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Annals of Tropical Medicine & Parasitology

ISSN: 0003-4983 (Print) 1364-8594 (Online) Journal homepage: http://www.tandfonline.com/loi/ypgh19

Recovery of Schistosoma haematobium eggsin venous blood collected for diagnosis ofWuchereria bancrofti infection

C. N. Wamae & Y. Fujimaki

To cite this article: C. N. Wamae & Y. Fujimaki (1996) Recovery of Schistosoma haematobiumeggs in venous blood collected for diagnosis of Wuchereria bancrofti infection, Annals of TropicalMedicine & Parasitology, 90:1, 87-90, DOI: 10.1080/00034983.1996.11813030

To link to this article: http://dx.doi.org/10.1080/00034983.1996.11813030

Published online: 15 Nov 2016.

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Annals of Tropical Yledicine and Parasitology, Vol. 90, No. l, 87-90 (1996)

Recovery of Schistosoma haematobium eggs 1n venous blood collected for diagnosis of Wuchereria bancrofti infection

The Kenyan coast has long been known as an endemic area for schistosomiasis caused by Schistosoma haematobium. Shimada et al. (1987), for example, found that 68·2% of the subjects they studied in Mwachinga village, Kwale District, Kenya, had the disease, and gross haematuria is common in the local school children. In this area, S. haematobium co-exists with several other parasites of man, including Wuchereria bancrofii, which is endemic in most of the warm and humid areas of East Africa. Infection rates with the nematode seem to vary considerably with the endemic focus studied. In the most affected foci in Coastal Province, Kenya, 28·4%-56% of males aged > 14 years were found to carry microfilariae (mff) (Wijers, 1977). Estambale et al. ( 1994) found an overall prevalence of 13·7% in Vanga-Lunga Lunga Location in Kwale District, Kenya.

Adult W bancrofii are extremely difficult to detect. Although the search for improved methods for diagnosis of lymphatic filariasis has recently been the object of intensive research, routine diagnosis still relies on the demonstration of mff in blood samples. The mff are usually detected in Giemsa-stained blood smears but use of another method, membrane filtration, gives higher sensitivity and more accurate estimates of microfilarial density in the blood.

On five occasions, we have now found S. haematobium eggs on the nuclepore mem­branes used to detect W bancrofii mff in venous blood samples from those living in filariasis foci in the Kwale and Kilifi Districts of Kenya.

The first incident occurred in 1989 in a male patient from Mwachinga village, Kwale District, who had been found positive for S. haematobium in 1984 and 1989, prior to the filariasis screening. Examination of 20 111 finger-prick blood revealed that the patient was microfilaraemic and he was recruited into a

0003-4983/96/010087+04 SIZ.00/0

W bancrofii transmission study. On follow-up, 17 S. haematobium eggs were recovered on the nuclepore membrane used to filter 1 m! venous blood to harvest the mff present.

In 1991, S. haematobium eggs were also detected in two patients from Malindi, Kilifi District, who were participants in our W bancrofii periodicity study. In an attempt to detect infection with mff, a 60-jli sample of finger-prick blood was taken from each patient and one S. haematobium egg was detected on the nuclepore filter used for each, after exami­nation of the filtrate used for dehaemoglobin­ization of blood films (Gatika et al., 1994 ). Subsequently, 45 S. haematobium eggs were recovered on a nuclepore membrane used to filter 1 m! venous blood from one of these two patients; eggs were also found in a urine sample from the same patient.

Most recently, in March 1994, S. haemato­bium eggs were found in venous blood samples from two subjects living in Muhaka, Kwale District. One subject was found to have 38 eggs/10 ml urine and two eggs and seven mff/ml blood (Figs 1 to 3). The second, a microfilaraemic individual had 32 eggs/10 m! urine and two eggs/m! blood.

Deposition of S. haematobium eggs has been recorded in cutaneous sites in the genital and perigenital areas and in papular or nodular lesions on the neck, chest and abdominal wall. Skin biopsies of such lesions commonly show viable eggs (Mathelier-Fusade et al., 1991). Ectopic cutaneous lesions develop from ova that have been deposited by adult worms, either following direct venous invasion by the worms or by embolization of the eggs. There are several possible routes that the parasites may travel from the pelvic veins to the various ectopic sites Ooyce et al., 1972). However, we are unaware of any previous report of S. haematobium in venous blood and find this phenomenon puzzling, given the comparative

t'l 1996 LiYerpool School of Tropical !vledicine

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Fig. 1. Egg of Schistosoma haematobium (~)and microfilaria of Wuchereria bancrofti (---> ). Bar=200 Jlm.

Fig. 2. Egg of Schistosoma haematobium. Bar=25 Jlm.

diameters of S. haematobium eggs and of the blood vessels that they may traverse prior to deposition in veins.

Hatchability tests, to check viability, were not performed on any of the eggs recovered

from blood. It may be argued that egg detection in the filtered blood may have resulted from external contamination of the venipunctured area by the patient. However, S. haematobium eggs were found consistently

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SCHISTOSOME EGGS IN VENOUS BLOOD 89

Fig. 3. Microfilaria of Wuchereria bancrofti. Bar=25 ~-tm.

in repeated and careful blood samples from one of the patients in the Malindi study. Carry­over contamination is unlikely since we used new filter assemblies in both the Mwachinga and Malindi studies. As the number of membrane-filter screenings for W. bancrofii is increasing in regions where S. haematobium exists, the present finding may become much more common.

ACKNOWLEDGEMENTS. We thank the Director, Kenya Medical Research Institute (KEMRI), for his permission to publish this paper and Dr. M. L. Eberhard for help with the preparation of the photomicrographs. The W. bancrofii periodicity study was financially supported by the KEMRI/Japan International Co-operation Agency Project, and the investi­gations on W. bancrofii in Muhaka village received financial support from the UNDP I

World Bank/WHO Programme for Research in Tropical Diseases.

c. N. WAMAE* Centre for Microbiology Research, Kenya Medical Research Institute, P.O. Box 54840, Nairobi, Kenya

Y. FUJIMAKI Department of Parasitology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki-shi, Nagasaki 852, Japan

Received 25 July 1995, Accepted 8 August 1995

*Present address: Parasitic Diseases Branch, F -13, Centres for Disease Control, 4770 Buford Highway NE, Atlanta, GA 30341, U.S.A.

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EsTAMBALE, B. B. A., SIMONSEN, P. E., KNIGHT, R. & BwAYO,].]. (1994). Annals a_{ Tropical Medicine and Parasitology, 88, 145-151.

GATIKA, S. M., FUJIMAKI, Y., NJUGUNA, M. N., GACHIHI, G. S. & MBUGUA,]. M. (1994).Journal ofTropical Medicine and Hygiene, 97, 60-64.

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]oYCE, P. R., BLACKWELL,]. B. & CHARTERS, A. D. (1972). Australia and New Zealand Journal of Obstetrics and Gynecology, 12, 137-141.

MATHELIER-FUSADE, P., BEAULIUE-LACOSTE, I., CALLIEZ, D. & AUDEBERT, C. (1991). Annates de Dermatologie et Veneriologie 118, 715-717.

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