Genetic diversity of Schistosoma haematobium parasite IS NOT associated with severity of disease in an endemic area in Sudan.

BACKGROUND: Over 650 million people globally are at risk of schistosomiasis infection, while more than 200 million people are infected of which the higher disease rates occur in children. Eighty three students between 6-20 years (mean 12.45 ± 3.2) from Quran School for boys in Radwan village, Gezira state were recruited to investigate for the relationship between the genetic diversity of Schistosoma haematobium strains and the severity of the disease. METHOD: Schistosoma haematobium infection was detected by filtration of urine. Ultrasonography was done on each study subject, while PCR technique was used for genotyping via random amplified polymorphic DNA (RAPD) with A01, A02, A12, Y20 and A13 primers. A01 primer gave three different genotypes (A01-1, A01-2 and A01-3). RESULTS: About 54.2% (45/83) were S. haematobium egg positive by urine filtration. On assessment of the upper and lower urinary tract by ultrasound technique, 61.4% (51/83) were positiveand73.3% (60/83) samples were PCR positive. No significant difference was found when comparing the three different genotypes with severity of the disease. CONCLUSION: This study concludes that no association was found between the different genotypes of S.haemtobium and the severity of the disease. Examination of more samples from different areas to identify any possible differences between the parasites genes and disease severity was recommended.

The contribution of bone SPECT to the diagnosis of bone metastases in an African population.

BACKGROUND: A number of studies have demonstrated the value of performing spinal SPECT in addition to planar scintigraphy for the diagnosis of bone metastases. This has not been demonstrated in an African population, however, where patients typically present with more advanced disease. AIM: To investigate the contribution of bone SPECT to the diagnosis of bone metastases in an African population. METHODS: In a retrospective survey the studies of all patients with known primary tumours who underwent skeletal scintigraphy for the diagnosis of bone metastases during one calendar year were reviewed. The studies of patients who underwent both planar imaging and SPECT were reinterpreted. Blinded to the SPECT study, the planar studies were graded for probability of metastatic disease using a four-point scale, and the number of spinal lesions was noted. This was repeated with the planar and SPECT studies reviewed together. The interpretation using the planar images alone was compared with that obtained after the addition of SPECT using non-parametric tests. Of a total of 576 patients, 119 (45 men and 74 women) underwent planar and SPECT imaging. RESULTS: The addition of SPECT resulted in a significant change in the interpretation of these studies (P<0.05), and a significantly lower proportion of patients had equivocal gradings (P<0.01). However, the actual numbers of patients affected was relatively small, varying from six to 21, representing about 5-18% of the 119 patients who underwent an additional SPECT. Furthermore, of the total population of 576 patients with known malignancies undergoing bone scintigraphy for bone metastases, the availability of SPECT only resulted in an altered classification in 1-4%. Equivocal planar gradings were far more likely to be altered following the addition of SPECT. The addition of SPECT also resulted in the detection of significantly more spinal lesions (P<0.01). CONCLUSION: In a setting where SPECT is not easily available, planar imaging alone is still adequate in the vast majority of cases.

Ultrasound findings in urinary shistosomaisis infection in school children in the Gezira State Central Sudan.

To evaluate the ultrasound findings of urinary schistosomiasis in Quran school (Khalwas) children in Gezira State Sudan, we studied all the students from two schools. A total of 103 boys were tested for urinary schistosomiasis using the urine filtration method. Schistosoma haematobium (S. haematobium) eggs were counted. Ultrasound was performed for all the positive subjects. Seventy-three (71%) subjects were positive for S. haematobium. The mean age was 11.3 ± 2.9 years. Sixty-six (90.4%) subjects showed urinary tract abnormalities. The findings revealed the following degrees of wall thickening: 53.0% mild, 18.2% moderate and 21.2% severe. Urinary bladder polyp(s) were noted in 43.3% (single) and 40.9% (multiple) of the subjects, and calcification of the bladder wall was observed in 7.6% subjects. Ureteric dilatation was noted in 38/73 (52.0%), while hydronephrosis was detected in 19/73 (26.3%). The vast majority of urinary tract schistomiasis lesions were in the urinary bladder. Ultrasound is a useful tool for identifying the morbidity of S. haematobium in endemic areas.