title: Epidemiology of Schistosomiasis and Usefulness of Indirect Diagnostic Tests in School-Age Children in Cubal, Central Angola.
abstract: BACKGROUND
  Schistosomiasis remains a public health major problem and little is known in many areas, mainly in Sub-Saharan Africa.
  
  
  OBJECTIVE
  To assess the burden and risk factors of schistosomiasis and intestinal parasitic helminthes in the children of Cubal, Angola, and to compare different diagnostic approaches for urinary schistosomiasis under field conditions.
  
  
  METHODS
  A cross-sectional study was conducted. Urine and faeces samples of school children were microscopically studied. A random sample of children was obtained from an alphabetically arranged list of children, taking one of two children. Urine dipstick, colorimetric test and macrohaematuria were considered as indirect diagnostic methods and compared to direct urine examination. Possible risk factors for the infection were sex, age, distance to the river and previous treatment with praziquantel; the assessment was performed using Chi-square test.
  
  
  RESULTS
  A total of 785 (61.18%) children showed S. haematobium eggs in urine; children living within 500 meters from the river had a higher odds for infection: Odds ratio 1.97 (1.45-2.7 CI 95%); urine dipstick showed sensitivity of 96% and specificity of 61.3%, with a positive predictive value; colorimetric test showed sensitivity of 52.5%, specificity of 74.6% and a positive predictive value of 77%. Proteinuria was present in 653 (51.1%) children, being more frequent in children with S. haematobium in urine (75.2%); 32 of 191 stool samples (16%) showed the presence of other intestinal parasites and 8 (4%) for S. haematobium.
  
  
  CONCLUSIONS
  Prevalence of urinary schistosomiasis in our study area is much higher than the national average, considering it as a high-risk community. Proximity to a source of water was a risk factor for the infection. Indirect tests, as urine dipstick and colorimetric test, were useful tools for diagnosis, due to ease of use and low cost. Proteinuria was a common finding, probably showing an early structural damage due to schistosomiasis in this group of children.
authors.affiliation: Special Program for Infectious Diseases Drassanes-Vall d'Hebron. PROSICS Barcelona, Spain/Hospital Nossa Senhora da Paz, Cubal, Angola.
authors.forename: Cristina
authors.initials: C
authors.lastname: Bocanegra
authors.affiliation: Hospital Nossa Senhora da Paz, Cubal, Angola.
authors.forename: Sara
authors.initials: S
authors.lastname: Gallego
authors.affiliation: EpidemiologyDepartment. University Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Jacobo
authors.initials: J
authors.lastname: Mendioroz
authors.affiliation: Hospital Nossa Senhora da Paz, Cubal, Angola.
authors.forename: Milagros
authors.initials: M
authors.lastname: Moreno
authors.affiliation: Microbiology Department. University Hospital Vall d'Hebron. PROSICS Barcelona, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Sulleiro
authors.affiliation: Infectious Diseases Department. University Hospital Vall d'Hebron. PROSICS Barcelona, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Salvador
authors.affiliation: Hospital Nossa Senhora da Paz, Cubal, Angola.
authors.forename: Nicolau
authors.initials: N
authors.lastname: Sikaleta
authors.affiliation: Hospital Nossa Senhora da Paz, Cubal, Angola.
authors.forename: Arlette
authors.initials: A
authors.lastname: Nindia
authors.affiliation: Hospital Nossa Senhora da Paz, Cubal, Angola.
authors.forename: Daniel
authors.initials: D
authors.lastname: Tchipita
authors.affiliation: Hospital Nossa Senhora da Paz, Cubal, Angola.
authors.forename: Morais
authors.initials: M
authors.lastname: Joromba
authors.affiliation: Hospital Nossa Senhora da Paz, Cubal, Angola.
authors.forename: Sebastiao
authors.initials: S
authors.lastname: Kavaya
authors.affiliation: Infectious Diseases Department. University Hospital Vall d'Hebron. PROSICS Barcelona, Spain.
authors.forename: Adrián
authors.initials: A
authors.lastname: Sánchez Montalvá
authors.affiliation: Hospital Nossa Senhora da Paz, Cubal, Angola.
authors.forename: Teresa
authors.initials: T
authors.lastname: López
authors.affiliation: Infectious Diseases Department. University Hospital Vall d'Hebron. PROSICS Barcelona, Spain.
authors.forename: Israel
authors.initials: I
authors.lastname: Molina
mesh_terms: D002648:Child; D002675:Child, Preschool; D003124:Colorimetry; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012553:Schistosomiasis haematobia / Q000175:diagnosis / Q000453:epidemiology*