• 1

    Kabatereine NB, Ariho C, Christensen NO, 1992. Schistosoma mansoni in Pachwach, Nebbi-District, Uganda, 40 years after Nelson. Trop Med Parasitol 43 :162–166.

    • Search Google Scholar
    • Export Citation
  • 2

    Kabatereine NB, Brooker S, Tukahebwa EM, Kazibwe F, Onapa AW, 2004. Epidemiology and geography of Schistosoma mansoni in Uganda: implications for planning control. Trop Med Int Health 9 :372–380.

    • Search Google Scholar
    • Export Citation
  • 3

    Kabatereine NB, Tukahebwa EM, Kazibwe F, Namwangye H, Zaramba S, Brooker S, Stothard JR, Kamenka C, Whawell S, Webster JP, Fenwick A, 2005. Fresh from the field: countrywide control of schistosomiasis and soil-transmitted helminthiasis in Uganda. Trans R Soc Trop Med Hyg (in press).

  • 4

    Kabatereine NB, Kemijumbi J, Ouma JH, Sturrock RF, Butterworth AE, Madsen H, Ornbjerg N, Dunne DW, Vennnervald BJ, 2003. Efficacy and side effects of praziquantel treatment in a highly endemic Schistosoma mansoni focus at Lake Albert, Uganda. Trans R Soc Trop Med Hyg 97 :599–603.

    • Search Google Scholar
    • Export Citation
  • 5

    King CH, 2001. Epidemiology of schistosomiasis: determinants of transmission of infection. Mahmoud AAF, ed. Schistosomiasis. London: Imperial College Press, 115–132.

  • 6

    Montresor A, Crompton DWT, Gyorkos TW, Savioli L, 2002. Helminth Control in School-Age Children: A Guide for Managers of Control Programmes. Geneva: World Health Organization.

  • 7

    Chitsulo L, Engels D, Montresor A, Savioli L, 2000. The global status of schistosomiasis and its control. Acta Trop 77 :41–51.

  • 8

    Montresor A, Crompton DWT, Bundy DAP, Hall A, Savioli L, 1998. Guidelines for the Evaluation of Soil-Transmitted Helminthiasis and Schistosomiasis at the Community Level. Geneva: World Health Organization.

  • 9

    Guyatt H, Brooker S, Lwambo NJS, Siza JE, Bundy DAP, 1999. The performance of school- based questionnaires of reported blood in urine in diagnosing Schistosoma haematobium infection: patterns by age and sex. Trop Med Int Health 4 :751–757.

    • Search Google Scholar
    • Export Citation
  • 10

    Red Urine Study Group, 1995. Identification of High Risk Communities for Schistosomiasis in Africa: A Multi-Country Study. Social and Economic Research Projects no. 15. Geneva: World Health Organization.

  • 11

    Brooker S, Kabatereine NB, Clements ACA, Stothard JR, 2004. Schistosomiasis control. Lancet 363 :658–659.

  • 12

    Brooker S, Whawell S, Kabatereine NB, Fenwick A, Anderson RA, 2004. Evaluating the epidemiological impact of national control programmes for helminthes. Trends Parasitol 20 :537–545.

    • Search Google Scholar
    • Export Citation
  • 13

    Brown DS, 1994. Freshwater Snails of Africa and Their Medical Importance. Second edition. London: Taylor & Francis.

  • 14

    Kirkwood BR, Sterne JAC, 2003. Essential Medical Statistics. Second edition. London: Blackwell Science.

  • 15

    Hamilton JV, Klinkert M, Doenhoff MJ, 1998. Diagnosis of schistosomiasis: antibody detection, with notes on parasitological and antigen detection methods. Parasitology 117 :S41–S57.

    • Search Google Scholar
    • Export Citation
  • 16

    Engels D, Chitsulo L, Montresor A, Savioli L, 2002. The global epidemiological situation of schistosomiasis and new approaches to control and research. Acta Trop 82 :139–146.

    • Search Google Scholar
    • Export Citation
  • 17

    Utzinger J, Bergquist R, Xiao SH, Singer BH, Tanner M, 2003. Sustainable schistosomiasis control - the way forward. Lancet 362 :1932–1934.

    • Search Google Scholar
    • Export Citation





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  • 1 Wolfson Wellcome Biomedical Laboratories, Biomedical Parasitology Division, Department of Zoology, Natural History Museum, London, United Kingdom; Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College, London, United Kingdom; Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; Vector Control Division, Ministry of Health, Kampala, Uganda

A novel, inexpensive handheld microscope, the Meade Readiview, was evaluated for field diagnosis of intestinal schistosomiasis by comparison of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) against conventional compound microscopy as part of a parasitologic survey in nine sentinel schools and a rapid mapping survey across 22 schools in Uganda. Fecal smears from 685 primary school children were examined and the overall prevalence of Schistosoma mansoni was 45%. However, prevalence by school ranged widely from 0% to 100%. For individual diagnosis the Readiview had a sensitivity of 85%, a specificity of 96%, a PPV of 95%, and an NPV of 88%. Due to the poorer movement control of the glass slide on the Readiview stage, fecal smears with less than four eggs could be overlooked. At the highest magnification (160×), egg-like objects could be confounding. Estimating prevalence by school was usually within ± 7% of that of conventional microscopy. Since the Readiview is more robust and portable, both in size and weight, and one-tenth as expensive as the traditional compound microscope, a change in the logistics and costs associated with field infection surveillance is possible. This inexpensive microscope is a pragmatic alternative to the compound microscope. It could play an important role in the collection of prevalence data to better guide anthelmintic drug delivery and also empower the diagnostic capacity of peripheral health centers where compound microscopes are few or absent.

Author Notes

Reprint requests: J. Russell Stothard, Wolfson Wellcome Biomedical Laboratories, Biomedical Parasitology Division, Department of Zoology, Natural History Museum, Cromwell Road, London SW7 5BD, United Kingdom.