Long term investigation of blood loss and egg load in urinary schistosomiasis in the adult African Bantu

Eight adult Bantu males from Southern Africa were selected, suffering from very severe urinary schistosomiasis (verified by cystoscopy) with persistent obvious haematuria. Urine was collected continuously in 12-hour periods, six subjects for 10 days, and two subjects for 19 days. The following are the salient findings (a) The colour of the urine is little guide to the amount of blood lost, and no guide to the number of eggs passed. (b) The average amount of blood lost is smaller than was expected; it varied from 1.3 to 6.1 ml. per diem. The haemoglobin levels of six subjects lay within normal limits; lower values were obtained with the two remaining subjects, who, however, also suffered from malaria. It is concluded that in urinary schistosomiasis in adult Bantu males, the amount of blood lost is insufficient to cause hypochromic anaemia, but it might well aggravate an anaemia due to other causes. (c) The number of eggs voided is subject to enormous fluctuation. One day there may be no eggs, and the next day tens of thousands. This irregularity once more draws attention to the unreliability of seeking to make a diagnosis of urinary schistosomiasis from single samples of urine.