THE PUBLIC-HEALTH SIGNIFICANCE OF URINARY SCHISTOSOMIASIS AS A CAUSE OF MORBIDITY IN 2 DISTRICTS IN MALI

Schistosoma haematobium-related morbidity was studied in the perennial irrigation area of Office du Niger and the small reservoirs area of P lateau Dogon in Mall. Questionnaire, clinical, parasitologic, and ultr asound examination data were collected from 1,041 individuals at the b aseline survey in 1991; 705 were re-examined one year after treatment. At baseline, the overall prevalence of S. haematobium infection was 5 5.2%; half of those infected had no clinical symptoms and 30% had path ologic lesions. Both infection and morbidity were more frequent in chi ldren than in adults, with a peak prevalence at 7-14 years of age. The rates of lesions were more than twice as high in those heavily infect ed as in lightly infected individuals. Reagent strip testing for micro hematuria was more sensitive in detecting individuals with pathologic lesions than in detecting individuals with infection. One year after t reatment with praziquantel, more than 80% of the urinary tract lesions had cleared. It is concluded that S. haematobium-related morbidity is frequent in Mall, but passive case detection for treatment would not cover a great deal of early stages of the disease; active intervention using reagent strip testing for microhematuria at the most peripheral levels would be an efficient system for morbidity control and monitor ing of control operations.