Urinary Schistosomiasis, some clinical and radiological features as seen at Kenyatta national Hospital

Abstract

A prospective study of the clinical pattern and radiological abnormalities of the urinary tract of patients presenting with schistosoma haematobium infection at Kenyatta National Hospital were carried out. Later, a retrospective study of patients with proven schistosoma haematobium previously treated in this hospital between 1980 to 1984 whose files could be traced in the records were done to extract similar information. In the pr-o apec aLve group a total of 31 patients were seen while in the retrospective group only 10 cases could be traced. For both the groups, their ages ranged from 6 to 65 years with 75% of them falling within the range of 11 to 25 years. The majority in the prospective group were coming for the first time and only 3 (6%) patients reported having been treated before. 23 (51%) patients in both groups had had symptoms for less than one year. In the prospective group, most of the patients were in fairly good general condition and did not have any signs or symptoms suggestive of complications of the urinary tract disease. Of the 20 patients in the prospective group who were radiologically examined, only 2 patients had radiological abnormalities of the urinary tract. Both had had the disease for more than two years. In one of the two cases, there was a left hydroureter with a large urinary (vi) bladder calcification. He was a 23 year old male from South Nyanza District. He had had urinary symptoms such as haematuria, dysuria and abdominal pain for about 10 years. The second with abnormal intravenous pyelogram (IVP) was a 21 year old female from Kisumu district. Her IVP showed radiological features of chronic pyelonephritis thought to be due to chronic bacterial infection supervening upon the damage caused by prolonged schistosoma haematobium infection, since significant bacterzurLa has been shown in these patients. In the retrospective group very scanty clinical notes were a~available. One patient required transfusion but no hemoglobin level was available. Only 1(10%) patient had elevated blood urea nitrogen while one patient was hypertensive. However, no radiological examination was done in all these patients to asses any abnormalities of the urinary tract.