Urological complications of endemic schistosomiasis in school-children

An account is given of the effects produced by endemic urinary schistosomiasis upon the children attending different schools in the Mwanza Region of Tanzania. At Usagara, where the incidence of infection rises to become 100% in the children of standard 4, up to 37% of the standard 6 pupils have irreversible lesions of the urinary tract. Nearby, where infection is less prevalent, there is a coincident decrease in lesions of the urinary tract. It is firmly established that the lesions—calcified bladder, deformity of the ureter, and hydronephrosis—are due to schistosomiasis, and that their prevalence is related to the weight of infection. Lesions occur even in the youngest examined, aged 6, but the prevalence of deformity of the ureter probably increases with age. There is a very marked and significant difference between boys and girls, hydronephrosis being much rarer in girls, but other lesions are equally common. On the basis of urological disease only, endemic urinary schistosomiasis has a considerable adverse effect on the economy of a country such as Tanzania where foci of disease are widespread. Pulmonary and systemic hypertension were not seen as complications of urinary schistosomiasis in the children studied, but pathological blood urea levels occur.