title: Bladder outlet obstruction; a rare complication of the neglected schistosome, Schistosoma haematobium: two case reports and public health challenges.
abstract: BACKGROUND
  Schistosomiasis is a severe parasitic infestation with debilitating complications and is the third most devastating tropical disease in the world. It is one of the neglected tropical diseases (NTDs) with a high disease-burden. We present two rare cases of bladder outlet obstruction: one which led to a chronic kidney disease and ultimately death and a second which recovered after treatment with praziquantel.
  
  
  METHODS
  A 72 year old male presented with lower urinary tract symptoms which culminated in an episode of acute urinary retention. The patient had never received preventive chemotherapy with praziquantel. After suprapubic aspiration, the cause of the obstructive uropathy was found to be several mature live worms of Schistosoma haematobium. Despite treatment with praziquantel and haemodialysis; we lost the patient due to sepsis from a urinary tract infection. In the second case, a 15 year old male presented with LUTS for a 1 year duration and was diagnosed to have schistosomiasis after eggs of Schistosoma haematobium were found in his urine. He was treated with praziquantel.
  
  
  CONCLUSIONS
  There are several gaps in the public health policies in place to control this NTD in Cameroon as annual distribution of preventive chemotherapy is inadequate due to inaccessibility of some high-endemic zones and is based on data obtained two decades ago. Population education is insufficient leading to poor health-seeking behaviour. These gaps in public health policies need to be addressed to aid in the overall achievement of the sustainable development goals.
authors.affiliation: Hope Clinic Bamenda, North West Region, Bamenda, Cameroon.
authors.forename: Valirie Ndip
authors.initials: VN
authors.lastname: Agbor
authors.affiliation: Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, Oxfordshire, UK. tsinjim@gmail.com.|Health and Human Development (2HD) Research Group, Douala, Cameroon. tsinjim@gmail.com.
authors.forename: Tsi
authors.initials: T
authors.lastname: Njim
authors.affiliation: District Hospital Ndu, North West Region, Cameroon.
authors.forename: Franklin Ngu
authors.initials: FN
authors.lastname: Mbolingong
mesh_terms: D000293:Adolescent; D000368:Aged; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use*; D002163:Cameroon; D057210:Delayed Diagnosis; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D011223:Praziquantel / Q000627:therapeutic use*; D011634:Public Health / Q000193:education; D012548:Schistosoma haematobium / Q000187:drug effects / Q000254:growth & development / Q000472:pathogenicity; D012553:Schistosomiasis haematobia / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology; D001743:Urinary Bladder / Q000187:drug effects / Q000469:parasitology / Q000473:pathology; D001748:Urinary Bladder Neck Obstruction / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology; D014552:Urinary Tract Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology
chemical_list: D000871:Anthelmintics; D011223:Praziquantel
keywords: Bladder outlet obstruction; Cameroon; Neglected tropical diseases; Schistosomiasis