Urinalysis reagent strips in the screening of children for urinary schistosomiasis in the RSA.

The use of urinalysis reagent strips (Labstix; Ames) in screening for Schistosoma haematobium infection in various schistosomiasis-endemic areas of the RSA was assessed in 941 children. Sensitivity, specificity, false-positive and false-negative rates and the positive predictive value for haematuria and proteinuria were calculated. Both haematuria and proteinuria were positively correlated with the presence of S. haematobium eggs in the urine. Intensity of infection correlated positively with the degree of haematuria and proteinuria (P less than 0.001). The presence and intensity of S. haematobium infection were more closely related to the presence and degree of haematuria than to proteinuria. Screening for haematuria alone enabled 83.1% of S. haematobium-positive and 89.7% of negative subjects to be detected accurately. The false-positive rate was 2.7%. It was found that a single parameter, haematuria, could be used to identify infected children in endemic areas. It was also found to be possible to use the reagent strips to select out S. haematobium-infected children with egg counts greater than 200 ova/10 ml urine. The simple model developed allows rapid identification of moderately to heavily infected children and can be used by paramedical staff in field situations.