Comparative Studies on the Use of Microscopy and Polymerase Chain Reaction in Detection of Schistosoma haematobium Infections in Urine of School Children in Ohaukwu Local Government Area, Ebonyi State, Nigeria

Abstract

Schistosma haematobium infection remains a significant health challenge in the sub- Saharan Africa particularly Nigeria. Despite control efforts, the disease persists due to factors like climate and low sensitivity of some conventional diagnostic techniques. The study compared the diagnostic effectiveness of microscopy and polymerase chain reaction (PCR) in detecting Schistosoma haematobium infection among 570 school children aged 5-19 years in Ohaukwu Local Government Area of Ebonyi State Nigeria. The overall prevalence by microscopy was 15.1% (86/570), PCR detected a higher prevalence 65.8 % (100/152) in a sub-sample of microscopic positive and negative samples. PCR was more sensitive (92.1%) than microscopy (55.0%). All the positive urine specimen by microscopy were positive by PCR, while 14 negative urine samples by microscopy were positive by PCR technique. Males were more infected in both diagnostic techniques than their female counterparts. By microscopy, males had a prevalence of 17.9 % (55/308) while females had 11.8 % (31/262).  In PCR analysis, males showed a higher prevalence of 73.3 % (66/90) than females 54.8% (34/62). The difference was statistically significant (X2 =3.71; P-value = 0.05). The prevalence varied by age group with age 11-15 years 20.5 % 62/302) more infected  by microscopy, and those aged 16-19 years 100 % (1/1) more infected by PCR. The differences in prevalence by age group in both techniques were statistically significant (P=0.001). The finding suggest that PCR technique is a more superior technique and should be used in our tertiary hospitals for accurate diagnosis particularly in chronic and asymptomatic cases.