A Comparative Diagnosis of Urinary Schistosomiasis in Patients from Primary Healthcare Centers in Keffi, North Central Nigeria, Using Microscopy and PCR

Abstract

Aims: This study was conducted to compare the diagnosis of urinary schistosomiasis by microscopy and PCR in patients in some selected primary healthcare centres in Keffi, North Central Nigeria. Study Design: The study was a cross sectional study. Place and Duration of Study: Keffi, Nasarawa State, between March 2021 and September 2021. Methodology: Urine samples were collected from 200 patients (29 samples from 29 patients, each from Gidan Zakara, Sabon Gida, Jigwada, Angwan Jaba and 28 samples from 28 patients, each from Kowa, Kaibo Mada and Yarkadai PHCs). Patients’ demographic information was obtained using structured questionnaires. The ova of S. haematobium were detected microscopically in the samples using the standard sedimentation technique. The DNA of S. haematobium was extracted from the samples, amplified and detected by conventional PCR technique using type-specific primers and analysed in a 1.5% agarose gel stained with ethidium bromide. The collected data were analysed using Smith’s Statistical Package (version 2.8, California, USA), with a P value of ≤ 0.05 considered statistically significant, and Cohen’s Kappa (κ) used to assess the level of agreement between the two diagnostic methods. Results: Out of the 200 samples screened, 86 (43.0%) were males while the remaining 114 (57.0%) were females. Of them, 6 (3.0%) and 15 (7.5%) were positive for urinary schistosomiasis by microscopy and PCR respectively indicating fair agreement between the two diagnostic methods (κ=0.3142). There was significant association between gender and urinary schistosomiasis (P<0.05), as more males were infected (microscopy: 5.8%, PCR: 15.1%) than their female counterparts (microscopy: 0.9%, PCR: 1.8%). Although both age and occupation of patients were not significantly associated with the infection (P>0.05), pupil/students (microscopy: 9.1%, PCR: 29.5%) aged ≤14years (microscopy: 8.0%, PCR: 18.0%) were mostly infected. Conclusion: Our results show variations between the two diagnostic techniques, with PCR detecting higher rates of urinary schistosomiasis confirming it to be a more sensitive method for diagnosing the infection. Although the findings suggest fair agreement between the two methods, continued efforts to improve diagnostic accuracy are essential for effective disease management.