URINE REAGENT STRIPS FOR DIAGNOSIS OF SCHISTOSOMIASIS HAEMATOBIUM IN WOMEN OF FERTILE AGE

Hematuria, proteinuria and leukocyturia were semiquantitatively assess ed by reagent strips in single morning urine of women of fertile age v isiting the outpatient department of the Mangochi district hospital, M alawi. This was part of a diagnostic approach to female genital schist osomiasis (FGS). In 51 women ova of Schistosoma haematobium were detec ted in urine by a filtration technique. In 33 of these women ova were also present in genital tissue as demonstrated by microscopic examinat ion of biopsies. In 209 women no ova were found in the single urine fi ltered. There were significantly higher scores for hematuria, proteinu ria and leukocyturia as well as of the combined reagent strip index (R SI) in egg-excreting than in egg-negative women. The sensitivity of a single hematuria, proteinuria and leukocyturia reading was 98, 84 and 73%, respectively. However, the respective specificity was only 24, 22 and 23%. The best prediction of urinary schistosomiasis was achieved by a +2 score for hematuria, of which the sensitivity was 94% and the specificity was 61%. The high false-positive rates can probably be exp lained by contamination of urine by vaginal secretion. Moreover, cases of schistosomiasis have probably been overlooked because only a singl e morning urine sample was examined. The total absence of hematuria, p roteinuria and leukocyturia, however, may be used to rule out heavy in fections in community surveys. There was no difference in reagent stri p scores between women with genital and urinary schistosomiasis as com pared with those with urinary tract lesions alone. Thus urine analysis reagent strip readings do not help to discriminate between S. haemato bium infected women with and without FGS.