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Late benefits of remote antischistosomal therapy were estimated among long-term residents of an area with high transmission of Schistosoma haematobium (Msambweni, Kenya) by comparing infection and disease prevalence in two local adult cohorts. We compared 132 formerly treated adults (given treatment in childhood or adolescence 
10 years previously) compared with 132 age- and sex-matched adults from the same villages who had not received prior treatment. The prevalence of current infection, hematuria, and ultrasound bladder abnormalities were significantly lower among the previously treated group, who were found to be free of severe bladder disease. Nevertheless, heavy infection was equally prevalent (2–3%) in both study groups, and present rates of hydronephrosis were not significantly different. Therapy given in childhood or adolescence appears to improve risk for some but not all manifestations of S. haematobium infection in later adult life. Future prospective studies of continued treatment into adulthood will better define means to obtain optimal, community-based control of S. haematobium-related disease in high-risk locations.
Received July 6, 2004. Accepted for publication February 28, 2005.
Acknowledgments: We thank the people of Milalani, Marigiza, Mabatani, Vindungeni, and Nganja for their participation in this study. We also thank Anthony Chome, Charles Nganga, Jackson Muinde, Robin Bundi, Idi Masemo, and Joyce Bongo for their invaluable contributions to the field work, and Grace Nguma for data entry and management. We offer appreciation for the help of Dr. Philip Muthoka (Medical Officer of Health, Kwale District), and the Director of Medical Services, Ministry of Health, Kenya for permission to publish this paper.
Financial support: This research was supported by the National Institute of Health International Center for Infectious Diseases Research Program (AI45473, National Institute of Allergy and Infectious Diseases).
* Address correspondence to Dr. Charles H. King, Center for Global Health and Diseases, Wolstein 4126, Case Western Reserve University School of Medicine, 10900 Euclid Avenue, Cleveland, OH 44106-7286. E-mail: chk{at}po.cwru.edu
Authors’ addresses: John H. Ouma, Biomedical Sciences and Technology Programme, Maseno University, Private Bag, Maseno, Kenya, Telephone: 254-733-725721, Fax: 254-20-2725833, E-mail: ouma{at}wananchi.com. Charles H. King, Center for Global Health and Diseases, Wolstein 4126, Case Western Reserve University School of Medicine, 10900 Euclid Avenue, Cleveland, OH 44106-7286, Telephone: 216-368-4818, Fax: 216-368-4825, E-mail: chk{at}.po.cwru.edu. Eric M. Muchiri and Peter Mungai, Division of Vector Borne Diseases, Ministry of Health, PO Box 20750, Nairobi, Kenya, Telephone: 254-20-725833, Fax: 254-20-720030, E-mails: schisto{at}wananchi.com Davy K. Koech and Edmund Ireri, Kenya Medical Research Institute, Mbagathi Road, Nairobi, Kenya, Telephone: 254-20-722541, Fax: 254-20-720030. Philip Magak, City X-Ray Services, PO Box 20930, Nairobi, Kenya, Telephone: 254-20-241105, Fax: 254-20-725624, E-mail: magak{at}insightkenya.com. Hilda Kadzo, Department of Radiology, Kenyatta National Hospital, Nairobi, Kenya, Telephone: 254-20-711888.
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