Urine albumen levels and schistosomiasis morbidity,
Ultrasonography training on Zanzibar (Unguja)
9th – 13th, May 2005
As part of the surveillance and monitoring component within the "Piga
vita kichocho" programme, a pilot study was conducted to assess a
relationship between excreted urine-albumin and levels of morbidity
associated with S. haematobium infection, as detected by ultrasound. A
collaborative study was conducted in Zanzibar with Dr Amadou Garba, SCI
National Programme Co-ordinator, Niger, working together with Drs Russell
Stothard and David Rollinson, Natural History Museum, U.K. in conjunction
with the Helminth Control Laboratory Unguja field team.
The survey took place in 4 primary schools in northern Unguja: Mwera,
Kilombero, Chaani and Kinyasini, where a total of 250 children were
examined. Mass drug administration had taken place within these schools
during 2004 and so intensity of infections was lighter than had been seen in
2003. Prevalence at both Chaani and Kinyasini, however, remained high and
this clearly shows that transmission around these habitats has been stable
and intense. As a consequence morbidity such as bladder-wall masses and
ureter-irregularities could still be found.
To further investigate levels of morbidity within the adult community, a
small walk-in cross-sectional survey of 60 adults took place at Chaani
health dispensary. In many of the adults, moderate to severe bladder/kidney
pathology could be seen, especially in those who had patent S.
haematobium infections and no history of previous PZQ treatment. From a
preliminary analysis of data, levels of excreted urine-albumin appeared to
be a good proxy of lower urinary tract morbidity. The portable Hemocue
urine-albumin photometer is a very good field-based assay and holds promise
as a useful biochemical indicator of morbidity caused by urinary
schistosomiasis.
The field study also provided a convenient platform for further hands-on
experience and additional on-the-job training of 4 ultrasonographers from
Unguja (Mr Khamis Adulrahman Simai and Mrs Salma Suleiman Seif) and Pemba
(Mr Mahmoud Badru Ali and Mr Masoud Hassan Juma) who had previously attended
the SCI ultrasound workshop in Mwanza earlier that year. Using the portable
ultrasound machine on loan from the Tanzanian mainland, under the guidance
of Dr Garba, a variety of typical upper and lower urinary tract morbidities
were seen, assessed and recorded. It is hoped that ultrasound will play an
important future role reassessing the morbidity burden of urinary
schistosomiasis in Zanzibar. |
