Evaluating the effectiveness of positive urinalysis in the diagnosis schistosoma haematobium infection in children in Abuja

Abstract

Objective: To determine the prevalence of urogenital schistosomiasis among children with positive urinalysis, and the diagnostic  efficacy of such in the diagnosis of urinary schistosomiasis.

Design: A cross sectional school-based study.

Setting: The study was among apparently healthy, school children from public primary schools in Gwagwalada Area Council, of Federal Capital Territory, Abuja, Nigeria.

Subjects: Urinalysis was carried out among 861 healthy primary school pupils. The egg of Schistosoma haematobium was sought in the urine sample of 145 subjects with positive urinalysis using light microscope. Their bio data, and social class were assigned to the subjects.

Results: One hundred and forty-five (16.8%) subjects had positive urinalysis. The prevalence of Schistosoma haematobium infection among such subjects was 36(24.8%). More of the infected were females (52.8%), those between 9-10years (36.1%), those from rural schools (86.1%), and those from low social class (58.3%). The most sensitive urinalysis morbidity indicator for Schistosoma  haematobium infection in this study was combination of haematuria+leucocyturia+nitrituria with sensitivity, specificity, positive predictive value, accuracy and reliability of 56.7%, 92.0%, 60.7%, 90.6%, 85.6%, and 0.743, followed by haematuria+leucocyturia.
The least were leucocyturia, and nitrituria with sensitivity, positive predictive values of 0.0% each, and reliability of 0.482 and 0.307 respectively. The only risk factor for Schistosoma Haematobium infection in this study was source of water supply, OR=3.71, 95% CI 0.93-16.02, p=0.009.

Conclusion: The prevalence of urinary schistosomiasis among primary school pupils with positive urinalysis was high. Presence of haematuria+leucocyturia+nitrituria or haematuria+leucocyturia can be a useful rapid diagnostic morbidity indicator for urinary  schistosomiasis.