People in 77 different countries are infected with schistosomiasis. Ninety percent of these live in Africa and 300 million women and girls in Africa are at risk of getting infected. Female genital schistosomiasis is a poverty-related water-transmitted parasitic disease which may create gynaecological symptoms, contact bleeding, friable blood vessels and inflammation. Children have been found to have urinary manifestations such as dysuria, haematuria and increased urinary frequency. Up to 75 % of the women who excrete eggs from Schistosomiasis haematobium in the urine may also have eggs in the uterus, cervix, vagina or vulva. It has frequently been hypothesized that the granulomatous inflammation that occurs due to ova deposition in the genitals may be the cause of abdominal pain, lower back pain and dyspareunia. However, it is not known whether children have pain in the abdomen as a consequence of this disease. Our aim was to investigate whether abdominal pain could be a symptom of urogenital schistosomiasis in children.
Materials and methods:
This investigation was nested in a larger school based study and included 10-12 year old girls from 3 different primary schools in the Ugu district area. Abdominal palpations were performed in all girls who gave consent. The stool and urine were investigated for schistosomiasis and other helminths, urine dipsticks and bacterial cultures were performed.
There was no significant association between lower abdominal pain and infection with schistosomiasis (p=0.31) or with general abdominal pain (p=0.83).
This pilot study did not show that schistosomiasis is associated with abdominal pain. Since there are many reasons for abdominal pain in children, abdominal pain is probably not a useful indicator for urogenital schistosomiasis in children.