An Assessment of Schistosoma haematobium infection and urinary tract bacterial infection amongst school children in rural eastern Nigeria
C Uneke, S Ugwuoke-Adibuah, K Nwakpu, B Ngwu
C Uneke, S Ugwuoke-Adibuah, K Nwakpu, B Ngwu. An Assessment of Schistosoma haematobium infection and urinary tract bacterial infection amongst school children in rural eastern Nigeria. The Internet Journal of Laboratory Medicine. 2009 Volume 4 Number 1.
Urinary schistosomiasis an important parasitic disease caused by
Urinary tract infection UTI is a pandemic disease that is responsible for much illness and contributes significantly to the cost of providing health globally, leading to a number of deaths either from acute infection or from chronic renal failure . UTI defines a condition in which the urinary tract is infected with a pathogen causing inflammation . Though the etiology and clinical presentation of infections are similar in industrialized and developing countries, it is evident that persons with these infections in resource-constrained tropical areas of the world including most African countries, often present for care with more severe illness and often only after complications have developed .
The incident of urinary tract inflections is greatly influenced by age and sex and by predisposing factors that impair the defense mechanism that maintain the sterility of the normal urinary tract . Infection in children is often hard to recognize because of the variable symptomotology and the difficulty of obtaining suitable specimens of urine in the very young, but they are of particular importance as causes of permanent damage to the developing kidney . In man, the urinary tract is the second commonest site, after the respiratory tract, for bacterial inflection; consequently, urethrius cystitis, and pyelonephritis are the infections of urinary tract which can be caused by bacteria like
In this present report, we present the findings from the assessment of urinary schistosomiasis and urinary tract bacteria infection among school children in two localities of south-eastern Nigeria, with the view to providing more insights on the relationship between
Material and Methods
Study area and population
This study was conducted from January 2006 to February 2008 in parts of Ebonyi State south-eastern Nigeria. The climate is tropical and the vegetation characteristic is predominantly the rain forest with an average annual rainfall of about 1600mm and average atmospheric temperature of 30oC. There are two distinct seasons, the wet and the dry season. The former takes place between April and October, while the latter occurs from November to March. The study took place in selected primary schools in the rural communities in two local government areas (LGA) within Ebonyi State. The first LGA was Ezza-North and the schools were Community Primary School CPS Ugalaba, and Community Primary School CPS Achiagu. The major sources of water supply in these communities are rivers, streams and ponds. The second LGA was Ngbo-West and the school used was Community Primary School CPS Ukpeshi. The major sources of water supply in this community are wells and boreholes. Systematic schistosomicidal treatment had never been applied in both LGAs. Primary school pupil were selected for this study because: (i) schools are accessible without much difficulties, (ii) the peak of prevalence of schistosomiasis is to be found in this group  and (iii) experience shows that there is general good compliance from children and parents .
This study protocol was approved by the Department of Medical Microbiology/Parasitology, Faculty of Clinical Medicine Ebonyi State University. The study was also approved by the Ezza-North and Ngbo-East Local Government Council Authorities, the Local Government Health Departments and the Parent-Teachers Association (PTA) of each of the schools used for the studied. Informed consent was obtained from each of the pupils before inclusion in the study. Demographic information such as age and water contact activities was obtained by interview from each participant.
About 20ml of clean-catch, midstream urine samples were collected in 50ml capacity, autoclaved, wide-mouthed, leak proof universal containers by subjects themselves, who were previously carefully instructed with illustration aids. This was to avoid any possible contamination during collection. Samples were obtained during school hours, between 10:00hrs and 14:00hrs , from pupil whose last micturation was at least 2 hours old  to accommodate bacteria analysis. Samples with visible haematunia were noted. Each sample collected was divided into two fractions. About 10ml of each urine sample (fraction A) was investigated for the presence of
The urine sedimentation technique described previously  was used to detect the presence of
Fraction B of the urine samples were aseptically cultured (immediately they were identified) on blood agar (BA) medium and cystine lactose electrolyte deficiency (CLED) medium according to standard protocol as described previously . The pairs of culture plates were incubated aerobically at 37oC for 24 hours. Colonial characteristics, gram reaction, catalase and coagulase tests, haemolysis on BA medium, lactose fermentation on CLED medium and other biochemical tests such as indole production, citrate utilization, urase activity, triple sugar iron (TSI) agar test (for glucose, sucrose, and lactose fermentation), gas and hydrogen sulphide production and oxidase test were conducted as described previously , for bacterial isolation and identification. The presence of UTI was described as bacteria count of equal or greater than 104 colony forming units per ml of urine (cfu/ml).
Differences in proportion were evaluated using the Chi-square test. Statistical significance was achieved it
A combined total of 803 persons participated in the study from the two LGAs. Of the 400 children studied in Ngbo-West LGA, 25(6.3%) had
In both LGAs, the male children were more infected with
The result of this study which showed
Although this present study did not clearly demonstrate that urinary schistosomiasis predisposes infected individuals to UTI caused by bacteria, this possibility can not however be overruled. This is because an earlier study noted that despite the fact that bacteria UTI prevalence values vary from one area to another and even from one report to another in the same country, they are generally much higher than those documented in the area with no
The reasons why individuals with
The commonest bacterium isolated in the UTI cases in this study which was
In conclusion, it is pertinent to state that since the potential exist for possible interaction between