J. Ansell et al., Self-diagnosis as a possible basis for treating urinary schistosomiasis: astudy of schoolchildren in a rural area of the United Republic of Tanzania, B WHO, 77(6), 1999, pp. 477-483
Citations number
26
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
A questionnaire for schoolchildren about symptoms of urinary schistosomiasi
s is becoming widely used to identify schools where the prevalence of infec
tion with Schistosoma haematobium is greater than 50%, the threshold for ap
plying mass treatment. This strategy typically leaves many schools without
treatment even though some of the children have urinary schistosomiasis and
blood in urine. We examined data collected during an evaluation of a schoo
l health programme in Tanga Region, the United Republic of Tanzania, to det
ermine whether self-diagnosis could be used as a basis for giving treatment
. Over 2300 children in 15 schools were asked by a nurse whether they had k
ichocho (urinary schistosomiasis) and their answers were compared with the
results of tests for visible and occult blood in urine, and microscopy for
S. haematobium eggs. An average of 75% of children were correct in their se
lf-diagnosis(95% confidence interval (CI) = 72-78%), while 3% gave a false-
positive diagnosis (95% CI = 2-4%). The remaining 22% gave a false-negative
diagnosis (95% CI = 20-25%)and would not have been treated, although most
of these children were lightly infected. These proportions were independent
of a wide range of prevalence levels (7-77%) and intensity of infection (2
3-827 eggs per 10 ml of urine). Self-reported schistosomiasis might thus be
used to treat children in schools where mass treatment is not applied.