Research

Comparison of findings using ultrasonography and cystoscopy in urogenital schistosomiasis in a public health centre in rural Angola

Julio Santos, Jacinta Chaves, Heriberto Araújo, Nuno Vale, José Manuel Costa, Paul J Brindley, Carlos Lopes, Jean Naples, Clive Shiff, Jorge Dupret, Lúcio Lara Santos

Abstract


Background. Schistosomiasis is a chronic disease caused by infection with parasitic worms of the genus Schistosoma. In sub-Saharan Africa, infections with S. haematobium are most common. Cystoscopic examination (CE) has been accepted as the gold-standard test for detecting the late manifestations of schistosomiasis, including urothelial cancer of the bladder. However, this procedure is invasive and 10 - 40% of tumours may remain undetected. A non-invasive examination and a new generation of biomarkers are needed for better monitoring of the disease.

Objective. To assess the usefulness of ultrasound (US) scans for monitoring of structural urinary tract disease by local public health services in areas of Angola in which urogenital schistosomiasis is endemic.

Methods. A cohort of 80 S. haematobium-infected patients was selected in order to compare changes in the bladder wall detected by US with those observed on CE.

Results. There was a notable correlation between the findings observed on CE and US. Patients with lesions of the bladder mucosa such as neoplasms, ulcers or granulomas detected by CE also had changes in bladder wall thickness on US. The results support increased use of portable ultrasound machines for non-invasive examination of the bladder by local general practitioners.

Conclusion. US examination should be an integral part of the investigation of haematuria and used in all S. haematobium control programmes. General practitioners may find it useful for more accurate diagnosis of haematuria and to identify bladder wall alterations in both adults and children in schistosomiasis-endemic regions.

 


Authors' affiliations

Julio Santos, Urology Unit, Americo Boavida Hospital, Luanda, Angola; Urology Unit, Sagrada Esperança Clinic, Luanda, Angola; Agostinho Neto University, Luanda, Angola

Jacinta Chaves, Urology Unit, Americo Boavida Hospital, Luanda, Angola; Urology Unit, Sagrada Esperança Clinic, Luanda, Angola; Agostinho Neto University, Luanda, Angola

Heriberto Araújo, Urology Unit, Sagrada Esperança Clinic, Luanda, Angola; Agostinho Neto University, Luanda, Angola

Nuno Vale, Centro de Investigação em Química da Universidade do Porto (CIQUP), Chemistry and Biochemistry Department, Faculty of Sciences, University of Porto, Porto, Portugal

José Manuel Costa, Centre for the Study of Animal Science, University of Porto, Portugal

Paul J Brindley, Department of Microbiology, Immunology and Tropical Medicine, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA

Carlos Lopes, Experimental Pathology and Therapeutics Group, Research Centre of the Portuguese Institute of Oncology, Porto, Portugal, and Oncocir – Education and Care in Oncology and National Cancer Centre, Angola

Jean Naples, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

Clive Shiff, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

Jorge Dupret, Ministry of Health, Angola

Lúcio Lara Santos, Experimental Pathology and Therapeutics Group, Research Centre of the Portuguese Institute of Oncology, Porto, Portugal, and Oncocir – Education and Care in Oncology and National Cancer Centre, Angola

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Keywords

Haematuria; Ultrasound; Cystoscopy; Urogenital schistosomiasis; General doctors; Angola

Cite this article

South African Medical Journal 2015;105(4):312-315. DOI:10.7196/SAMJ.8564

Article History

Date submitted: 2014-06-15
Date published: 2015-03-07

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