Screening and treatment of urinary schistosomiasis in Dar es Salaam.
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Biomedical subjects
Publications and source records attributed to R K Sarda.
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In order to assess the efficacy of praziquantel against Schistosoma haematobium and its effect on the morbidity indices, haematuria and proteinuria, a study was carried out using school receiving praziquantel at 40 mg/kg body weight. Twenty-four weeks after treatment, the percentage of cure was high and reached 100% among the 'light' and 'moderate' infection groups. In the 'heavy' infection group, a cure rate of 50% and a 69.3% egg reduction was observed. An overall cure rate of 94% was achieved at 24 weeks. Microhaematuria and proteinuria were reduced by 96.6% and 92.5%, respectively.
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The reliability of using visible haematuria as an indirect screening technique to detect Schistosoma haematobium was investigated in 418 school children from Dar es Salaam, Tanzania. The sensitivity of the test varied significantly with the time of urine collection and the portion of the micturition stream examined. Whereas sensitivity was 50% and accuracy 73% in the morning, in the afternoon sensitivity and accuracy had increased to 75% and 97% respectively if terminal urine samples were examined. It is concluded that visible haematuria is a sensitive, highly accurate and reliable indirect screening test for urinary schistosomiasis provided that the method of collection and examination of the urine samples is standardized.
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A cross sectional survey for Schistosoma haematobium infections was undertaken in 12 primary schools in the city of Dar es Salaam. The prevalence in the schools ranged from 5.3 to 55.1%, with an overall prevalence of 19.3%. More males (23.5%) than females (15.0%) were infected, and the highest prevalence was recorded in the 11-16 year age group. Intensity of infection was high, ranging from 12 to 96 eggs/10 ml urine in individual schools. 26% of the infected excreted more than 50 eggs/10 ml urine, and high rates of haematuria and proteinuria were observed in infected children. Interviews indicated that the majority of the children had acquired their infection in the city. Malacological surveys showed two potential vectors, Bulinus (Physopsis) globosus and B. (Ph.) nasutus, to be common in Dar es Salaam. Laboratory and field findings confirmed that these two species were vectors of S. haematobium. Factors responsible for continued transmission in this urban environment are discussed.
393 primary school children were screened for Schistosoma haematobium using four indirect techniques (a) history of haematuria, (b) visual appearance of urine and use of chemical reagent strips to detect presence of (c) blood and (d) protein in urine. Results showed that the use of chemical reagent strips for the detection of blood was the most specific and sensitive method, even in areas of lower prevalence and intensity. History of haematuria, protein in urine and visual appearance were respectively next in order in terms of specificity and sensitivity. The implications of these findings for further studies have been made.