{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T10:40:35Z","timestamp":1791974435023,"version":"4.4.0"},"reference-count":34,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T00:00:00Z","timestamp":1645056000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Background: Schistosomiasis is a neglected tropical disease caused by helminths of the genus Schistosoma. Morbidity markers and cytological observations such as squamous metaplastic cells, inflammatory cells, and hyperkeratotic cells in the urine of S. haematobium-infected children may suggest disease severity. They may also help predict severe forms of clinical presentation, such as bladder cancer in later years, among infected ones who miss out on early detection and treatment. Insights into possible changes in the morbidity markers and cytological observations in the urine of these S. haematobium-infected children before and after treatment would be of high clinical importance. Aim: The aim of this study was to identify changes\/dynamics in morbidity markers and cytological abnormalities in the urine deposits of S. haematobium-infected children, pre- and post-praziquantel treatment. Methodology: This was a longitudinal study involving baseline and follow-up sampling among basic school children living in schistosomiasis-endemic communities. Urine samples were collected from 520 children at baseline and examined for S. haematobium ova by microscopy, while urine chemistry analyses were used for the examination of morbidity markers. The cytological analyses involved cytopathological examination of the urine deposits. Children whose urine showed positivity for S. haematobium eggs were treated with a single oral dose of praziquantel (40 mg\/kg), after which urine chemistry and cytological analyses were repeated weekly for comparison with baseline, until the eighth week. Results: Morbidity markers such as hematuria, proteinuria, and leukocyturia were detected both at baseline and post-treatment among the infected children (30\/520). Hematuria was the predominant parameter (90%, 27\/30) detected at baseline, followed by proteinuria (53.3%, 16\/30). Leukocyturia was the rarest parameter detected at baseline (13.3%, 4\/30). However, almost all these parameters declined gradually post-treatment. Regarding cytological analyses, inflammatory cells were observed most (70.0%, 21\/30) at baseline. For hyperkeratotic cells and squamous metaplastic cells, 46.7% and 26.7% were respectively observed at baseline, all of which gradually declined during the weekly follow-ups. Notably, squamous metaplastic cells persisted in all the participants from Week 1 through Week 3 post-treatment, but declined gradually thereafter. Conclusions: Morbidity markers and cytological observations in the children gradually decreased after treatment. Therefore, we continue to recommend routine cytological screening for urogenital schistosomiasis patients at hospitals in S. haematobium-endemic locations using both baseline and follow-up samples to detect these abnormalities early and monitor changes that may be occurring after treatment. Such changes may be useful in assessing treatment progress in infected persons.<\/jats:p>","DOI":"10.3390\/medsci10010014","type":"journal-article","created":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T20:25:45Z","timestamp":1645129545000},"page":"14","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Dynamics in Morbidity Markers and Cytological Observations Made in Urine of Schistosoma haematobium-Infected Children: Pre- and Post-Praziquantel Treatment in an Endemic Setting"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3344-4869","authenticated-orcid":false,"given":"Patience B.","family":"Tetteh-Quarcoo","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asamoah","family":"Ampong","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4491-6902","authenticated-orcid":false,"given":"Nicholas T. K. D.","family":"Dayie","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0617-5210","authenticated-orcid":false,"given":"John","family":"Ahenkorah","sequence":"additional","affiliation":[{"name":"Department of Anatomy, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilia A.","family":"Udofia","sequence":"additional","affiliation":[{"name":"Department of Community Health, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Afutu","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3643-4217","authenticated-orcid":false,"given":"Robert","family":"Aryee","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0946-8833","authenticated-orcid":false,"given":"Benjamin P.","family":"Niriwa","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0286-3638","authenticated-orcid":false,"given":"Fleischer C. N.","family":"Kotey","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana"},{"name":"FleRhoLife Research Consult, Teshie, Accra P.O. Box TS 853, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric S.","family":"Donkor","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick F.","family":"Ayeh-Kumi","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,17]]},"reference":[{"key":"ref_1","first-page":"7912186","article-title":"Cytological and Wet Mount Microscopic Observations Made in Urine of Schistosoma haematobium-Infected Children: Hint of the Implication in Bladder Cancer","volume":"2019","author":"Akuetteh","year":"2019","journal-title":"Can. J. Infect. Dis. Med. Microbiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"151","DOI":"10.4236\/ojmm.2013.33023","article-title":"Urinary Schistosomiasis in Children\u2014Still a Concern in Part of the Ghanaian Capital City","volume":"3","author":"Marian","year":"2013","journal-title":"Open J. Med. Microbiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1016\/S0140-6736(06)69440-3","article-title":"Human schistosomiasis","volume":"368","author":"Gryseels","year":"2006","journal-title":"Lancet"},{"key":"ref_4","first-page":"691","article-title":"Parasitic diseases and urban development","volume":"68","author":"Mott","year":"1990","journal-title":"Bull. WHO"},{"key":"ref_5","unstructured":"World Health Organization (W.H.O.) (2019, March 16). Schistosomiasis, Fact Sheet No. 115. Available online: http:\/\/www.who.int\/mediacentre\/factsheets\/fs115\/en\/index.html."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1016\/j.trstmh.2008.03.010","article-title":"Efficacy and side effects of Praziquantel treatment against Schistosoma haematobium infection among primary school children in Zimbabwe","volume":"102","author":"Midzi","year":"2008","journal-title":"Trans. R Soc. Trop. Med. Hyg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1017\/S003118201000154X","article-title":"Efficacy of two Praziquantel treatments among primary school children in an area of high Schistosoma mansoni endemicity, Nile Delta, Egypt","volume":"138","author":"Barakat","year":"2011","journal-title":"Parasitology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1128\/CMR.00046-07","article-title":"Current Status of Vaccines for Schistosomiasis","volume":"21","author":"McManus","year":"2008","journal-title":"Clin. Microbiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"74","DOI":"10.4269\/ajtmh.2011.10-0542","article-title":"Human Schistosomiasis resistance to Praziquantel in China: Should we be worried","volume":"85","author":"Wong","year":"2011","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_10","first-page":"222","article-title":"Genetic diversity among natural populations of Schistosoma haematobium might contribute to inconsistent virulence and diverse clinical outcomes","volume":"4","author":"Afifi","year":"2016","journal-title":"Jmau"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Tetteh-Quarcoo, P.B., Forson, P.O., Amponsah, S.K., Ahenkorah, J., Opintan, J.A., Ocloo, J.E.Y., Okine, E.N., Aryee, R., Afutu, E., and Anang, A.K. (2020). Persistent urogenital schistosomiasis and its associated morbidity in endemic communities within southern Ghana: Suspected praziquantel resistance or reinfection?. Med. Sci., 8.","DOI":"10.3390\/medsci8010010"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1721","DOI":"10.1093\/carcin\/21.9.1721","article-title":"Comparison of Genetic Changes in Schistosome-Related Transitional and Squamous Bladder Cancers Using Comparative Genomic Hybridization","volume":"21","author":"Muscheck","year":"2000","journal-title":"Carcinogen"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"320","DOI":"10.12927\/whp.2008.19581","article-title":"Squamous cell abnormalities in ex-foliated cells from urine of Schistosoma haematobium infected adults in a rural fishing community in Nigeria","volume":"10","author":"Akinwale","year":"2008","journal-title":"World Health Popul."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"207","DOI":"10.2478\/v10019-010-0042-8","article-title":"Urine and bladder washing cytology for detection of urothelial carcinoma: Standard test with new possibilities","volume":"44","author":"Flezar","year":"2010","journal-title":"Radiol. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1016\/S0090-4295(01)00920-7","article-title":"Evaluation of asymptomatic microscopic hematuria in adults: The American Urological Association best practice policy-part II: Patient evaluation, cytology, voided markers, imaging, cystoscopy, nephrology evaluation, and follow-up","volume":"57","author":"Grossfeld","year":"2001","journal-title":"Urology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"229","DOI":"10.21608\/jbaar.2017.126469","article-title":"The validity of haematuria and proteinuria by chemical reagent strip for diagnosis of Schistosoma haematobium infection","volume":"3","author":"Yameny","year":"2017","journal-title":"J. Biosci. Appl. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"390","DOI":"10.4111\/kju.2014.55.6.390","article-title":"A Comparison Between ThinPrep Monolayer and Cytospin Cytology for the Detection of Bladder Cancer","volume":"55","author":"Kim","year":"2014","journal-title":"Korean, J. Urol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/S0022-5347(17)67418-4","article-title":"Papanicolaou Examination of Urine in Diagnosis of Urinary Cancer. I. as a Test in Mass Screening","volume":"73","author":"Presti","year":"1955","journal-title":"J. Urol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1111\/j.1365-3156.2012.03054.x","article-title":"Simple questionnaire and urine reagent strips compared to microscopy for the diagnosis of Schistosoma haematobium in a community in northern Ghana","volume":"17","author":"Bogoch","year":"2012","journal-title":"Trop. Med. Int. Health"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1186\/1756-3305-5-298","article-title":"Dynamics of Schistosoma haematobium egg output and associated infection parameters following treatment with Praziquantel in school-aged children","volume":"5","author":"Stete","year":"2012","journal-title":"Parasites Vectors"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/0035-9203(79)90134-2","article-title":"The significance of proteinuria and haematuria in Schistosoma haematobium infection","volume":"73","author":"Wilkins","year":"1979","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.actatropica.2010.12.009","article-title":"Impact of Schistosoma haematobium infection on urinary tract pathology, nutritional status and anaemia in school-aged children in two different endemic areas of the Niger River Basin, Mali","volume":"120","author":"Sacko","year":"2011","journal-title":"Acta Tropica"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1172\/JCI117499","article-title":"Proteinuria in passive Heymann nephritis is associated with lipid peroxidation and formation of adducts on type IV collagen","volume":"94","author":"Neale","year":"1994","journal-title":"J. Clin. Investig."},{"key":"ref_24","first-page":"260","article-title":"A Novel Mouse Model of Schistosoma haematobium Egg-Induced Immunopathology","volume":"10","author":"Fu","year":"2012","journal-title":"PLoS Pathog."},{"key":"ref_25","first-page":"626","article-title":"Comparative Assessment of Health Benefits of Praziquantel Treat. of Urogenital Schistosomiasis in Pre-school Children and Primary School Aged Children","volume":"91","author":"Wami","year":"2016","journal-title":"Biomed. Reseach Int."},{"key":"ref_26","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."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"84","DOI":"10.4161\/viru.1.2.10487","article-title":"Schistosoma haematobium and bladder cancer","volume":"1","author":"Botelho","year":"2009","journal-title":"Virulence"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.7243\/2052-7896-3-1","article-title":"Tissue schistosomiasis in Accra Ghana: A retrospective histopathologic review at the Korle-bu Teaching Hospital (2004\u20132011)","volume":"3","author":"Der","year":"2015","journal-title":"Pathol. Discov."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1038\/nrm2146","article-title":"Metaplasia and trans-differentiation: From pure biology to the clinic","volume":"8","author":"Slack","year":"2007","journal-title":"Nat. Rev. Mol. Cell Biol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1017\/S0031182011000722","article-title":"Population genetics of Schistosoma haematobium: Development of novel microsatellite markers and their application to schistosomiasis control in Mali","volume":"138","author":"Gower","year":"2011","journal-title":"Parasitology"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/S0255-0857(21)02644-X","article-title":"Association of parasitic infection and cancer","volume":"23","author":"Khurana","year":"2005","journal-title":"Indian J. Med. Microbiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1016\/0035-9203(87)90158-1","article-title":"Haematuria and proteinuria during Schistosoma haematobium infection: Relationship to intensity of infection and the value of chemical reagent strips for pre-and post-treatment diagnosis","volume":"81","author":"Murare","year":"1987","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1126\/science.101.2629.519","article-title":"Urine sediment smears as a diagnostic procedure in cancers of the urinary tract","volume":"101","author":"Papanicolaou","year":"1945","journal-title":"Science"},{"key":"ref_34","unstructured":"Taylor, M.G. (1987). Immune Responses in Parasitic Infections: Trematodes and Cestodes, CRC Press."}],"container-title":["Medical Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3271\/10\/1\/14\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:21:37Z","timestamp":1760134897000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3271\/10\/1\/14"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,17]]},"references-count":34,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,3]]}},"alternative-id":["medsci10010014"],"URL":"https:\/\/doi.org\/10.3390\/medsci10010014","relation":{},"ISSN":["2076-3271"],"issn-type":[{"value":"2076-3271","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,17]]}}}