Resolution and resurgence of Schistosoma haematobium-induced pathology after community-based chemotherapy in Ghana, as detected by ultrasound

Community-based treatment is recommended for endemic populations with urina ry schistosomiasis; however, the optimal target group for treatment and ret reatment interval have not been established. Using ultrasound, this study i dentified subpopulations whose lesions were most likely to respond to treat ment and characterized resurgence of pathology. Ultrasound examination of 1 202 infected patients was followed by chemotherapy with praziquantel, A sam ple of 698 patients was followed for 18 months after treatment. Nearly all types of bladder pathologies resolved after treatment, regardless of patien t's age or intensity of initial infection, However, many patients' upper ur inary tract pathologies (62.5%) did not resolve. During the 18-month follow -up period, reappearance of severe bladder pathologies was rare, and <10% o f persons had resurgence of mild bladder pathologies. For this population, retreatment is not needed annually but might be cost effective if given sev eral years later. Confirmation from other areas is required before general policies can be formed.