Haematuria and proteinuria during Schistosoma haematobium infection: relationship to intensity of infection and the value of chemical reagent strips for pre- and post-treatment diagnosis

The relationship of haematuria and proteinuria to intensity of Schistosoma haematobium infection, the possibility of using haematuria and proteinuria for diagnosing S. haematobium infection, and the value of haematuria and proteinuria in assessing chemotherapeutic efficacy after treatment with praziquantel were studied in 235 male and female schoolchildren, 9-to 14-year old. A correlation was found between both severity of dipstick proteinuria/haematuria and frequency of visible haematuria, and intensity of S. haematobium infection. Haematuria and proteinuria proved reasonably sensitive indicators of urinary schistosomiasis (78% and 86% respectively) and both techniques detected all heavy infections (over 64 eggs/10 ml urine), but haematuria was considered the overall better indicator due to its greater specificity before (83% vs 64%) and after (78% vs 67%) treatment. The presence of visible haematuria detected 19% of all infected children and two-thirds of those passing more than 64 eggs/10 ml urine, and can provide a useful saving of time and the use of reagent strips. Comparison of the results with those obtained elsewhere confirmed regional differences in the intensity of infection inducing specific levels of haematuria/proteinuria and in the sensitivity and specificity of urinary blood and protein as indicators of infection.