{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T10:54:26Z","timestamp":1786964066629,"version":"build-2736575974"},"update-to":[{"DOI":"10.1371\/journal.pntd.0012991","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T00:00:00Z","timestamp":1746403200000}}],"reference-count":23,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T00:00:00Z","timestamp":1744243200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009139","name":"Deutsches Zentrum f\u00fcr Infektionsforschung","doi-asserted-by":"publisher","award":["CTP TTU 03.702."],"award-info":[{"award-number":["CTP TTU 03.702."]}],"id":[{"id":"10.13039\/100009139","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Historically, urinary tract pathology caused by <jats:italic>S. haematobium<\/jats:italic> infection was thought to affect predominantly school-age children (SAC) and adults. Increasing availability of ultrasound data from endemic areas demonstrates that even younger children develop potentially irreversible pathology.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methodology\/principal findings<\/jats:title>\n<jats:p>Point-of-care ultrasound for urinary schistosomiasis and urine microscopy were performed across age groups in 105 patients with symptomatic urogenital schistosomiasis in Lambar\u00e9n\u00e9, Gabon. Of 96 ultrasound scans with sufficient image quality, bladder wall thickening &gt; 5mm was found in 9\/20 (45%) preschool-age children (PSAC), 29\/51 (57%) SAC and 7\/25 (28%) adults. Upper urinary tract pathology was found in 19\/90 (21%) patients across age groups, up from three years of age. Urine egg counts were highest in PSAC, with high-intensity infection (\u2265 50 eggs\/10\u2009ml urine) in 19\/24 (79%) and hyper-infection (\u2265 500 eggs\/10\u2009ml urine) in 10\/24 (42%). Bladder wall thickening &gt; 5mm and upper urinary tract pathology correlated significantly with high-intensity infection with crude odds ratios of 8.6 (95% CI 3.1-23.8; p&lt;0.001) and 6.6 (95% CI 1.4-30.7; p=0.02), respectively. Three months after praziquantel treatment, parasitology showed a cure rate of 51% and egg reduction rate of 95%, while bladder wall thickening and upper urinary tract pathology persisted in 12\/41 (29%) and 7\/12 (58%) patients.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Conclusions\/significance<\/jats:title>\n<jats:p>A high proportion of PSAC in areas endemic for urogenital schistosomiasis already have detectable urinary tract pathology. Our findings highlight the urgent need to include this age group in mass drug administration programs, as recommended now by WHO. Further, particular attention should be paid to individual patient care.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0012991","type":"journal-article","created":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T17:33:02Z","timestamp":1744306382000},"page":"e0012991","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Point-of-care ultrasound reveals extensive pathology in Gabonese preschool-age children with urogenital schistosomiasis"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7493-5878","authenticated-orcid":true,"given":"Jonathan","family":"Remppis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anais","family":"Verheyden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayten","family":"Sultanli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amaya Lopez","family":"Bustinduy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Heller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayola Akim","family":"Adegnika","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin Peter","family":"Grobusch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Ramharter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Joekes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"B\u00e9lard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,4,10]]},"reference":[{"key":"pntd.0012991.ref001","author":"World Health Organization."},{"issue":"2","key":"pntd.0012991.ref002","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":"B Barda","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"issue":"4","key":"pntd.0012991.ref003","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.4269\/ajtmh.18-0343","article-title":"Ultrasound evolution of pediatric urinary schistosomiasis after treatment with praziquantel in a highly endemic area","volume":"99","author":"C Bocanegra","year":"2018","journal-title":"Am J Trop Med Hyg"},{"key":"pntd.0012991.ref004","doi-asserted-by":"crossref","first-page":"444","DOI":"10.3389\/fgene.2014.00444","article-title":"Schistosome and liver fluke derived catechol-estrogens and helminth associated cancers","volume":"5","author":"JM Correia da Costa","year":"2014","journal-title":"Front Genet"},{"issue":"9","key":"pntd.0012991.ref005","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1093\/trstmh\/trad020","article-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","volume":"117","author":"E Joekes","year":"2023","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"pntd.0012991.ref006","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":"AL Bustinduy","year":"2022","journal-title":"Adv Parasitol"},{"key":"pntd.0012991.ref007","author":"World Health Organization.","year":"2022"},{"key":"pntd.0012991.ref008","doi-asserted-by":"crossref","first-page":"106317","DOI":"10.1016\/j.actatropica.2022.106317","article-title":"Schistosomiasis in Gabon from 2000 to 2021 - A review","volume":"228","author":"JC Dejon-Agob\u00e9","year":"2022","journal-title":"Acta Trop"},{"issue":"1","key":"pntd.0012991.ref009","first-page":"38","article-title":"Focused Assessment with Sonography for Urinary Schistosomiasis (FASUS)-pilot evaluation of a simple point-of-care ultrasound protocol and short training program for detecting urinary tract morbidity in highly endemic settings","volume":"114","author":"J Remppis","year":"2020","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"pntd.0012991.ref010","first-page":"1","article-title":"The control of schistosomiasis. 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