title: Schistosoma haematobium in Guinea-Bissau: unacknowledged morbidity due to a particularly neglected parasite in a particularly neglected country.
abstract: Schistosomiasis is the major neglected tropical helminthic disease worldwide. Current knowledge on the epidemiology of schistosomiasis in Guinea-Bissau is scarce and regarding to the absence of Schistosoma haematobium (S.h.). Therefore, a pilot study was undertaken to assess the prevalence and morbidity due to S.h. infection in randomly selected 90 children and adolescents aged 6 to 15 years. Prevalence of S.h. infection was 20.00 % (18/90). Microhematuria was observed in 61.11 % (11/18) of S.h.-egg-excreting vs. 37.50 % (27/72) of non-S.h.-egg-excreting children p ≤ 0.01. Body mass index (BMI) was less than 15 kg/m(2) in 52/90 (57.78 %) of all children and adolescents, but this proportion increased to 66.67 % (12/18) in S.h.-infected children who were more frequently stunted and wasted than in non-infected children. The mean weight-for-age Z score (WAZ) was reduced in S.h. infected as compared to non-infected children (-1.48 ± 1.08 SD vs. -0.80 ± 1.11 SD; p ≤ 0.01). To our knowledge, this is the first epidemiologic report on S. haematobium infection in Guinea-Bissau since 22 years. Even in this relatively small study sample, it appears that S. haematobium, besides the well-known symptoms such as hematuria, leads to significant, albeit commonly unacknowledged morbidity such as stunting and wasting. These observations underscore the notion that this vulnerable but neglected population urgently needs to be targeted for implementation of measures for treatment and control.
authors.affiliation: INSA, National Institute of Health, Porto, Portugal.|IPATIMUP/I3S, Institute of Pathology and Molecular Immunology/Instituto de Investigação e Inovação, da Universidade do Porto, Porto, Portugal.
authors.forename: Monica C
authors.initials: MC
authors.lastname: Botelho
authors.affiliation: Laboratory of Hydrobiology and Ecology, Institute of Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Machado
authors.affiliation: Division of Endocrinology, Diabetes and Metabolism, Hospital Santo Antonio-Centro Hospitalar do Porto (CHP), Porto, Portugal.
authors.forename: André
authors.initials: A
authors.lastname: Carvalho
authors.affiliation: INSA, National Institute of Health, Porto, Portugal.
authors.forename: Manuela
authors.initials: M
authors.lastname: Vilaça
authors.affiliation: INSA, National Institute of Health, Porto, Portugal.
authors.forename: Orquídea
authors.initials: O
authors.lastname: Conceição
authors.affiliation: IICT, Instituto de Investigação Científica Tropical, Lisbon, Portugal.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Rosa
authors.affiliation: INSA, National Institute of Health, Porto, Portugal.
authors.forename: Helena
authors.initials: H
authors.lastname: Alves
authors.affiliation: Tropical Medicine Unit, Department for Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany. Joachim.Richter@med.uni-duesseldorf.de.
authors.forename: Joachim
authors.initials: J
authors.lastname: Richter
authors.affiliation: Laboratory of Hydrobiology and Ecology, Institute of Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal.
authors.forename: Adriano Agostinho
authors.initials: AA
authors.lastname: Bordalo
mesh_terms: D000293:Adolescent; D000818:Animals; D002648:Child; D005260:Female; D005843:Geography; D006169:Guinea-Bissau / Q000453:epidemiology; D006801:Humans; D008297:Male; D009017:Morbidity; D058069:Neglected Diseases; D009752:Nutritional Status; D010865:Pilot Projects; D015995:Prevalence; D012548:Schistosoma haematobium / Q000302:isolation & purification*; D012553:Schistosomiasis haematobia / Q000453:epidemiology* / Q000469:parasitology
keywords: Guinea-Bissau; Hematuria; Nutrition status; Schistosoma haematobium; Schistosomiasis; Stunting wasting; Unacknowledged morbidity