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Saudi Journal of Kidney Diseases and Transplantation
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LETTER TO THE EDITOR  
Year : 2013  |  Volume : 24  |  Issue : 6  |  Page : 1252-1253
Ultrasound findings in urinary schistosomiasis infection in school children in Gezira State, Central Sudan


Professor in Pediatrics and Child Health, Department of Pediatrics, Al-Kindy College of Medicine, Baghdad University, Baghdad, Iraq

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Date of Web Publication13-Nov-2013
 

How to cite this article:
Al-Mendalawi MD. Ultrasound findings in urinary schistosomiasis infection in school children in Gezira State, Central Sudan. Saudi J Kidney Dis Transpl 2013;24:1252-3

How to cite this URL:
Al-Mendalawi MD. Ultrasound findings in urinary schistosomiasis infection in school children in Gezira State, Central Sudan. Saudi J Kidney Dis Transpl [serial online] 2013 [cited 2019 Aug 22];24:1252-3. Available from: http://www.sjkdt.org/text.asp?2013/24/6/1252/121295
To the Editor,

I have two comments on the interesting paper by Elmadani et al [1] on the ultrasound findings in urinary schistosomiasis infection in school children in Gezira state, Central Sudan.

First, the best applications for which an ultrasonographic investigation of schistosomiasis is now considered as mandatory are community-based studies and post-therapeutic follow-up of the populations. However the poor specificity of some images is a major limitation for use in zones of low prevalence. [2] Also, lack of funds, proper equipment or training, particularly in developing countries with endemic schistosomiasis, are additional limitations. Despite these limitations, results have indicated that urinary tract abnormalities are common (18% overall prevalence) in Schistosoma hematobium transmission areas, with a 2-4% risk of either severe bladder abnormality or advanced ureteral obstruction. [3] Interestingly, the prevalence of 83.6% urinary tract ultrasonographic abnormalities reported by Elmadani et al [1] is alarmingly high. Elmadani et al [1] did not address the factors contributing to that spike in ultrasonographic abnormalities in their studied cohort. I presume that factors implicated in the evolution of high ultrasonographic urinary pathology might be probably related to a lack of or irregular mass treatment programs conducted during a national anti-schistosomiasis program in Sudan, intensity and duration of exposure, co-infection with other parasite strains, complex immune mechanisms resulting in slow acquisition of immune resistance, patients' age and genetic and nutritional backgrounds. Therefore, strategic anti-schistosomiasis programs consisting of early detection, proper treatment and regular follow-up as well as comprehensive preventive measures are still in paramount need in Sudan.

Second, apart from the common ultrasonographic findings of urinary bladder wall thickening, calcification, polyp(s), ureteric dilatation and hydronephrosis addressed in Elmadani et al's study [1] and various studies worldwide, additional ureteric wall abnormalities in term of strictures and ureterocele-like lesions of the ostium have been reported that tend to disappear after proper treatment with anti-schistosomiasis drugs. [4] Expanding the knowledge of ultrasonographers on the whole spectrum of ultrasonographic findings in schistosomiasis is crucial.

 
   References Top

1.Elmadani AE, Hamdoun AO, Monis A, Karamino NE, Gasmelseed N. Ultrasound findings in urinary shistosomaisis infection in school children in the Gezira state central Sudan. Saudi J Kidney Dis Transpl 2013;24:162-7.  Back to cited text no. 1
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2.Boisier P. Ultrasonoic diagnosis of morbidity related to schistosomiasis due to Schistosoma mansoni and Schistosoma haematobium: Epidemiological and individual value. Med Trop (Mars) 2000;60:395-401.  Back to cited text no. 2
    
3.King CH. Ultrasound monitoring of structural urinary tract disease in Schistosoma haematobium infection. Mem Inst Oswaldo Cruz 2002;97 Suppl 1:149-52.  Back to cited text no. 3
    
4.Kardorff R, Traoré M, Doehring-Schwerdtfeger E, Vester U, Ehrich JH. Ultrasonography of ureteric abnormalities induced by Schistosoma haematobium infection before and after praziquantel treatment. Br J Urol 1994;74:703-9.  Back to cited text no. 4
    

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Correspondence Address:
Mahmood Dhahir Al-Mendalawi
Professor in Pediatrics and Child Health, Department of Pediatrics, Al-Kindy College of Medicine, Baghdad University, Baghdad
Iraq
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DOI: 10.4103/1319-2442.121295

PMID: 24231496

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