Point-of-care ultrasound reveals extensive pathology in Gabonese preschool-age children with urogenital schistosomiasis.

Urogenital schistosomiasis (UGS) is a waterborne parasitic disease mainly resulting from infection with Schistosoma haematobium. It belongs to the neglected tropical diseases and affects almost 240 million people worldwide [1]. Untreated infection causes substantial morbidity of both the urinary and genital tract in endemic areas. Urinary tract pathology occurs in the early stage of infection, mainly affects the bladder wall and distal ureters and is often reversible after treatment [2]. In chronically infected patients, UGS can cause persistent bladder wall changes, irreversible hydronephrosis with a risk for kidney failure as well as squamous cell carcinoma of the bladder [3–5]. Genital schistosomiasis (GS) is a still underrated manifestation of S. haematobium infection, which can lead to sexual dysfunction and infertility in both females and males and increases the risk for ectopic pregnancies [6].

In Gabon, UGS is endemic and preventive chemotherapy is generally recommended by the WHO [7]. The local epidemiology differs substantially between provinces and different areas, with S. haematobium prevalence estimates ranging from 0.8 to 45% in school-age children [8]. While data on the epidemiology of UGS has increased during the last two decades, most of it is limited to parasitological determinants. Evaluation of morbidity has been rarely undertaken, as access to diagnostic tools such as ultrasound was limited; thus, little remains known about the prevalence and extent of associated urinary tract pathology. However, morbidity data across the age ranges is needed to estimate the disease burden for the local population and to guide local control strategies.

Our study aimed to detect urinary tract pathology in symptomatic UGS patients in an endemic area and to correlate the findings with demographic, clinical, and parasitological factors.