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Urogenital schistosomiasis in women of reproductive age and pregnant mothers in Kwale County, Kenya

Published online by Cambridge University Press:  08 October 2013

J.H. Kihara*
Affiliation:
Ministry of Public Health and Sanitation, Division of Vector-Borne Diseases & NTDs, PO Box 20750, 00202Nairobi, Kenya Kenya Medical Research Institute, PO Box 54840, 00200Nairobi, Kenya
H.L. Kutima
Affiliation:
Jomo Kenyatta University of Agriculture and Technology, PO Box 6200, 00200Nairobi, Kenya
J. Ouma
Affiliation:
Jomo Kenyatta University of Agriculture and Technology, PO Box 6200, 00200Nairobi, Kenya
T.S. Churcher
Affiliation:
Department of Infectious Disease Epidemiology, Imperial College London, LondonW2 1PG, UK
J.M. Changoma
Affiliation:
Centre for Microbiology Research, Kenya Medical Research Institute, PO Box 134, 80403Kwale, Kenya
M.A. Mwalisetso
Affiliation:
Jomo Kenyatta University of Agriculture and Technology, PO Box 6200, 00200Nairobi, Kenya
M.D. French
Affiliation:
Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, Imperial College London, LondonW2 1PG, UK
C.S. Mwandawiro
Affiliation:
Kenya Medical Research Institute, PO Box 54840, 00200Nairobi, Kenya
*
*Fax +2542717521 E-mail: jimmykihara09@gmail.com

Abstract

Generally, women residing in areas endemic for urinary schistosomiasis may suffer from female genital schistosomiasis which is acquired during childhood. The objective of this cross-sectional study was to estimate the prevalence and intensity of infection of Schistosoma haematobium in women of reproductive age (16–45 years) and to investigate whether S. haematobium had any effect on kidney function. A total of 394 women of known pregnancy status (158 pregnant and 236 non-pregnant) were recruited from five villages (known for their high prevalence of infection of S. haematobium) in Kwale County. Serum samples were analysed to determine levels of urea and creatinine as proxy indicators of kidney function. Data revealed that pregnant women did not, on average, have a higher prevalence or intensity of infection of urinary schistosomiasis than non-pregnant women. During pregnancy, the level of prevalence and intensity of infection of S. haematobium was highest in the first trimester (0–13 weeks), dropped in the second trimester (14–26 weeks) and rose again in the third trimester (27–40 weeks). In addition, 24.8% of women were infected with hookworm, while none were diagnosed with malaria parasites. Of 250 samples analysed for serum urea and creatinine, none had significant levels of pathology, either in pregnant or non-pregnant women. Despite World Health Organization (WHO) recommendations that pregnant women should be treated with praziquantel after the first trimester, in practice this has not been the case in many countries, including Kenya. In view of this, healthcare providers should be informed to consider treatment of pregnant women infected with schistosomiasis during antenatal visits and whenever there is mass drug administration as recommended by the WHO.

Type
Research Papers
Copyright
Copyright © Cambridge University Press 2013 

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References

Ajanga, A., Lwambo, J.S.N., Blair, L., Nyandindi, U., Fenwick, A. & Brooker, S. (2006) Schistosoma mansoni infection and association with anaemia in northwest Tanzania. Transactions of the Royal Society of Tropical Medicine and Hygiene 100, 5963.Google Scholar
Brooker, S., Kabatereine, N.B., Gyapong, J.O., Stothard, J.R. & Utzinger, J. (2009) Rapid mapping of schistosomiasis and other neglected tropical diseases in the context of integrated control programmes in Africa. Parasitology 136, S1707S1718.Google Scholar
Coutinho, H.M., Acosta, L.P., McGarvey, S.T., Jarilla, B., Jiz, M., Pablo, A., Su, L., Manalo, D.L., Olveda, R.M., Kurtis, J.D. & Friedman, J.F. (2006) Nutritional status improves after treatment of Schistosoma japonicum-infected children and adolescents. Journal of Nutrition 136, 183188.CrossRefGoogle ScholarPubMed
Downs, J.A., Mguta, C., Kaatano, G.M., Mitchell, K.B., Bang, H., Simplice, H., Kalluvya, S.E., Changalucha, J.M., Johnson, W.D. Jr & Fitzgerald, D.W. (2011) Urogenital schistosomiasis in women of reproductive age in Tanzania's Lake Victoria Region. American Journal of Tropical Medicine and Hygiene 84, 364369.Google Scholar
Feldmeier, H., Krantz, I. & Poggensee, G. (1994) Female genital schistosomiasis as a risk factor for the transmission of HIV. International Journal of STD/AIDS 5, 368372.Google Scholar
Friedberg, D., Berry, A. & Schneider, J. (1991) Schistosomiasis of the female genital tract. South Africa Medical Journal 80 (Suppl.), 215.Google ScholarPubMed
Friedman, J.F., Priya, M., Hemal, K.K., Olds, R.G. & Kurtis, J.D. (2007) Schistosomiasis and pregnancy. Trends in Parasitology 23, 159164.Google Scholar
Hotez, P.J., Fenwick, A. & Kjetland, E.F. (2009) Africa's 32 cents solution or HIV/AIDS. PLoS Neglected Tropical Diseases 3, e430.Google Scholar
Kahama, A.I., Kremsner, P.G., Van dam, G.J. & Deelder, A.M. (1998) The dynamic of soluble egg antigen of Schistosoma haematobium in relation to egg counts, circulating anodic and cathodic antigen and pathology markers before and after chemotherapy. Transactions of the Royal Society of Tropical Medicine and Hygiene 92, 629633.Google Scholar
Katz, N., Chaves, A. & Pellegrino, J. (1972) A simple device for quantitative stool thick smear technique in schistosomiasis mansoni. Revista do Instituto Medicina Tropical de Sao Paulo 14, 397400.Google Scholar
Kenya National Bureau of Statistics (KNBS), (2009) Kenya population and housing census. Nairobi, Kenya, KNBS.Google Scholar
Kihara, J.H., Mwandawiro, C., Waweru, B., Gitonga, C.W. & Brooker, S. (2011) Preparing for national school-based deworming in Kenya: the validation and large-scale distribution of school questionnaires with urinary schistosomiasis. Tropical Medicine and International Health 16, 13261333.Google Scholar
Kjetland, E.F., Poggensee, G., Helling-Giese, G., Richter, J., Sjaastad, A., Chitsulo, L., Kumwenda, N., Gundersen, S.G., Krantz, I. & Feldmeier, H. (1996) Female genital schistosomiasis due to Schistosoma haematobium. Clinical and parasitological findings in women in rural Malawi. Acta Tropica 62, 239255.Google Scholar
Kjetland, E.F., Ndhlovu, P.D., Mduluza, T., Gomo, E., Gwanzura, L., Mason, P.R., Kurewa, E.N., Midzi, N., Friis, H. & Gundersen, S.G. (2005) Simple clinical manifestations of genital Schistosoma haematobium infection in rural Zimbabwean women. American Journal of Tropical Medicine and Hygiene 72, 311319.CrossRefGoogle ScholarPubMed
Kjetland, E.F., Ndhlovu, P.D., Gomo, E., Mduluza, T., Midzi, N., Gwanzura, L., Mason, P.R., Sandvik, L., Friis, H. & Gundersen, S.G. (2006) Association between genital schistosomiasis and HIV in rural Zimbabwean women. AIDS 20, 593600.CrossRefGoogle ScholarPubMed
Kjetland, E.F., Kurewa, E.N., Ndhlovu, P.D., Midzi, N., Gwanzura, L., Mason, P.R., Gomo, E., Sandvik, L., Mduluza, T., Friis, H. & Gundersen, S.G. (2008) Female genital schistosomiasis – a differential diagnosis to sexually transmitted disease: genital itch and vaginal discharge as indicators of genital Schistosoma haematobium morbidity in a cross-sectional study in endemic rural Zimbabwe. Tropical Medicine and International Health 13, 15091517.Google Scholar
Leenstra, T., Coutinho, H.M., Acosta, L.P., Langdon, G.C., Su, L., Olveda, R.M., McGarvey, S.T., Kurtis, J.D. & Friedman, J.F. (2006) Schistosoma japonicum reinfection after praziquantel treatment causes anemia associated with inflammation. Infection and Immunity 74, 63986407.Google Scholar
Lehman, J.S. Jr, Farid, Z. & Bassily, S. (1970) Renal function in urinary schistosomiasis. America Journal of Tropical Medicine and Hygiene 29, 10011006.Google Scholar
Leutscher, P.D.C., Ramarokoto, C.E., Hoffmann, S., Jensen, J.S., Ramaniraka, V., Randrianasolo, B., Raharisolo, C., Migliani, R. & Christensen, N. (2008) Coexistence of urogenital schistosomiasis and sexually transmitted infection in women and men living in an area where Schistosoma haematobium is endemic. Clinical Infectious Disease 47, 775782.Google Scholar
Lwambo, N.J.S., Siza, J.E., Brooker, S., Bundy, D.A.P. & Guyatt, H. (1999) Patterns on concurrent hookworm infection and schistosomiasis in schoolchildren in Tanzania. Transactions of the Royal Society of Tropical Medicine and Hygiene 93, 497502.Google Scholar
Mohamberry, R.C., Kotiswari, N. & Ishwarlall, J. (1987) Renal function in urinary schistosomiasis in Natal Province of South Africa. America Journal of Tropical Medicine and Hygiene 37, 556561.Google Scholar
Ozumba, N.A., Christensen, N.O., Nwosu, A.B.C. & Nwaorgu, O.C. (1989) Endemicity, focality and seasonality of transmission of human schistosomiasis in Amagunze village, Eastern Nigeria. Journal of Helminthology 63, 206212.Google Scholar
Peters, P.A., El Alamy, M., Warren, K.S. & Mahmoud, A.A.F. (1980) Quick Kato smear for field quantifications of Schistosoma mansoni eggs. American Journal of Tropical Medicine and Hygiene 29, 217219.Google Scholar
Poggensee, G., Kiwelu, I., Weger, V., Goppner, D., Diedrich, T., Krantz, I. & Feldmeier, H. (2000) Female genital schistosomiasis of the lower genital tract: prevalence and disease-associated morbidity in northern Tanzania. Journal of Infectious Disease 181, 12101213.CrossRefGoogle ScholarPubMed
Poggensee, G., Sahebali, S., Van Marck, E., Swai, B., Krantz, I. & Feldmeier, H. (2001) Diagnosis of genital cervical schistosomiasis: comparison of cytological, histopathological and parasitological examination. American Journal of Tropical Medicine and Hygiene 65, 233236.Google Scholar
Sturrock, R.F., Diaw, O.T., Talla, I., Niang, M., Piau, J.P. & Capron, A. (2001) Seasonality in the transmission of schistosomiasis and in populations of its snail intermediate hosts in and around a sugar irrigation scheme at Richard Toll, Senegal. Parasitology 123, 7789.Google Scholar
Swai, B., Poggensee, G., Mtweve, S. & Krantz, I. (2006) Female genital schistosomiasis as evidence of a neglected cause for reproductive ill-health: a retrospective histopathological study. BMC Infectious Diseases 6, 134.Google Scholar
Tweyongyere, R., Mawa, P.A., Emojong, N.O., Mpairwe, H., Jones, F.M., Duong, T., Dunne, D.W., Vennervald, B.J., Katunguka-Rwakishaya, E. & Elliott, A.M. (2009) Effect of praziquantel treatment of Schistosoma mansoni during pregnancy on intensity of infection and antibody responses to schistosome antigens: results of a randomized placebo-controlled trial. BMC Infectious Diseases 9, 32.Google Scholar
WHO (1999) Monitoring helminthic programmes. Guidelines for monitoring the impact of control programmes aimed at reducing morbidity caused by soil-transmitted helminths and schistosomes, with particular reference to school-age children. Geneva, WHO.Google Scholar
WHO (2002) Report of the WHO informal consultation on the use of Praziquantel during pregnancy/lactation and albendazole/mebendazole in children under 24 months. Geneva, WHO.Google Scholar
WHO (2009) WHO Working Group on urogenital schistosomiasis and HIV transmission, 2009. Available at websitehttp://www.who.int/neglected_diseases/integrated_media_urogenital_schistosomiasis/en/index.html (accessed accessed 16 September 2013).Google Scholar