Ultrasound for detecting Schistosoma haematobium urinary tract complications: comparison with radiographic procedures

Chronic infection with Schistosoma haematobium primarily causes urinary tract complications. These lesions are often silent or ignored and not detected until irreversible changes have occurred. However, early chemotherapy can prevent progression and usually reverse all but the more severe abnormalities. Recently, abdominal ultrasound has been shown to be an inexpensive, portable and safe means of detecting schistosomal morbidity. A prospective study was performed on 40 patients comparing abdominal radiography, excretory urography (IVP), cystoscopy and ultrasound to detect urinary tract morbidity due to S. haematobium infection. Ultrasound was as sensitive as an IVP in detecting bladder masses, hydronephrosis and renal stones. It detected hydroureter less frequently (sensitivity 62.5%) than an IVP but visualized this lesion and hydronephrosis in some patients with nonfunctioning kidneys. Ultrasound demonstrated bladder stones as well as an x-ray but it detected bladder wall calcification with less sensitivity (65%) and was much less sensitive (12.5%) for detecting ureteral stones.