Serra João Tiago, Silva Carina, Sidat Mohsin, Belo Silvana, Ferreira Pedro, Ferracini Natália, Kaminstein Daniel, Thompson Ricardo, Conceiçao Claúdia
Institute of Hygiene and Tropical Medicine, IHMT, NOVA University, Lisbon, Portugal.
Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, IHMT, NOVA University, Lisbon, Portugal.
PLoS Negl Trop Dis. 2024 Dec 16;18(12):e0012738. doi: 10.1371/journal.pntd.0012738. eCollection 2024 Dec.
Mozambique is one of the countries with the highest prevalence of schistosomiasis, although there is little data on the prevalence of disease and associated morbidity in the adult population. This study aimed to describe and characterize the morbidity associated with schistosomiasis in the adult population of Chókwè district and to explore the use of anamnestic questionnaires and urine dipsticks, as well as point-of-care ultrasound for urinary related findings, to better characterize disease prevalence and morbidity.
Between April and October 2018, we conducted a cross-sectional study embedded within the Chókwè Health Research and Training Centre. Data were collected on sociodemographic variables, signs and symptoms for schistosomiasis and water related activities. Infection status was determined by urine filtration, Kato-Katz thick smear and DNA detection. Point-of care urinary tract ultrasonography was performed to assess structural morbidity associated with Schistosoma haematobium infection. Multivariate logistic regression was used to search for associations between risk factors, signs and symptoms, infection status and ultrasound abnormalities.
Our study included 1033 participants with a median age of 34 years old. The prevalence of Schistosoma haematobium, Schistosoma mansoni and ultrasound detected urinary tract abnormalities were 11.3% (95% CI 9.5%-13.4%), 5.7% (95% CI 4.3%-7.5%) and 37.9% (95% CI 34.8%-41.2%), respectively. Of the 37.9% with urinary tract abnormalities, 14.5% were positive for Schistosoma haematobium. Reported hematuria in the last month (p = 0.004, aOR 4.385) and blood in the urine dipstick (p = 0.004, aOR 3.958) were markers of Schistosoma haematobium infection. Reporting lower abdominal pain (p = 0.017, aOR 1.599) was associated with ultrasound abnormalities.
Using microscopy and DNA analysis for both Schistosoma haematobium and Schistosoma mansoni in conjunction with urinary ultrasound abnormalities gives us several insights into correlations between disease prevalence (microscopic and anatomical) and demographic details in a high-risk population.
莫桑比克是血吸虫病患病率最高的国家之一，尽管关于成年人群中疾病患病率及相关发病率的数据很少。本研究旨在描述和表征乔克韦区成年人群中与血吸虫病相关的发病率，并探索使用既往症调查问卷、尿试纸条以及即时超声检查来发现泌尿系统相关问题，以更好地表征疾病患病率和发病率。
2018年4月至10月期间，我们在乔克韦健康研究与培训中心开展了一项横断面研究。收集了社会人口统计学变量、血吸虫病的体征和症状以及与水相关活动的数据。通过尿液过滤、加藤厚涂片法和DNA检测确定感染状况。进行即时泌尿系统超声检查以评估与埃及血吸虫感染相关的结构发病率。采用多变量逻辑回归分析来寻找危险因素、体征和症状、感染状况与超声异常之间的关联。
我们的研究纳入了1033名参与者，中位年龄为34岁。埃及血吸虫、曼氏血吸虫的患病率以及超声检测到的泌尿系统异常率分别为11.3%（95%可信区间9.5%-13.4%）、5.7%（95%可信区间4.3%-7.5%）和37.9%（95%可信区间34.8%-41.2%）。在37.9%有泌尿系统异常的人群中，14.5%的人埃及血吸虫检测呈阳性。过去一个月报告有血尿（p = 0.004，调整后比值比4.385）和尿试纸条检测有血（p = 0.004，调整后比值比3.958）是埃及血吸虫感染的标志物。报告下腹部疼痛（p = 0.017，调整后比值比1.599）与超声异常有关。
对埃及血吸虫和曼氏血吸虫同时使用显微镜检查和DNA分析，并结合泌尿系统超声异常情况，使我们对高危人群中疾病患病率（显微镜检查和解剖学检查）与人口统计学细节之间的相关性有了深入了解。
