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URINARY TRACT PATHOLOGY ATTRIBUTED TO SCHISTOSOMA HAEMATOBIUM: DOES PARASITE GENETICS PLAY A ROLE?

Disease outcome in persons infected with Schistosoma haematobium varies dramatically, ranging from mild symptoms to severe damage of the kidneys and/or bladder. We used ultrasonography to characterize the extent of urinary tract pathology of infected children in Zimbabwe, and random genetic markers to examine the relationship between genetic diversity of S. haematobium and clinical outcome. One hundred thirty-three parasite isolates from 12 students with mild lesions and 13 with severe lesions were compared. Using four randomly amplified polymorphic DNA (RAPD) markers, we scored parasite allelic frequencies at 53 loci. Although parasite heterogeneity did not differ, allelic frequencies at eight loci differed significantly between the mild and severe groups. Parasite isolates were analyzed further using a modified cluster analysis that segregated the population into 13 clusters of associated genotypes. Three clusters were significantly over-represented in children with severe lesions. Our findings, although preliminary, suggest that parasite genetic associations may be important in clinical outcome.

Received March 8, 2002. Accepted for publication December 9, 2002.

Acknowledgments: We thank the field staff of the Blair Research Laboratory who facilitated collection and processing of parasitologic samples. We are very grateful to the Chikwaka District Health Office, the staff of the Bosha Rural Health Centre, and the Nyagui, Chipangura, and Mavhudzi schools for their cooperation with our surveys. Thanks are due to the Japan International Cooperation Agency, which provided us with the ultrasound machine for examinations. Special thanks are given to Dr. Fred Lewis, Dr. Yung-San Liang, and Francis Barnes (Biomedical Research Institute, Rockville, MD) for providing snails and parasite material for the study.

Financial support: This work received financial support from the National Institutes of Health (grant 1 RO3 DK53207-01 and training grant T32 AI-07417) and the J. William Fulbright Fellowship program.

Authors’ addresses: Kimberly C. Brouwer and Clive J. Shiff, The W. Harry Feinstone Department of Molecular Microbiology & Immunology, Bloomberg School of Public Health, 615 N. Wolfe Street, Johns Hopkins University, Baltimore, MD 21205, Telephone: 410-955-1263, Fax: 410-955-0105, E-mail: cshiff{at}jhsph.edu. Patricia D. Ndhlovu and Anderson Munatsi, Blair Research Laboratory, Ministry of Health and Child Welfare, Harare, Zimbabwe. Yukiko Wagatsuma, Department of International Health, Bloomberg School Public Health, Johns Hopkins University, Baltimore, MD 21205.

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