02983nas a2200289   4500000000100000008004100001100001600042700001400058700001600072700001300088700001500101700001500116700001500131700001300146700001500159700001400174700001300188700002500201700001300226700001300239245012900252856007900381300001300460490000600473520220000479022001402679       2015                            d1 aBocanegra C1 aGallego S1 aMendioroz J1 aMoreno M1 aSulleiro E1 aSalvador F1 aSikaleta N1 aNindia A1 aTchipita D1 aJoromba M1 aKavaya S1 aSánchez Montalvá A1 aLópez T1 aMolina I00aEpidemiology of schistosomiasis and usefulness of indirect diagnostic tests in school-age children in Cubal, Central Angola.  uhttp://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0004055   ae00040550 v93 a<p><strong>Editor's Abstract: </strong></p>

<p>INTRODUCTION:<strong> </strong>Schistosomiasis remains a public health major problem and little is known in many areas, mainly in Sub-Saharan Africa.</p>

<p>OBJECTIVES: To assess the burden and risk factors of schistosomiasis and intestinal parasitic helminthes in the children of Cubal, Angola, and to compare different diagnostic approaches for urinary schistosomiasis under field conditions.</p>

<p>METHODS:<strong> </strong>A cross-sectional study was conducted. Urine and faeces samples of school children were microscopically studied. A random sample of children was obtained from an alphabetically arranged list of children, taking one of two children. Urine dipstick, colorimetric test and macrohaematuria were considered as indirect diagnostic methods and compared to direct urine examination. Possible risk factors for the infection were sex, age, distance to the river and previous treatment with praziquantel; the assessment was performed using Chi-square test.</p>

<p>RESULTS:<strong> </strong>A total of 785 (61.18%) children showed S. haematobium eggs in urine; children living within 500 meters from the river had a higher odds for infection: Odds ratio 1.97 (1.45-2.7 CI 95%); urine dipstick showed sensitivity of 96% and specificity of 61.3%, with a positive predictive value; colorimetric test showed sensitivity of 52.5%, specificity of 74.6% and a positive predictive value of 77%. Proteinuria was present in 653 (51.1%) children, being more frequent in children with S. haematobium in urine (75.2%); 32 of 191 stool samples (16%) showed the presence of other intestinal parasites and 8 (4%) for S. haematobium.</p>

<p>CONCLUSIONS:<strong> </strong>Prevalence of urinary schistosomiasis in our study area is much higher than the national average, considering it as a high-risk community. Proximity to a source of water was a risk factor for the infection. Indirect tests, as urine dipstick and colorimetric test, were useful tools for diagnosis, due to ease of use and low cost. Proteinuria was a common finding, probably showing an early structural damage due to schistosomiasis in this group of children.</p>
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