Mild Haematuria among School Children in an Urban and Two ...

World Journal of Zoology 2 (2): 36-39, 2007
ISSN 1817-3098
© IDOSI Publications, 2007

Mild Haematuria among School Children in an Urban and
Two Rural Ijebu Communities, Southwest Nigeria

1O.M. Agbolade, 1N.C. Agu and 2G.C. Agu

1Parasitology and Medical Entomology Laboratory, Department of Plant Science and
Applied Zoology, Olabisi Onabanjo University, P.M.B. 2002, Ago-Iwoye, Ogun State, Nigeria
2Department of Microbiology, Olabisi Onabanjo University, P.M.B. 2002, Ago-Iwoye, Ogun State, Nigeria

Abstract: The occurrence of mild haematuria was investigated among school children in an urban and two rural
Ijebu communities of Ogun State, southwest Nigeria. A total of 921 (457 males, 464 females) school children
aged 3-18 years were interviewed using a questionnaire and had urine samples collected from them between
11.00 and 13.00 hrs from June 2005 to July 2006. Each urine sample was observed for gross haematuria and
thereafter tested for mild haematuria using a diagnostic reagent strip. The pooled prevalence of mild haematuria
was 22.6%. The prevalence of mild haematuria in the urban centre (16.9%) and the rural communities (26.9%)
were statistically similar (x2 = 2.28, P>0.05). The prevalence among males (23.9%) was not significantly different
from that among females (21.3%) (x2 = 0.15, P>0.05). 17% of the school children with mild haematuria indulged
in swimming and bathing in streams and ponds, 8.5% had experienced bloody urine, while 10.6% were swimming
and bathing in streams and ponds and had also experienced bloody urine. We concluded that reliable rapid
indirect diagnosis of Schistosoma haematobium infection in the study area will require a combination of history
of haematuria, observation of gross haematuria and testing for mild haematuria.

Key words: Urinary schistosomiasis haematuria diagnostic reagent strips indirect diagnosis Nigeria

INTRODUCTION hope that this study will elucidate the practicability of
indirect diagnosis in urinary schistosomiasis control in
Schistosomiasis is of great public health significance the study area.
in many tropical developing countries and children of
school-age are at high risk particularly because in them MATERIALS AND METHODS
the disease has its greatest prominence and pathological
effects [1, 2]. Although both Schistosoma mansoni and Study area: This consisted of Ijebu-Ode in Ijebu-Ode
S. haematobium infections exist in Nigeria, the latter is Local Government Area and Okun-Owa and Ijesha-Ijebu
more widespread. Recent reports from several parts of the in Odogbolu Local Government Area in Ijebu area of
country lend support to the claim of continued endemicity Ogun State, southwest Nigeria. The study area lies in the
of S. haematobium in Nigeria [3-5]. rainforest belt within latitudes 6°30' and 6°40' N,
longitudes 3°40' and 3°50' E.
Indirect diagnosis of urinary schistosomiasis through
the use of chemical reagent strips has been proven highly Ijebu-Ode is both urban and cosmopolitan, it is the
sensitive and specific in many endemic areas of the world headquarters of Ijebu-Ode Local Government Area and its
[1, 6]. Many studies in Nigeria have further validated the population consists of civil servants, artisans, traders and
usefulness and suitability of indirect diagnosis of urinary farmers. The town has one secondary health centre, many
schistosomiasis especially among school children [7-9]. public and private health centres and thirty public primary
schools. Okun-Owa and Ijesha-Ijebu are developing rural
This study aimed to study the epidemiology of communities whose inhabitants predominantly engage in
urinary schistosomiasis through haematuria detection subsistence farming. Okun-Owa has three public primary
among school children in an urban and two rural schools, one public secondary school, while Ijesha-Ijebu
communities in Ijebu area, southwest Nigeria. It is our

Corresponding Author: Dr. O.M. Agbolade, Parasitology and Medical Entomology Laboratory, Department of Plant Science and
Applied Zoology, Olabisi Onabanjo University, P.m.b. 2002, Ago-iwoye, Ogun State, Nigeria
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World J. Zool., 2 (2): 36-39, 2007

has one public primary school. Each of the last two Table 1: Prevalence of mild haematuria among the schools visited in Ijebu
communities has one public primary health centre and a
private clinic. division, southwest Nigeria

Potable water supply is infrequent in the three Schools No. examined No. (%) positive
communities. Therefore, the inhabitants usually rely on
streams (especially in the rural communities), wells, bore- St Jude’s Pry School, Ijesha-Ijebu 69 18 (26.1)
holes and rain water (in rainy season) for their domestic
water needs. Faecal disposal facilities used by the St Philips’ Pry School, Okun-Owa 73 24 (32.9)
inhabitants of all the communities include water closet,
pit latrine (commonest in the rural areas) and open St Barnabas’ Pry School, Okun-Owa 112 31 (27.7)
defaecation.
Moslem Pry School, Okun-Owa 97 31 (32.0)
Pre-survey protocols and study subjects: Prior to the
commencement of the study, permission was obtained Multilateral Grammar School, Okun-Owa 174 37 (21.3)
from the local education authority of each of the local
government areas. The head teacher and teachers of each Emmanuel Pry School, Ijebu-Ode 49 9 (18.4)
selected school were contacted and the parents and
pupils were adequately enlightened on the purpose of St Michael’s Pry School, Ijebu-Ode 61 11 (18.0)
the study. All the public schools in Okun-Owa, the public
primary school in Ijesha-Ijebu and eight randomly- CAC Pry School, Ijebu-Ode 52 8 (15.4)
selected public primary schools in Ijebu-Ode were
included in the study. The examined population size was Our Saviour’s Pry School, Ijebu-Ode 55 8 (14.5)
921 (457 males, 464 females) and their age range was
3-18 years. Wesley Pry School, Ijebu-0de 70 14 (20.0)

Questionnaire administration, sample collection and Otubu Memorial Pry School, Ijebu-Ode 50 6 (12.0)
examination: For each participating school child, a
questionnaire was administered to obtain information Joke Taiwo Pry School, Ijebu-Ode 27 5 (18.5)
such as age, sex, freshwater contact activities, presence of
blood in urine (bloody urine) and toilet facilities. Labelled Moslem Pry School, Ijebu-Ode 32 6 (18.8)
sterile specimen bottles were used to collect terminal
urine samples from the school children between 11.00 and Total 921 208 (22.6)
13.00 hrs from June 2005 to July 2006. Immediately after
collection, each sample was observed for visible (gross) 30 Males
haematuria. Subsequently, a diagnostic chemical reagent
strip (combi-screen 9) was dipped into each urine Females
sample. The reagent strip was read for mild haematuria by Total
comparing it with the diagnostic colour chart on the bottle 25
of the reagent strip between 60 and 120 seconds.
20
RESULTS
15
Out of the 921 school children whose urine samples
were tested in the study area 208 (22.6%) had mild 10
haematuria. The recorded prevalence of mild haematuria
in the rural areas (26.9%) was statistically similar to that in 5
the urban centre, Ijebu-Ode (16.9%) (x2 = 2.28, P>0.05).
Table 1 summarises the prevalence of mild haematuria 0 9-14 yrs 15-18 yrs
in the schools visited in this study. In both the rural 3-8 yrs
areas and the urban centre, there were no significant
Fig. 1: Prevalence of mild haematuria among genders and
age groups in Ijebu division, Southwest Nigeria

differences between the prevalences of mild haematuria
among the schools (x2 = 3.16, P>0.05; x2 = 3.02, P>0.05,
respectively).

Figure 1 shows the prevalence of mild haematuria
among genders and age groups in the study area. The
total prevalence among males (23.9%) was not
significantly different from that among females (21.3%)
(x2 = 0.15, P>0.05). The total prevalences among the age
groups were statistically similar (x2 = 0.98, P>0.05).

In the rural communities and the urban centre, 59.2%
and 56% of the school children interviewed, respectively
reported swimming and bathing in streams and ponds
(x2 = 0.09, P>0.05). 27.6% of the school children in the
rural communities fetched water from streams and ponds
for drinking and domestic purposes. Among the school
children positive for mild haematuria, 17% were swimming
and bathing in streams and ponds, 8.5% answered having

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World J. Zool., 2 (2): 36-39, 2007

experienced bloody urine, while 10.6% were swimming and human schistosome eggs thereby enhancing continual
bathing in streams and ponds and had experienced transmission [14]. The seemingly low practice of
bloody urine. 53.2% claimed that they were neither swimming and bathing among subjects with mild
swimming and bathing in streams nor experiencing bloody haematuria in this study would have been reinforced
urine. However, none of the urine samples collected in by other freshwater contact activities. For instance,
this study had gross haematuria and 1.5% of those tested water fetching from streams and ponds is common in
in the urban centre tested negative for mild haematuria the rural communities of the study area. In addition,
though they reported previous history of haematuria. it is common knowledge that children of school-age
have an innate flair for frequenting natural
DISCUSSION freshwater bodies [13, 14]. All these factors would have
contributed to the high prevalence of mild haematuria
The presence of mild haematuria among school in the study communities.
children in this study indicates S. haematobium
infection in the positive subjects, according to previously Effective, sustainable and cost-effective control of
established opinion [1, 6-8]. A recent study by the first schistosomiasis with an in-built rapid, cheap and reliable
author of this paper and his group revealed that some diagnostic approach has been consistently advocated
of those with mild haematuria in this study actually had for adoption in endemic regions [1, 2, 9]. The results of
S. haematobium in their faecal samples [10]. The recorded this study show that although some school children were
prevalence of mild haematuria in this study was high able to self-diagnose urinary schistosomiasis (which is a
compared to report from another part of Ogun State [4]. cheap way to diagnose the disease) many were
This discrepancy may be because the present study handicapped mainly because of the hideous nature of
included exclusively school children who are known to mild haematuria which may be indicative of low intensity
be more at risk of schistosomiasis than adults [2]. of S. haematobium infection in such children. However,
Also, the prevalences of mild haematuria in both the it is important to note that in some endemic communities
rural areas and the urban centre were higher than the some children infected with S. haematobium may test
ranges of reported haematuria recorded earlier by some negative for mild haematuria [15]. A similar observation
workers [11]. This is expected since diagnostic reagent was recorded in the present study. In view of the
strips detect not only gross, but also mild, haematuria foregoing, it is our opinion that reliable diagnosis of
which normally escape detection by visual urine urinary schistosomiasis in the study area will require a
observation. combination of history of haematuria, visual observation
of urine for gross haematuria and testing for mild
The similarity in the prevalence of mild haematuria in haematuria using diagnostic reagent strips.
the rural areas and the urban centre possibly shows, at
least, similar prevalence of S. haematobium among school ACKNOWLEDGEMENTS
children in the communities. The fact that both genders
had similar prevalence of mild haematuria conforms to We sincerely thank the local education authorities of
previous reports that S. haematobium infection is not Odogbolu and Ijebu-Ode Local Government areas of
gender-specific in many parts of Nigeria [3, 4]. It also Ogun State, southwest Nigeria, for their permission to
suggests that only S. haematobium infection can be carry out this study. We also appreciate the cooperation
implicated for the presence of blood in the urine of the of the heads, teachers, parents and children of the
affected children. Occurrence of haematuria in all the schools visited during the study.
tested age groups in this study agrees with the presence
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