Review of Recent Prevalence of Urogenital Schistosomiasis in Sub-Saharan Africa and Diagnostic Challenges in the Field Setting
Abstract
:1. Introduction
2. Recent Status of UGS in Sub-Saharan Africa
2.1. Overall Reports on Prevalence
2.2. Mapping Reports
2.3. Local Prevalence Reports
3. Diagnosis of UGS
3.1. Urine Microscopy
3.1.1. UM by Filtration
3.1.2. UM by Centrifugation
3.1.3. UM by or Mobile Phone Microscopy or SchistoScope
3.2. Detection of Hematuria
3.2.1. Detection of Microhematuria by Urine Reagent Strips
3.2.2. Macrohematuria
3.3. Serodiagnosis and Molecular Diagnosis of UGS
3.3.1. Serology
3.3.2. Molecular Diagnosis
Country | Urine Strip Test for Microhematuria | Gold-Standard (%) | References | ||||
---|---|---|---|---|---|---|---|
Positive Rate (%) | Sensitivity (%) | Specificity (%) | Positive Predictive Value | Negative Predictive Value | |||
Angola | 65.7 | 96.0 | 61.3 | 88.8 | UM 61.2 | [7] | |
Cameroon | 24.9 | 70.3 | 87.9 | UM 31.5 | [12] | ||
Ethiopia | 22.5 | 99.3 | 88.1 | 53.8 | 99.8 | UM 12.2 | [19] |
Ethiopia | 2.35 | 100 | 97.4 | UM 0.2 | [22] | ||
Tanzania | 9.3 | 78 | 99.8 | 97.8 | 97.8 | UM 7.4 | [62] |
0 | |||||||
48.0 | 96.6 | 82.6 | 77.8 | 97.4 | UM 38.7 | ||
Zimbabwe | 81 | 96.9 | 87.2 | 95.2 | Early SI | [78] | |
Zambia DDIA | 60 | UM 61% | [75] | ||||
IHA | 74 | ||||||
Meta-analysis | 81 | 89 | [89] | ||||
Tanzania | 26.6 | 75.0 | 75.7 | 18.4 | 97.6 | UM 6.8 | [90] |
Senegal | 23.1 | UM 20.3 qPCR 34.6 | [98] |
3.4. Ultrasound Scanning
4. Conclusions
Funding
Conflicts of Interest
Abbreviations
CAA | circulating anodic antigen |
CCA | circulating cathodic antigen |
ELISA | enzyme-linked immunosorbent assay |
IS | intestinal schistosomiasis |
KK | Kato–Katz |
LAMP | loop-mediated isothermal amplification |
MacH | macrohematuria |
M&E | monitoring and evaluation |
MDA | mass drug administration |
MDGs | millennium development goals |
MicH | microhematuria |
NGO | non-governmental organization |
NTDs | neglected tropical diseases |
PC | preventive chemotherapy |
PCR | polymerase chain reaction |
qPCR | quantitative polymerase chain reaction |
RPA | recombinase polymerase amplification |
SAC | school-aged children |
SCI | schistosomiasis control initiative |
SDGs | sustainable developmental goals |
SEA | soluble egg antigen |
SSA | sub-Saharan Africa |
UGS | urogenital schistosomiasis |
UM | urine microscopy |
UN | United Nations |
WHO | World Health Organization |
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Countries | No. of Treated People | No. of Treated SAC | SAC Coverage (%) | National Coverage (%) |
---|---|---|---|---|
Angola | 2,025,995 | 2,025,995 | 62.6 | 40.0 |
Benin | 755,772 | 755,772 | 79.5 | 28.6 |
Botswana | 364,502 | 364,502 | 86.3 | 25.7 |
Burkina Faso | 1,154,320 | 870,624 | 89.9 | 89.9 |
Burundi | 1,681,868 | 1,681,868 | 105.5 | 96.5 |
Cameroon | 2,766,864 | 2,766,864 | 83.7 | 51.1 |
Central African Republic | 106,940 | 106,940 | 68.4 | 6.5 |
Chad | 1,887,341 | 1,887,341 | 91.3 | 45.5 |
Congo | 79,859 | 79,859 | 70.2 | 18.5 |
Côte d’Ivoire | 2,328,781 | 1,904,844 | 85.4 | 56.7 |
Democratic Republic of Congo | 11,885,901 | 11,146,568 | 93.4 | 67.8 |
Egypt (2020) | 2,897,891 | 1,448,102 | 98.9 | 98.8 |
Eritrea | 374,853 | 168,590 | 95.3 | 82.8 |
Ethiopia | 3,562,162 | 3,071,245 | 84.2 | 23.0 |
Gambia | 63,011 | 37,607 | 46.6 | 13.6 |
Ghana | 2,792,184 | 2,792,184 | 79.5 | 24.1 |
Guinea | 2,192,543 | 2,192,543 | 91.8 | 45.4 |
Guinea-Bissau | 83,515 | 83,515 | 99.8 | 50.7 |
Kenya | 3,165,901 | 1,374,465 | 95.2 | 80.0 |
Liberia | 489,715 | 489,715 | 84.8 | 35.3 |
Madagascar (2020) | 2,705,026 | 2,676,453 | 80.4 | 27.3 |
Malawi | 2,780,558 | 1,431,603 | 82.6 | 30.6 |
Mali | 3,977,709 | 3,896,892 | 93.9 | 42.3 |
Mauritania | 141,370 | 141,370 | 86.7 | 15.2 |
Mozambique | 1,125,297 | 864,811 | 95.6 | 6.5 |
Namibia (2019) | 143,383 | 143,383 | 70.7 | 57.4 |
Niger | 6,943,175 | 2,748,014 | 92.8 | 65.2 |
Nigeria | 1,810,420 | 1,433,132 | 49.0 | 6.6 |
Rwanda | 2,856,299 | 1,027,010 | 98.4 | 94.8 |
Sao Tome and Principe | 17,322 | 17,322 | 90.2 | 42.8 |
Senegal | 1,845,926 | 1,482,743 | 95.6 | 64.1 |
Sierra Leone (2020) | 1,071,836 | 678,929 | 61.1 | 35.7 |
Somalia (2020) | 2,549,993 | 2,549,993 | 113.7 | 89.6 |
South Sudan | 12,461 | 8,067 | 66.1 | 0.4 |
Sudan (2019) | 3,058,201 | 2,483,677 | 55.0 | 37.9 |
Togo | 463,782 | 174,469 | 94.6 | 11.3 |
Uganda (2020) | 5,301,075 | 2,628,166 | 84.1 | 53.0 |
Tanzania | 9,374,223 | 8,209,186 | 82.2 | 51.6 |
Zambia | 1,925,614 | 1,925,614 | 80.0 | 43.8 |
Zimbabwe (2020) | 404,006 | 317,617 | 79.0 | 11.8 |
Countries | Studies | Subjects | No. of Examined | Positive Rate, % by | Year of Survey | Year of Publish | References | ||
---|---|---|---|---|---|---|---|---|---|
UM | MicH | MacH | |||||||
Angola | Mapping | SAC | 31,938 | 12.6 | 2018-9 | 2022 | [5] | ||
Cross-sectional | SAC | 17,093 | 5.0 | 13.6 | 2022 | [6] | |||
Cross-sectional | SAC | 1283 | 61.2 | 65.7 | 17.1 | 2013-4 | 2015 | [7] | |
Benin | Mapping | SAC | 19,250 | 17.56 | 2013-5 | 2019 | [8] | ||
Burkina Faso | Cross-sectional | SAC | 228 | 0 | 2021 | [9] | |||
Cameroon | Cross-sectional | Men | 89 | 31.4 | 2022 | [10] | |||
Cross-sectional | SAC | 389 | 32.6 | 24.4 | 2018 | 2021 | [11] | ||
Cross-sectional | Community residents | 778 | 31.5 | 24.9 | 2018 | 2021 | [12] | ||
Cross-sectional | Adults | 509 | 18.7 | 16.5 | 2019 | 2021 | [13] | ||
Chad | Cross-sectional | SAC | 11,832 | 100 | 55 | 2015-9 | 2022 | [14] | |
Cross-sectional | SAC + Ad | 258 | 39.2 | 58.9 | 2019 | 2022 | [15] | ||
Côte d’Ivoire | Cross-sectional | SAC | 170 | 20.6 | 2023 | [16] | |||
Cohort/ | SAC + Ad | 12,239 | 13.1 | 2015-9 | 2022 | [17] | |||
Cross-sectional | Ad | 901 | 1.0 | 2022 | [18] | ||||
Ethiopia | Cross-sectional | SAC | 1171 | 12.2 | 22.5 | 2022 | [19] | ||
Cross-sectional | SAC | 1288 | 31.6 | 32.1 | 2021-2 | 2022 | [20] | ||
Mapping | SAC | 15,133 | 0.13 | 2.8 | 2018-9 | 2022 | [21] | ||
Cross-sectional | SAC + Ad | 12,102 | 0.2 | 2.4 | 2022 | [22] | |||
Gabon | Cross-sectional | SAC | 451 | 26.3 | 2021 | [23] | |||
Longitudinal | SAC | 328 | 43 | 2019 | [24] | ||||
Longitudinal | SAC | 739 | 30.3 | 2012-4 | 2018 | [25] | |||
Gambia | Cross-sectional | SAC | 2016 | 10.2 | 18.0 | 0.5 | 2015 | 2021 | [26] |
Mapping | SAC | 10,434 | 4.2 | 2014 | 2021 | [27] | |||
Ghana | Cross-sectional | SAC | 336 | 12.8 | 2022 | [28] | |||
Cross-sectional | SAC | 520 | 6.5 | 2022 | [29] | ||||
Cross-sectional | SAC + Ad | 114 | 22.8 | 2022 | [30] | ||||
Cross-sectional | SAC | 309 | 10.4 | 2021 | [31] | ||||
Cross-sectional | SAC | 469 | 21.1 | 2021 | [32] | ||||
Cross-sectional | SAC + PSAC | 493 | 1.6 | 2021 | [33] | ||||
Kenya | Cross-sectional | Women | 534 | 3.8 | 2018 | 2022 | [34] | ||
Cross-sectional | SAC + Ad | 897 | 3.2 | [35] | |||||
Cross-sectional | Health center visitors | 451 | 15.1 | 2018 | 2020 | [36] | |||
Madagascar | Cross-sectional | SAC | 1958 | 30.5 | 2015 | 2016 | [37] | ||
Malawi | Cross-sectional | Fisherman | 129 | 20.9 | 2022 | [38] | |||
Cross-sectional | SAC | 240 | 24.0 | 2019 | 2020 | [39] | |||
Mozambique | Cross-sectional | SAC | 19,039 | 60.4 | 2011 | 2018 | [40] | ||
Niger | Cross-sectional | SAC + Ad | 48,192 | 15.7 | 2011 | 2020 | [41] | ||
54,451 | 8.8 | 2015 | 2020 | [41] | |||||
Nigeria | Cross-sectional | SAC | 250 | 15.2 | 2023 | [42] | |||
Cross-sectional | SAC | 5514 | 7.1 | 2019 | 2022 | [43] | |||
Cross-sectional | Pastoral community | 34.2 | 2.5 | 2022 | [44] | ||||
Cross-sectional | SAC | 279 | 67.4 | 29.7 | 2022 | [45] | |||
Cross-sectional | SAC | 777 | 1.7 | 11.6 | 2015-6 | 2022 | [46] | ||
Cross-sectional | SAC + Ad | 432 | 28.9 | 2020 | 2022 | [47] | |||
Cross-sectional | SAC | 487 | 34.1 | 2022 | [48] | ||||
Cross-sectional | SAC | 1113 | 13.7 | 13.7 | 2021 | [49] | |||
Cross-sectional | SAC | 2023 | 10.4 | 2021 | [50] | ||||
Cross-sectional | SAC | 466 | 19.1 | 2021 | [51] | ||||
Cross-sectional | SAC | 400 | 49.2 | 83.0 | 2021 | [52] | |||
Cross-sectional | SAC | 400 | 17.3 | 22.0 | 2021 | [53] | |||
Cross-sectional | SAC | 251 | 65.3 | 2018 | [54] | ||||
Senegal | Cross-sectional | Sac | 821 | 66.7 | 2018 | 2021 | [55] | ||
Cross-sectional | SAC Ad | 1285 300 | 54.2 32.0 | 2016-8 | 2020 | [56] | |||
South Africa | Cohort | SAC | 1976 | 16.9 | 2007-8 | 2020 | [57] | ||
Cross-sectional | SAC | 970 | 32.2 | 2010 | 2020 | [58] | |||
South Sudan | Cross-sectional | SAC | 13,286 | 3.7 | 2016-9 | 2022 | [59] | ||
Sudan | Longitudinal | SAC | 9.1/35.2 | 2020 | [60] | ||||
Mapping | SAC | 100,726 | 5.2 | 2016-7 | 2019 | [61] | |||
Tanzania | Cross-sectional | SAC + PSAC | 20,389 | 7.4 | 9.3 | 0.3 | 2019 | 2022 | [62] |
Hospital | Women | 216 | 2.3 | 2021 | 2022 | [63] | |||
Cross-sectional | SAC | 396 | 5.8 | 2022 | [64] | ||||
Cross-sectional | SAC | 649 | 52.7 | 46.2 | 13.1 | 2021 | 2022 | [65] | |
Cross | PSAC | 385 | 16.9 | 17.9 | 6 | 2021 | 2022 | [66] | |
Cross-sectional | Adolescents | 433 | 15.9 | 3.0 | 2022 | [67] | |||
Cross-sectional | SAC | 1288 | 31.6 | 32.1 | 2021-2 | 2022 | [68] | ||
Cross-sectional | SAC | 389 | 6.9 | 9.5 | 1.3 | 2022 | [69] | ||
Cross-sectional | SAC+ PSAC | 1560 | 0.83 | 0.9 | 2021 | [70] | |||
Cross-sectional | Women RA | 426 | 4.5 | 2019 | 2020 | [71] | |||
Mapping | Population-based subjects | 17,280 | 5.3 | 2006-7 | 2020 | [72] | |||
Cross-sectional | SAC Adult | 39,207 18,155 | 5.4 2.7 | 6.5 | 2013-6 | 2018 | [73] | ||
Zambia | Cross-sectional | SAC | 173 | 3.5 | 2022 | [74] | |||
Cross-sectional | SAC | 421 | 9.7 | 2022 | [75] | ||||
Cross-sectional | SAC | 243,148 | 61 | 2020 | [76] | ||||
Zimbabwe | Cross-sectional | PSAC | 136 | 22.1 | 2022 | [77] | |||
Cross-sectional | Pregnant women | 4437 | 10.6 | 24.4 | 2021 | [78] | |||
Longitudinal | PSAC | 204 | 19.6 | 2019 | 2021 | [79] | |||
Cross-sectional | SAC | 361 | 26.8 | 2020 | [80] | ||||
Cross-sectional | SAC | 12,656 | 17.6 | 2010-1 | 2020 | [81] | |||
Cross-sectional | PSAC | 416 | 35.1 | 2020 | [82] |
Diagnosis | Advantages | Limitations | Cost–Benefit Analysis |
---|---|---|---|
Urine microscopy | Standard method Familiar in most endemic areas High specificity (96.6–100%) | Low sensitivity (25.9–46.4%) Very low sensitivity in ultra-light infections (<10%) | Good Cheap cost Feasible |
CCA/CAA | High sensitivity (89%) and moderate specificity (55%) for intestinal schistosomiasis Good for field surveys in areas with ultra-light infection | Reliable for S. mansoni infections Not acceptable for diagnosis of UGS Cross reactions with other types of schistosomiasis Limited supply of the kit | Moderate Moderate cost Most feasible in the field setting for IS |
Urine reagent strips for microhematuria | High sensitivity (71–79%) High specificity (84–90%) Easy to implement | Not standard, supplementary to UM | Good Cheap cost Most feasible in the field setting for UGS |
Gross screening of macrohematuria | Cheap Easy High specificity Reflects acute infections | Low sensitivity (<10%) with numerous false-negative cases | Most cheap |
Serology (ELISA) | High sensitivity (87–96%) Optimal in non-endemic areas | Low specificity (31–32%) Not practical in the endemic field setting in SSA | Moderate Moderate cost Lab facilities required |
Molecular diagnosis (PCR, qPCR, and LAMP) | High sensitivity (>90%) High specificity (>95%) Optimal for setting gold standard Expensive reagents and high technique | Well-established lab support, not practical in the field setting Feasible for small-scale surveys | Poor Expensive method and feasible only in lab |
Ultrasound | High sensitivity (>80%) High specificity (>80%) Morbidity information of UGS on site Detection of other co-morbidities | Experienced sonographer Expensive sonograph Feasible for small-scale surveys | Poor Expensive method Feasible with a portable sonograph |
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Hong, S.-T. Review of Recent Prevalence of Urogenital Schistosomiasis in Sub-Saharan Africa and Diagnostic Challenges in the Field Setting. Life 2023, 13, 1670. https://doi.org/10.3390/life13081670
Hong S-T. Review of Recent Prevalence of Urogenital Schistosomiasis in Sub-Saharan Africa and Diagnostic Challenges in the Field Setting. Life. 2023; 13(8):1670. https://doi.org/10.3390/life13081670
Chicago/Turabian StyleHong, Sung-Tae. 2023. "Review of Recent Prevalence of Urogenital Schistosomiasis in Sub-Saharan Africa and Diagnostic Challenges in the Field Setting" Life 13, no. 8: 1670. https://doi.org/10.3390/life13081670