Urinary Schistosomiasis - An Overview

Introduction

Urinary schistosomiasis is caused by a flatworm called Schistosoma haematobium, which infects the veins surrounding the bladder and urinary tract. It is prevalent in sub-Saharan Africa, affecting over 200 million people, particularly in impoverished areas with poor sanitation and limited access to clean water. Symptoms include painful urination, blood in the urine, and a higher risk of bladder cancer. It has significant economic consequences due to reduced productivity and increased healthcare costs. Despite control efforts, it remains a major public health challenge and requires continued investment in prevention and treatment strategies.

What Are the Causes of Urinary Schistosomiasis?

The primary cause of urinary schistosomiasis is exposure to contaminated water sources that contain Schistosoma haematobium larvae. The following are the subheadings that explain the causes of urinary schistosomiasis in detail:

• Water Contamination: Schistosoma haematobium larvae are commonly found in freshwater bodies such as rivers, lakes, and ponds in sub-Saharan Africa, the Middle East, and some parts of South America. People who come into contact with contaminated water while swimming, bathing, or washing clothes can get infected with the larvae. The larvae penetrate the skin and enter the bloodstream. From there, they move to the urinary system and mature into adult worms that lay eggs.

• Poor Sanitation: Poor sanitation practices, such as open defecation and lack of access to clean water, can increase the risk of urinary schistosomiasis. When people defecate in or near bodies of water, Schistosoma haematobium eggs in their feces can contaminate the water and infect others who come into contact with it.

• Occupational Exposure: Individuals who work in jobs that involve water contact, such as fishermen, farmers, and irrigation workers, are more likely to get urinary schistosomiasis. These people may have frequent and prolonged exposure to contaminated water sources, which increases their risk of infection.

• Poor Hygiene: Poor hygiene practices, such as infrequent hand washing and inadequate personal hygiene, can also increase the risk of urinary schistosomiasis. When people do not wash their hands after using the restroom, they can inadvertently spread Schistosoma haematobium eggs to others or reintroduce them to their bodies.

What Are the Symptoms of Urinary Schistosomiasis?

Urinary Schistosomiasis, an infection caused by parasitic worms, can result in a range of symptoms and complications. The severity and duration of symptoms depend on factors such as the intensity of the infection and the individual's immune response. The following are common symptoms of Urinary Schistosomiasis:

• Painful Urination: Individuals infected with urinary schistosomiasis may experience pain or discomfort while urinating. This symptom is often described as a burning or stinging sensation.

• Blood in Urine: Blood in the urine is another common symptom of urinary schistosomiasis. Urine may appear red or brown due to the presence of blood.

• Abdominal Pain: Lower abdominal pain is another symptom that individuals with urinary schistosomiasis may experience.

• Urinary Frequency and Urgency: Urinary schistosomiasis can cause affected individuals to urinate more frequently than usual. Additionally, they may experience a sudden and urgent need to urinate.

• Urinary Tract Infections: Individuals with urinary schistosomiasis are more likely to develop urinary tract infections.

• Bladder and Kidney Damage: If left untreated, urinary schistosomiasis can lead to chronic infections that cause bladder and kidney damage. This can result in urinary incontinence, chronic kidney disease, and even bladder cancer.

How to Diagnose Urinary Schistosomiasis?

Diagnosing urinary schistosomiasis is essential to ensure appropriate treatment and prevent complications. Here are the steps involved in diagnosing this condition:

• Clinical Examination: The clinical examination is the first step in diagnosing urinary schistosomiasis. It involves reviewing the patient's medical history and conducting a physical examination. Symptoms of urinary schistosomiasis include painful urination, hematuria (blood in urine), and frequent urination. Other symptoms, such as abdominal pain, fever, and fatigue, may also be present.

• Laboratory Tests: Laboratory tests confirm the presence of Schistosoma haematobium eggs or antibodies in the patient's body. The following tests are commonly used to diagnose urinary schistosomiasis:

• Urine Analysis: A urine sample is collected and examined under a microscope to check for Schistosoma haematobium eggs. The eggs are oval-shaped and have a terminal spine, distinguishing them from other parasites' eggs.

• Serology: A blood sample is collected and tested for Schistosoma haematobium antibodies. The test detects antibodies produced by the body in response to the parasite.

• Imaging Studies: Imaging studies are used to diagnose any complications of urinary schistosomiasis. Ultrasonography can identify bladder wall thickening, hydronephrosis (enlarged kidney due to urine retention), and ureteral dilation.

• Biopsy: In some cases, a bladder biopsy may be necessary to confirm the diagnosis. The biopsy involves removing a small piece of the bladder tissue and examining it under a microscope for the presence of Schistosoma haematobium eggs.

What Is the Treatment of Urinary Schistosomiasis?

Urinary schistosomiasis is a parasitic infection that requires several strategies to eliminate the parasite and prevent complications. Here are some treatment options:

• Medications: The primary treatment for urinary schistosomiasis involves anthelmintic medications that target the parasite. Praziquantel is the most commonly used drug, which paralyzes the parasite's muscles and facilitates elimination by the body. A single dose of 40mg per 88.18 pounds. is recommended, and a repeat treatment may be necessary for severe or chronic infections. Other drugs used include Oxamniquine and Metrifonate.

• Management of Complications: Urinary schistosomiasis can cause several complications, such as urinary tract infections, bladder cancer, and kidney damage. Therefore, managing these complications is an essential aspect of the treatment. Antibiotics can treat urinary tract infections, bladder cancer, and kidney damage but may require specialized treatment such as surgery or chemotherapy.

• Prevention: Preventing urinary schistosomiasis is crucial for managing the disease. Several strategies can help prevent the infection, including avoiding contact with contaminated water sources, treating contaminated water with chemicals or heat, and wearing protective clothing when working in contaminated areas. Mass drug administration programs have also successfully reduced the prevalence of schistosomiasis in some areas.

• Follow-up: Patients with urinary schistosomiasis require regular follow-up after treatment to monitor for any complications or recurrences of the infection. Follow-up may include urine and blood tests to detect the presence of the parasite or signs of kidney damage. Patients should also be educated on how to prevent reinfection and manage any symptoms that may occur.

Conclusion

Urinary schistosomiasis is a parasitic infection that can be avoided and cured. If left unattended, it can lead to severe sickness and death. Identifying the condition at an early stage and treating it promptly, along with taking preventative measures, can assist in decreasing the impact of this illness in communities affected by it.