{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T20:01:30Z","timestamp":1774382490577,"version":"3.50.1"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2023,4,12]],"date-time":"2023-04-12T00:00:00Z","timestamp":1681257600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["AI-45473"],"award-info":[{"award-number":["AI-45473"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["TW\/ES01543"],"award-info":[{"award-number":["TW\/ES01543"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Complications of urogenital schistosomiasis include acute inflammatory and chronic fibrotic changes within the urogenital tract. Disease burden of this neglected tropical disease is often underestimated, as only active, urine egg-patent Schistosoma infection is formally considered. Previous studies have focussed on short-term effects of praziquantel treatment on urinary tract pathology, demonstrating that acute inflammation is reversible. However, the reversibility of chronic changes is less well studied.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Our study compared, at two time points 14\u2009y apart, urine egg-patent infection and urinary tract pathology in a cohort of women living in a highly endemic area having intermittent praziquantel treatment(s). In 2014 we matched 93 women to their findings in a previous study in 2000.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Between 2000 and 2014 the rate of egg-patent infection decreased from 34% (95% confidence interval [CI] 25 to 44) to 9% (95% CI 3 to 14). However, urinary tract pathology increased from 15% (95% CI 8 to 22) to 19% (95% CI 11 to 27), with the greatest increase seen in bladder thickening and shape abnormality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Despite praziquantel treatment, fibrosis from chronic schistosomiasis outlasts the presence of active infection, continuing to cause lasting morbidity. We suggest that future efforts to eliminate persistent morbidity attributable to schistosomiasis should include intensified disease management.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/trstmh\/trad020","type":"journal-article","created":{"date-parts":[[2023,4,12]],"date-time":"2023-04-12T09:10:09Z","timestamp":1681290609000},"page":"637-644","source":"Crossref","is-referenced-by-count":2,"title":["A 14-year follow-up of ultrasound-detected urinary tract pathology associated with urogenital schistosomiasis in women living in the Msambweni region of coastal Kenya"],"prefix":"10.1093","volume":"117","author":[{"given":"Elizabeth","family":"Joekes","sequence":"first","affiliation":[{"name":"Department of Radiology, Liverpool University Hospitals NHS Foundation Trust , Liverpool L7\u00a08XP , UK"},{"name":"Department of Clinical Sciences, Liverpool School of Tropical Medicine , Liverpool L3\u00a05QA , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate","family":"McMonnies","sequence":"additional","affiliation":[{"name":"Department of Tropical Disease Biology, Liverpool School of Tropical Medicine , Liverpool L3\u00a05QA , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Blanshard","sequence":"additional","affiliation":[{"name":"Department of Tropical Disease Biology, Liverpool School of Tropical Medicine , Liverpool L3\u00a05QA , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francis M","family":"Mutuku","sequence":"additional","affiliation":[{"name":"Department of Environment and Health Science, Technical University of Mombasa , Mombasa , Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edmund","family":"Ireri","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute, CCR Radiology Unit , Nairobi , Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Mungai","sequence":"additional","affiliation":[{"name":"Center for Global Health and Diseases, Case Western Reserve University, Cleveland , OH 44106 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J Russell","family":"Stothard","sequence":"additional","affiliation":[{"name":"Department of Tropical Disease Biology, Liverpool School of Tropical Medicine , Liverpool L3\u00a05QA , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amaya L","family":"Bustinduy","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, London School of Hygiene and Tropical Medicine , London WC1E\u00a07HT , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles H","family":"King","sequence":"additional","affiliation":[{"name":"Center for Global Health and Diseases, Case Western Reserve University, Cleveland , OH 44106 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,4,12]]},"reference":[{"issue":"48","key":"2023090112283566100_bib1","first-page":"621","article-title":"Schistosomiasis and soil-transmitted helminthiases: progress report, 2021","volume":"97","author":"World Health Organization","year":"2022","journal-title":"Wkly Epidemiol Rec"},{"issue":"4","key":"2023090112283566100_bib2","first-page":"1211","article-title":"Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990\u20132016: a systematic analysis for the Global Burden of Disease Study 2016","volume":"390","author":"GBD 2016 Disease Injury and Incidence and Prevalence Collaborators","year":"2017","journal-title":"Lancet"},{"issue":"2","key":"2023090112283566100_bib3","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.actatropica.2009.11.012","article-title":"Parasites and poverty: the case of schistosomiasis","volume":"113","author":"King","year":"2010","journal-title":"Acta Trop"},{"issue":"9936","key":"2023090112283566100_bib4","doi-asserted-by":"crossref","first-page":"2253","DOI":"10.1016\/S0140-6736(13)61949-2","article-title":"Human schistosomiasis","volume":"383","author":"Colley","year":"2014","journal-title":"Lancet"},{"key":"2023090112283566100_bib5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/bs.apar.2021.12.003","article-title":"An update on female and male genital schistosomiasis and a call to integrate efforts to escalate diagnosis, treatment and awareness in endemic and non-endemic settings: the time is now","volume":"115","author":"Bustinduy","year":"2022","journal-title":"Adv Parasitol"},{"issue":"4","key":"2023090112283566100_bib6","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1111\/j.1365-3024.2009.01098.x","article-title":"Immunopathogenesis of human schistosomiasis","volume":"31","author":"Burke","year":"2009","journal-title":"Parasite Immunol"},{"issue":"1","key":"2023090112283566100_bib7","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1111\/j.0105-2896.2004.00176.x","article-title":"Immunopathogenesis of schistosomiasis","volume":"201","author":"Wynn","year":"2004","journal-title":"Immunol Rev"},{"issue":"4","key":"2023090112283566100_bib8","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1148\/rg.324115162","article-title":"Genitourinary schistosomiasis: life cycle and radiologic-pathologic findings","volume":"32","author":"Shebel","year":"2012","journal-title":"Radiographics"},{"issue":"6","key":"2023090112283566100_bib9","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.4269\/ajtmh.2011.11-0282","article-title":"Learning curve of vesico-urinary ultrasonography in Schistosoma haematobium infection with WHO practical guide: a \u201csimple to learn\u201d examination","volume":"85","author":"Bonnard","year":"2011","journal-title":"Am J Trop Med Hyg"},{"issue":"1","key":"2023090112283566100_bib10","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1007\/s00345-011-0751-7","article-title":"Urologic complications of genitourinary schistosomiasis","volume":"30","author":"Khalaf","year":"2012","journal-title":"World J Urol"},{"issue":"5)","key":"2023090112283566100_bib11","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1086\/520522","article-title":"Lifting the burden of schistosomiasis\u2014defining elements of infection-associated disease and the benefits of antiparasite treatment","volume":"196","author":"King","year":"2007","journal-title":"J Infect Dis"},{"key":"2023090112283566100_bib12","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/S0065-308X(01)48007-9","article-title":"The use of ultrasound in schistosomiasis","volume":"48","author":"Hatz","year":"2001","journal-title":"Adv Parasitol"},{"issue":"9\u201310","key":"2023090112283566100_bib13","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1111\/pim.12040","article-title":"The use of imaging to detect schistosomes and diagnose schistosomiasis","volume":"35","author":"Skelly","year":"2013","journal-title":"Parasite Immunol"},{"issue":"4","key":"2023090112283566100_bib14","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1007\/s00436-015-4389-z","article-title":"The WHO ultrasonography protocol for assessing morbidity due to Schistosoma haematobium. Acceptance and evolution over 14 years. Systematic review","volume":"114","author":"Akpata","year":"2015","journal-title":"Parasitol Res"},{"key":"2023090112283566100_bib15","author":"Richter","year":"2000","journal-title":"Ultrasound in schistosomiasis: a practical guide to the standardized use of ultrasonography for the assessment of schistosomiasis-related morbidity"},{"issue":"2","key":"2023090112283566100_bib16","doi-asserted-by":"crossref","first-page":"e0005400","DOI":"10.1371\/journal.pntd.0005400","article-title":"Ultrasonographic evaluation of urinary tract morbidity in school-aged and preschool-aged children infected with Schistosoma haematobium and its evolution after praziquantel treatment: a randomized controlled trial","volume":"11","author":"Barda","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"issue":"5","key":"2023090112283566100_bib17","doi-asserted-by":"crossref","first-page":"775","DOI":"10.4269\/ajtmh.1998.59.775","article-title":"Evolution of Schistosoma haematobium-related pathology over 24 months after treatment with praziquantel among school children in southeastern Tanzania","volume":"59","author":"Hatz","year":"1998","journal-title":"Am J Trop Med Hyg"},{"issue":"6","key":"2023090112283566100_bib18","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1086\/314786","article-title":"Resolution and resurgence of Schistosoma haematobium-induced pathology after community-based chemotherapy in Ghana, as detected by ultrasound","volume":"179","author":"Wagatsuma","year":"1999","journal-title":"J Infect Dis"},{"issue":"6","key":"2023090112283566100_bib19","doi-asserted-by":"crossref","first-page":"taab122","DOI":"10.1093\/jtm\/taab122","article-title":"Prospective cohort study using ultrasonography of Schistosoma haematobium-infected migrants","volume":"28","author":"Tamarozzi","year":"2021","journal-title":"J Travel Med"},{"issue":"Suppl 4","key":"2023090112283566100_bib20","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1590\/S0074-02761992000800031","article-title":"Age-targeted chemotherapy for control of urinary schistosomiasis in endemic populations","volume":"87","author":"King","year":"1992","journal-title":"Mem Inst Oswaldo Cruz"},{"issue":"2","key":"2023090112283566100_bib21","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1177\/0049475513490422","article-title":"Sonographic response in the liver and urinary bladder of children 14 months after treatment for schistosomiasis","volume":"43","author":"Strahan","year":"2013","journal-title":"Trop Doct"},{"issue":"3","key":"2023090112283566100_bib22","doi-asserted-by":"crossref","first-page":"476","DOI":"10.4269\/ajtmh.1999.61.476","article-title":"Long-term suppression of adult bladder morbidity and severe hydronephrosis following selective population chemotherapy for Schistosoma haematobium","volume":"61","author":"Subramanian","year":"1999","journal-title":"Am J Trop Med Hyg"},{"issue":"5","key":"2023090112283566100_bib23","doi-asserted-by":"crossref","first-page":"e685","DOI":"10.1371\/journal.pntd.0000685","article-title":"The impact of Schistosoma japonicum infection and treatment on ultrasound-detectable morbidity: a five-year cohort study in southwest China","volume":"4","author":"Carlton","year":"2010","journal-title":"PLoS Negl Trop Dis"},{"issue":"2","key":"2023090112283566100_bib24","doi-asserted-by":"crossref","first-page":"371","DOI":"10.4269\/ajtmh.15-0153","article-title":"Case-control study of posttreatment regression of urinary tract morbidity among adults in Schistosoma haematobium-endemic communities in Kwale County, Kenya","volume":"93","author":"Magak","year":"2015","journal-title":"Am J Trop Med Hyg"},{"issue":"2","key":"2023090112283566100_bib25","doi-asserted-by":"crossref","first-page":"359","DOI":"10.4269\/ajtmh.2005.73.359","article-title":"Late benefits 10\u201318 years after drug therapy for infection with Schistosoma haematobium in Kwale District, Coast Province, Kenya","volume":"73","author":"Ouma","year":"2005","journal-title":"Am J Trop Med Hyg"},{"issue":"2","key":"2023090112283566100_bib26","doi-asserted-by":"crossref","first-page":"e0005372","DOI":"10.1371\/journal.pntd.0005372","article-title":"Decline in infection-related morbidities following drug-mediated reductions in the intensity of Schistosoma infection: a systematic review and meta-analysis","volume":"11","author":"Andrade","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"issue":"5 Suppl","key":"2023090112283566100_bib27","doi-asserted-by":"crossref","first-page":"127","DOI":"10.4269\/ajtmh.1996.55.127","article-title":"Dynamics and control of Schistosoma haematobium transmission in Kenya: an overview of the Msambweni Project","volume":"55","author":"Muchiri","year":"1996","journal-title":"Am J Trop Med Hyg"},{"issue":"1","key":"2023090112283566100_bib28","doi-asserted-by":"crossref","first-page":"83","DOI":"10.4269\/ajtmh.2006.75.83","article-title":"Factors affecting infection or reinfection with Schistosoma haematobium in coastal Kenya: survival analysis during a nine-year, school-based treatment program","volume":"75","author":"Satayathum","year":"2006","journal-title":"Am J Trop Med Hyg"},{"issue":"2)","key":"2023090112283566100_bib29","first-page":"217","article-title":"Sonographic screening for urinary tract abnormalities in patients with Schistosoma haematobium infection: pitfalls in examining pregnant women","volume":"74","author":"Richter","year":"1996","journal-title":"Bull World Health Org"},{"issue":"1","key":"2023090112283566100_bib30","doi-asserted-by":"crossref","first-page":"57","DOI":"10.4269\/ajtmh.2004.70.57","article-title":"Low heritable component of risk for infection intensity and infection-associated disease in urinary schistosomiasis among Wadigo village populations in Coast Province, Kenya","volume":"70","author":"King","year":"2004","journal-title":"Am J Trop Med Hyg"},{"issue":"4","key":"2023090112283566100_bib31","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1038\/ki.1985.62","article-title":"Circadian variation of ova excretion, proteinuria, haematuria, and leukocyturia in urinary schistosomiasis","volume":"27","author":"Doehring","year":"1985","journal-title":"Kidney Int"},{"key":"2023090112283566100_bib32","volume-title":"Basic laboratory methods in medical parasitology","author":"World Health Organization","year":"1991"},{"issue":"3","key":"2023090112283566100_bib33","doi-asserted-by":"crossref","first-page":"133","DOI":"10.4269\/ajtmh.2000.63.133","article-title":"Predisposition to urinary tract epithelial metaplasia in Schistosoma haematobium infection","volume":"63","author":"Hodder","year":"2000","journal-title":"Am J Trop Med Hyg"},{"issue":"2","key":"2023090112283566100_bib34","doi-asserted-by":"crossref","first-page":"212","DOI":"10.4269\/ajtmh.1989.41.212","article-title":"Effects of borehole wells on water utilization in Schistosoma haematobium endemic communities in Coast Province, Kenya","volume":"41","author":"el Kholy","year":"1989","journal-title":"Am J Trop Med Hyg"},{"issue":"1","key":"2023090112283566100_bib35","doi-asserted-by":"crossref","first-page":"162","DOI":"10.4103\/1319-2442.106362","article-title":"Ultrasound findings in urinary schistosomiasis infection in school children in the Gezira State Central Sudan","volume":"24","author":"Elmadani","year":"2013","journal-title":"Saudi J Kidney Dis Transpl"},{"issue":"Suppl 1","key":"2023090112283566100_bib36","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1590\/S0074-02762002000900028","article-title":"Ultrasound monitoring of structural urinary tract disease in S. haematobium infection","volume":"97","author":"King","year":"2002","journal-title":"Mem Inst Oswaldo Cruz"},{"issue":"2","key":"2023090112283566100_bib37","doi-asserted-by":"crossref","first-page":"92","DOI":"10.4103\/1115-3474.164865","article-title":"Pattern of urinary bladder sonographic findings in patients evaluated for urinary schistosomiasis","volume":"22","author":"Ma'aji","year":"2015","journal-title":"West Afr J Radiol"},{"issue":"4","key":"2023090112283566100_bib38","doi-asserted-by":"crossref","first-page":"e2807","DOI":"10.1371\/journal.pntd.0002807","article-title":"Diagnostic performance of Schistosoma real-time PCR in urine samples from Kenyan children infected with Schistosoma haematobium: day-to-day variation and follow-up after praziquantel treatment","volume":"8","author":"Vinkeles Melchers","year":"2014","journal-title":"PLoS Negl Trop Dis"},{"issue":"3","key":"2023090112283566100_bib39","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/S0001-706X(02)00262-0","article-title":"Epidemiological assessment of Schistosoma haematobium-induced kidney and bladder pathology in rural Zimbabwe","volume":"85","author":"Brouwer","year":"2003","journal-title":"Acta Trop"},{"issue":"4","key":"2023090112283566100_bib40","doi-asserted-by":"crossref","first-page":"361","DOI":"10.4269\/ajtmh.1988.39.361","article-title":"Urinary tract morbidity in schistosomiasis haematobia: associations with age and intensity of infection in an endemic area of Coast Province, Kenya","volume":"39","author":"King","year":"1988","journal-title":"Am J Trop Med Hyg"},{"issue":"10","key":"2023090112283566100_bib41","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1586\/eri.11.101","article-title":"Improving diagnosis of urogenital schistosome infection","volume":"9","author":"Mutapi","year":"2011","journal-title":"Expert Rev Anti Infect Ther"},{"issue":"11","key":"2023090112283566100_bib42","doi-asserted-by":"crossref","first-page":"2020","DOI":"10.1086\/425579","article-title":"Increased ratio of tumor necrosis factor-alpha to interleukin-10 production is associated with Schistosoma haematobium-induced urinary-tract morbidity","volume":"190","author":"Wamachi","year":"2004","journal-title":"J Infect Dis"},{"key":"2023090112283566100_bib43","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1186\/1471-2334-9-189","article-title":"A comparison of urinary tract pathology and morbidity in adult populations from endemic and non-endemic zones for urinary schistosomiasis on Unguja Island, Zanzibar","volume":"9","author":"Lyons","year":"2009","journal-title":"BMC Infect Dis"},{"issue":"9","key":"2023090112283566100_bib44","doi-asserted-by":"crossref","first-page":"615","DOI":"10.2471\/BLT.20.252270","article-title":"Integration of prevention and control measures for female genital schistosomiasis, HIV and cervical cancer","volume":"98","author":"Engels","year":"2020","journal-title":"Bull World Health Org"},{"issue":"4","key":"2023090112283566100_bib45","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.pt.2013.02.001","article-title":"Schistosomiasis in African infants and preschool children: let them now be treated!","volume":"29","author":"Stothard","year":"2013","journal-title":"Trends Parasitol"}],"container-title":["Transactions of The Royal Society of Tropical Medicine and Hygiene"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/trstmh\/article-pdf\/117\/9\/637\/51326791\/trad020.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/trstmh\/article-pdf\/117\/9\/637\/51326791\/trad020.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T15:06:24Z","timestamp":1693580784000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/trstmh\/article\/117\/9\/637\/7115603"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,12]]},"references-count":45,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,4,12]]},"published-print":{"date-parts":[[2023,9,1]]}},"URL":"https:\/\/doi.org\/10.1093\/trstmh\/trad020","relation":{},"ISSN":["0035-9203","1878-3503"],"issn-type":[{"value":"0035-9203","type":"print"},{"value":"1878-3503","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,9]]},"published":{"date-parts":[[2023,4,12]]}}}