.
authors.forename: Uriel
authors.initials: U
authors.lastname: Kitron
authors.affiliation: Department of Radiology, Kenyatta National Hospital, Nairobi, Kenya; Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Pediatrics, University Hospitals of Cleveland, Cleveland, Ohio; Kenya Medical Research Institute, Nairobi, Kenya; Division of Vector Borne and Neglected Tropical Diseases, Ministry of Public Health and Sanitation, Nairobi, Kenya; Department of Environmental Sciences, Emory University, Atlanta, Georgia chk@cwru.edu.
authors.forename: Charles H
authors.initials: CH
authors.lastname: King
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011223:Praziquantel / Q000627:therapeutic use; D015995:Prevalence; D012548:Schistosoma haematobium / Q000187:drug effects; D012553:Schistosomiasis haematobia / Q000188:drug therapy* / Q000453:epidemiology*; D014551:Urinary Tract / Q000469:parasitology / Q000473:pathology*; D055815:Young Adult
chemical_list: D011223:Praziquantel