Bladder outlet obstruction; a rare complication of the neglected schistosome, Schistosoma haematobium: two case reports and public health challenges.
BACKGROUND
Schistosomiasis is a severe parasitic infestation with debilitating complications and is the third most devastating tropical disease in the world. It is one of the neglected tropical diseases (NTDs) with a high disease-burden. We present two rare cases of bladder outlet obstruction: one which led to a chronic kidney disease and ultimately death and a second which recovered after treatment with praziquantel.


CASE PRESENTATIONS
A 72 year old male presented with lower urinary tract symptoms which culminated in an episode of acute urinary retention. The patient had never received preventive chemotherapy with praziquantel. After suprapubic aspiration, the cause of the obstructive uropathy was found to be several mature live worms of Schistosoma haematobium. Despite treatment with praziquantel and haemodialysis; we lost the patient due to sepsis from a urinary tract infection. In the second case, a 15 year old male presented with LUTS for a 1 year duration and was diagnosed to have schistosomiasis after eggs of Schistosoma haematobium were found in his urine. He was treated with praziquantel.


CONCLUSION
There are several gaps in the public health policies in place to control this NTD in Cameroon as annual distribution of preventive chemotherapy is inadequate due to inaccessibility of some high-endemic zones and is based on data obtained two decades ago. Population education is insufficient leading to poor health-seeking behaviour. These gaps in public health policies need to be addressed to aid in the overall achievement of the sustainable development goals.
['Agbor|Valirie Ndip|VN|', 'Njim|Tsi|T|', 'Mbolingong|Franklin Ngu|FN|']
D000293:Adolescent D000368:Aged D000818:Animals D000871:Anthelmintics D002163:Cameroon D057210:Delayed Diagnosis D007722:Health Knowledge, Attitudes, Practice D006801:Humans D008297:Male D011223:Praziquantel D011634:Public Health D012548:Schistosoma haematobium D012553:Schistosomiasis haematobia D001743:Urinary Bladder D001748:Urinary Bladder Neck Obstruction D014552:Urinary Tract Infections
Bladder outlet obstruction Schistosomiasis Neglected tropical diseases Cameroon