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Control of Morbidity Due to Schistosoma haematobium on Pemba Island: Egg Excretion and Hematuria as Indicators of Infection
The variability of Schistosoma haematobium egg excretion using a quantitative syringe filtration technique and the variability of hematuria detected visually and by reagent strips were studied in a population of 520 subjects from the village of Pujini (Pemba Island, Zanzibar, Tanzania) for 6 consecutive days. A high degree of day-to-day variability of egg excretion within subjects was found both in the whole population and in the 5–19 year age group. Subjects with 1 urinary egg count of ≥50 eggs/10 ml urine were not similarly classified in 36–61% of the other 5 examinations and 4–16% of their other examinations were negative. Gross hematuria had a specificity of almost 100%, when related to a positive filtration on any day, and was closely related to egg counts of ≥ 50 eggs/10 ml urine. The finding of a strongly positive reaction for hematuria on a given single day was closely associated with the subject having a high egg count (≥50 eggs/10 ml urine) on at least one of the 6 days of the study. At the primary health care level, single highly positive semiquantitative values for hematuria were a more useful diagnostic indicator than a single egg count to select patients with heavy infections for selective population chemotherapy.