EVALUATION OF AN ULTRASONOGRAPHIC SCORE FOR URINARY-BLADDER MORBIDITYIN SCHISTOSOMA-HAEMATOBIUM INFECTION

An ultrasonographic urinary bladder morbidity score was developed and tested in 510 patients with schistosomiasis haematobia, and then evalu ated for screening 1,134 randomly selected children from villages ende mic for Schistosoma haematobium. The ultrasonographic urinary bladder morbidity score had four grades ranging from normal to marked thickeni ng of the urinary bladder wall or any polyps or masses. Among both pat ients and randomly screened subjects, the ultrasonographic score was g reater (P = 0.01 and P < 0.01) in males than in females. Children exam ined in the clinic had higher (P = 0.03) ultrasonographic scores than adults. Infected subjects in communities were more likely (P < 0.001) to have urinary bladder morbidity than uninfected subjects, and clinic patients with egg counts greater than or equal to 20 eggs/10 mi of ur ine had higher (P = 0.03) ultrasonographic urinary bladder morbidity s cores than those with lighter infections. The geometric mean egg count was higher (P = 0.04) in clinic patients with grade II and III lesion s than in those with grade 0 and I lesions. There was progressive impr ovement of the grade of urinary bladder morbidity scores in patients t reated with praziquantel at each follow-up examination (P < 0.001) and there was a positive relationship (P < 0.01) between urinary bladder morbidity scores and ultrasonographic-detected renal back pressure cha nges, The ultrasonographic urinary bladder morbidity score objectively measured the severity of urinary bladder morbidity and correlated wit h intensity of S. haematobium infection in our subjects. It call be us ed in evaluating both morbidity in patients and in community surveys a nd in following the outcome of chemotherapy.