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Bladder outlet obstruction; a rare complication of the neglected schistosome, Schistosoma haematobium : two case reports and public health challenges

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ABSTRACT

Background: Schistosomiasis is a severe parasitic infestation with debilitating complications and is the third most devastating tropical disease in the world. It is one of the neglected tropical diseases (NTDs) with a high disease-burden. We present two rare cases of bladder outlet obstruction: one which led to a chronic kidney disease and ultimately death and a second which recovered after treatment with praziquantel.

Case presentations: A 72 year old male presented with lower urinary tract symptoms which culminated in an episode of acute urinary retention. The patient had never received preventive chemotherapy with praziquantel. After suprapubic aspiration, the cause of the obstructive uropathy was found to be several mature live worms of Schistosoma haematobium. Despite treatment with praziquantel and haemodialysis; we lost the patient due to sepsis from a urinary tract infection. In the second case, a 15 year old male presented with LUTS for a 1 year duration and was diagnosed to have schistosomiasis after eggs of Schistosoma haematobium were found in his urine. He was treated with praziquantel.

Conclusion: There are several gaps in the public health policies in place to control this NTD in Cameroon as annual distribution of preventive chemotherapy is inadequate due to inaccessibility of some high-endemic zones and is based on data obtained two decades ago. Population education is insufficient leading to poor health-seeking behaviour. These gaps in public health policies need to be addressed to aid in the overall achievement of the sustainable development goals.

No MeSH data available.


Related in: MedlinePlus

Urine aspirate from supra-pubic puncture; showing adult worms of Schistosoma haematobium (white arrow) and a macroscopic haematuria (black arrow)
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Fig1: Urine aspirate from supra-pubic puncture; showing adult worms of Schistosoma haematobium (white arrow) and a macroscopic haematuria (black arrow)

Mentions: On day 2, the patient started having macroscopic hematuria with blockage of urinary catheter. A suprapubic puncture was done with extraction of several live worms which were confirmed to be S. haematobium in the laboratory (Fig. 1). The patient was then placed on praziquantel 40 mg/kg and hemodialysis.Fig. 1


Bladder outlet obstruction; a rare complication of the neglected schistosome, Schistosoma haematobium : two case reports and public health challenges
Urine aspirate from supra-pubic puncture; showing adult worms of Schistosoma haematobium (white arrow) and a macroscopic haematuria (black arrow)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5120452&req=5

Fig1: Urine aspirate from supra-pubic puncture; showing adult worms of Schistosoma haematobium (white arrow) and a macroscopic haematuria (black arrow)
Mentions: On day 2, the patient started having macroscopic hematuria with blockage of urinary catheter. A suprapubic puncture was done with extraction of several live worms which were confirmed to be S. haematobium in the laboratory (Fig. 1). The patient was then placed on praziquantel 40 mg/kg and hemodialysis.Fig. 1

View Article: PubMed Central - PubMed

ABSTRACT

Background: Schistosomiasis is a severe parasitic infestation with debilitating complications and is the third most devastating tropical disease in the world. It is one of the neglected tropical diseases (NTDs) with a high disease-burden. We present two rare cases of bladder outlet obstruction: one which led to a chronic kidney disease and ultimately death and a second which recovered after treatment with praziquantel.

Case presentations: A 72 year old male presented with lower urinary tract symptoms which culminated in an episode of acute urinary retention. The patient had never received preventive chemotherapy with praziquantel. After suprapubic aspiration, the cause of the obstructive uropathy was found to be several mature live worms of Schistosoma haematobium. Despite treatment with praziquantel and haemodialysis; we lost the patient due to sepsis from a urinary tract infection. In the second case, a 15 year old male presented with LUTS for a 1 year duration and was diagnosed to have schistosomiasis after eggs of Schistosoma haematobium were found in his urine. He was treated with praziquantel.

Conclusion: There are several gaps in the public health policies in place to control this NTD in Cameroon as annual distribution of preventive chemotherapy is inadequate due to inaccessibility of some high-endemic zones and is based on data obtained two decades ago. Population education is insufficient leading to poor health-seeking behaviour. These gaps in public health policies need to be addressed to aid in the overall achievement of the sustainable development goals.

No MeSH data available.


Related in: MedlinePlus