Self-Diagnosis as a Possible Basis for Treating Urinary Schistosomiasis: A Study of Schoolchildren in a Rural Area of the United Republic of Tanzania

Bulletin of the World Health Organization, June 1999 | Go to article overview

Self-Diagnosis as a Possible Basis for Treating Urinary Schistosomiasis: A Study of Schoolchildren in a Rural Area of the United Republic of Tanzania


Voir page 482 le resume en francais. En la pagina 482 figura un resumen en espanol.

Introduction

School health services are potentially among the most cost-effective of public health programmes in developing countries (1). Also, treating children with anthelminthic drugs is one of the most attractive health services that can be provided in schools, for a number of epidemiological, clinical, and practical reasons. First, school-age children typically harbour the heaviest infections with many species of worms, and such children appear to contribute most to the transmission of infections in their communities (2, 3). Second, the disease caused by moderate-to-heavy worm burdens can affect children's growth and nutritional status (4) and, even perhaps, absenteeism (5), cognitive function, and school achievement (6, 7). Treating worms during the school-age years is therefore timely and has the potential to promote child development (8). Third, the drugs used to treat most species of worms are safe, highly effective and inexpensive, and are administered as single doses (9). Lastly, in many countries where worms are endemic, a large proportion of children are enrolled in school, which makes them accessible to health care delivered through an existing infrastructure (10). The questions which arise in this context are therefore more operational in nature. The Partnership for Child Development has, since its establishment in 1992, worked with the governments of several countries to explore simple, inexpensive methods to deliver anthelminthics to children in schools to treat intestinal worms and urinary schistosomiasis (10).

Urinary schistosomiasis, which is caused by moderate-to-heavy infections with Schistosoma haematobium, causes symptoms that include lower abdominal pain and the presence of blood in the urine (11). Of the 100 million people estimated to be infected with S. haematobium, 70% live in sub-Saharan Africa (12). In most communities, school-age children harbour the heaviest infections; in some schools in the United Republic of Tanzania, blood has been detected in the urine of up to 80% of children (13).

The recommended treatment for urinary schistosomiasis is praziquantel, typically given as a single dose at 40 mg/kg body weight (14), which keeps treatment simple and ensures compliance. Because praziquantel is safe and highly effective, WHO recommends its use in mass treatment of children in schools where the prevalence of infection with Schistosoma spp. is greater than 50% (15).

Because infections with S. haematobium tend to be focal, there is a need to be able to identify schools where mass treatment is required. Diagnosis of the infection by urine microscopy is time-consuming and expensive and requires technical skills; detecting blood in urine is simpler, but still requires urine to be collected and tested using reagent strips costing up to US$ 0.15 each. Because the symptoms of urinary schistosomiasis are fairly specific, a simple questionnaire administered to pupils by their teachers has been developed which records, among a list of other self-reported health problems, urinary schistosomiasis and the presence of blood in urine. This questionnaire, which was developed in the United Republic of Tanzania (16) and then validated in seven African countries under the auspices of WHO (17), has been found to be a useful tool for identifying schools and communities where mass treatment for urinary schistosomiasis is required. In 1996, the questionnaire was used by the Regional School Health Programme to identify schools in Tanga, Muheza, and Korogwe districts, Tanga Region, United Republic of Tanzania, where the prevalence of urinary schistosomiasis was estimated to be greater than 50%. Validation of the questionnaire using reagent strips and urine microscopy indicated that the prevalence of reported schistosomiasis of 25% was equivalent to a prevalence of infection of 50% (13, 18). …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Note: primary sources have slightly different requirements for citation. Please see these guidelines for more information.

Cited article

Self-Diagnosis as a Possible Basis for Treating Urinary Schistosomiasis: A Study of Schoolchildren in a Rural Area of the United Republic of Tanzania
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen
Items saved from this article
  • Highlights & Notes
  • Citations
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Search by... Author
    Show... All Results Primary Sources Peer-reviewed

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.