Diagnostic Accuracy of Urine Test Strip and Morbidity Indicators of Urogenital Schistosomiasis in Kwara State, Nigeria

Abstract

Background: The efficient management of schistosomiasis depends on the rapid and accurate diagnosis of infection. Rapid diagnostic tests are essential for identifying morbidity markers of urogenital schistosomiasis.

Methods: A total of 1,341 urine samples collected from school-age pupils in Kwara State were screened for Schistosoma haematobium eggs using the syringe filtration method. Haematuria and proteinuria were assessed using commercial urine reagent strips (Medi-Test Combur-9).

Results: Overall, 277 paticipants were infected, of which children >15 yr accounted for 37.5% of the disease prevalence. Only light and moderate infection was observed. Microhaematuria varied significantly with egg intensity (P<0.05), but no association was found between hematuria severity and age. The overall prevalence of macrohaematuria was 1.3%, while microhaematuria and proteinuria were 53.9% and 19%, respectively. Macrohaematuria was found in 88.9% of S. haematobium-positive children while 13% of positive children tested negative for microhaematuria. Microhaematuria showed higher sensitivity (70.8%) compared to other biomarkers, while macrohaematuria had higher specificity (99.8%).

Conclusion: In the absence of other morbidity markers, microhaematuria appears to be a good proxy for urogenital schistosomiasis in our setting.