Vere Maryline, Ham-Baloyi Wilma Ten, Oyedele Opeoluwa, Mduluza Takafira, Melariri Paula E
Department of Environmental Health, Faculty of Health Sciences, Nelson Mandela University, University Way, Summerstrand, Gqeberha 6001 South Africa.
Department of Nursing Science, Faculty of Health Sciences, Nelson Mandela University, University Way, Summerstrand, Gqeberha 6001 South Africa.
Acta Trop. 2025 Sep;269:107716. doi: 10.1016/j.actatropica.2025.107716. Epub 2025 Jul 7.
Schistosomiasis, is a parasitic infection that leads to chronic illness and socioeconomic challenges in tropical regions. Adult Schistosoma (S.) haematobium worms inhabit the bladder's venous plexus and produce eggs that cause tissue inflammation and systemic pathologies, detectable as urinary biomarkers in bodily fluids like urine, blood, and serum. Urinalysis offers a rapid, cost-effective, non-invasive assessment of schistosomiasis-related urinary biomarkers.
This systematic review aimed to identify urinary biomarkers indicative of S. haematobium infections and assess their diagnostic relevance.
A systematic search was conducted in databases including PubMed, EbscoHost, and Google Scholar to find studies on urogenital schistosomiasis urinary biomarkers detected by point-of-care dipsticks in sub-Saharan Africa. From 699 screened studies, 19 met the inclusion criteria. These studies focused on point-of-care dipstick use for all age groups, excluding those using laboratory-based methods. The Joana Briggs quality assesment tool was used to evaluate the selected articles, and a detailed narrative summary was created. A meta-analysis assessed study variability.
The analysis identified haematuria and proteinuria as key urinary markers for diagnosing urinary schistosomiasis infections. The meta-analysis found a statistically significant pooled prevalence for haematuria, proteinuria, leukocyturia, nitrates, bilirubin, and urobilinogen. Significant heterogeneity was observed in studies measuring haematuria, proteinuria, leukocyturia, and nitrates (over 80 %), with lower but still non-significant heterogeneity for nitrates (39.3 %).
Haematuria, proteinuria and leukocyturia are indicators of urogenital schistosomiais morbidity; nonetheless, further investigation is necessary to measure metabolite concentrations directly associated with schistosomiasis morbidity for improved diagnostic precision.
血吸虫病是一种寄生虫感染，在热带地区会导致慢性病和社会经济挑战。成年埃及血吸虫寄生在膀胱静脉丛中，产出的虫卵会引发组织炎症和全身性病变，这些病变可在尿液、血液和血清等体液中作为尿液生物标志物被检测到。尿液分析为血吸虫病相关尿液生物标志物提供了快速、经济高效且非侵入性的评估方法。
本系统评价旨在识别指示埃及血吸虫感染的尿液生物标志物，并评估其诊断相关性。
在包括PubMed、EbscoHost和谷歌学术在内的数据库中进行系统检索，以查找关于撒哈拉以南非洲地区通过即时检测试纸条检测泌尿生殖系统血吸虫病尿液生物标志物的研究。在699项筛选出的研究中，19项符合纳入标准。这些研究聚焦于所有年龄组使用即时检测试纸条的情况，排除了使用基于实验室方法的研究。使用乔安娜·布里格斯质量评估工具对所选文章进行评估，并创建了详细的叙述性总结。进行荟萃分析以评估研究的变异性。
分析确定血尿和蛋白尿是诊断泌尿生殖系统血吸虫病感染的关键尿液标志物。荟萃分析发现血尿、蛋白尿、白细胞尿、硝酸盐、胆红素和尿胆原的合并患病率具有统计学意义。在测量血尿、蛋白尿、白细胞尿和硝酸盐的研究中观察到显著的异质性（超过80%），硝酸盐的异质性较低但仍无统计学意义（39.3%）。
血尿、蛋白尿和白细胞尿是泌尿生殖系统血吸虫病发病的指标；尽管如此，仍需进一步研究以直接测量与血吸虫病发病直接相关的代谢物浓度，以提高诊断准确性。
