Presumptive diagnosis of schistosoma haematobium and Schistosoma mansoni using microscopy as gold standard in a Riverrine community of southwestern Nigeria

Abstract

A cross-sectional study was carried out in Ilie community of Olorunda Local Government Area in Osun state, southwestern Nigeria to comparatively evaluate the presumptive diagnosis of schistosoma infections using microscopy as gold standard. One hundred and thirty seven consented primary school children aged 4 to 15 years were examined for presence of schistosome eggs. The urine samples were analyzed with urinalysis strips for microhaematuria as indicators of presumptive diagnosis for urinary schistosomiasis while fecal samples were analyzed with fecal occult blood test kits for occult blood detection as an indicator of presumptive diagnosis for intestinal schistosomiasis. The indicators of presumptive diagnosis were compared with microscopy examination of urine and stool while sensitivity and specificity of the presumptive diagnostic methods were determined. The results of the prevalence showed that 107(78.1%) had co- infection and overall prevalence of 73.5% and 26.3% recorded for both S. haematobium and S mansoni infection respectively. It was observed that the use of microhaematuria alone had 52% sensitivity and 91.67% specificity while stool occult blood recorded 73.685 and 66.67% for sensitivity and specificity respectively. This study shows that presumptive diagnosis of urinary schistosomiasis is significantly more sensitive  (P<0.05) than intestinal schistosomiasis. Also, various degrees of co- infections were observed across all age groups of study subjects with age group 10- 12 years exhibiting highest co- infection rate 48(13.4); and tendency towards increased transmission and re-infection. Use of these alternatives is recommended in resource limited settings, to be confirmed by gold standard when feasible.

Keywords: Presumptive diagnosis, Schistoma haematobium, Schistoma mansoni, Microscopy, Holoendemic Community.