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2014 Research Abstract

Schistosoma haematobium and urinary tract infections among women in rural Malawi

Investigator: Patricia Carr Reese, George Washington University School of Medicine and Health Sciences

Mentor: Abigail Norris Turner, PhD

Background: Nearly 250 million people worldwide have schistosomiasis, a neglected tropical infection caused by parasites of the Schistosoma genus. In women, Schistosoma eggs lead to inflammation, granuloma formation, ulceration and bleeding in the sites where they deposit in the bladder, urethra and throughout the genital tract. Blockages and impeded urine flow from urinary schistosomiasis granulomas could make schistosomiasis‐infected women more likely to develop bacterial urinary tract infections (UTIs), compared to women who do not have schistosomiasis. This study aims to establish the prevalences of, and correlation between, urinary schistosomiasis and bacterial UTIs in the Bwenzi La Thanzi (‘Healthy Friend’) study, a convenience sample of 200 women presenting for care at a rural health clinic in central Malawi.

Methods: Eligible women are those 18-45, non-pregnant or currently menstruating, Chichewa speaking, Lilongwe district residents who were seeking care for any of a broad range of genitourinary symptoms. Urinary schistosomiasis was diagnosed by urine microscopy. UTIs were diagnosed by urine culture.

Results: Recruitment began in January 2015 and to date 166 participants have enrolled. Recruitment will continue until 200 patients have enrolled. Participants’ median age is 33 years (interquartile range (IQR): 28-39 years). Most participants (92%) are married and women reported a median of 3.5 children (IQR: 2-5 children). After urinating most participants (82.3%) cleanse and dry using only their petticoats and a majority reported cleansing themselves from back to front, rather than front to back after defecating (53.2%). To date, 1 woman has been positive for Schistosoma haematobium on urine microscopy. UTIs are common: 23% of participants were diagnosed with symptomatic UTIs via interview and urine cultures.

Conclusions: UTIs are common in this sample of care-seeking women in rural Malawi. Whether an association exists between genital schistosomiasis and increased UTI prevalence will be assessed when the full study sample has been enrolled.

Last modified: 9/11/2015

Updated on September 11, 2015.