Evaluation of CD4(+)/CD8(+) status and urinary tract infections associated with urinary schistosomiasis among some rural Nigerians.

BACKGROUND Data on urinary schistosomiasis in Nigeria are mainly epidemological. The knowledge of co-infections of urinary schistosomiasis and other pathogens are important epidemiological tools for the control and health benefits of the rural dwellers. The granulomatous reactions in urinary schistosomiasis is CD4(+) dependent. The CD8(+) is cytotoxic to parasites and it is activated by CD4(+). These parameters therefore participate in the immune responses to urinary schistosomiasis. OBJECTIVE In this study, we evaluated the polyparasitism involving urinary schistosomiasis and urinary tract co - infections among some rural Nigerians. The CD4(+):CD8(+) ratio and status with age groups in years were also investigated. METHODS Parasitological investigation using ova on urine was carried out on 216 volunteers. The urine samples were examined for bacteriuria and subsequently subjected to standard microbiological urine culture. CD4(+)/CD8(+) were determined using the CD T 4 Dynabead techniques. Data were analysed using MicroSoft Excel. RESULTS The inhabitants with light infections of urinary schistosomiasis as indicated by <50 ova /10 ml of urine had a mean CD4(+):CD8(+) ratio of 1.57 while those with heavy infections as shown by >50 ova/10 ml of urine had a relatively lower CD4(+):CD8(+) ratio of 1.03. In all, the overall CD4+:CD8+ ratio of 1.23 was recorded with the mean CD4+ count of 257.96 cells/microL and the mean CD8(+) count of 210.45 cells/microL. Comparatively, the control uninfected subjects had a CD4(+):CD8(+) ratio of 5.97. The CD4(+) and the CD8(+) counts were correlated with the ova of S. haematobium in their urine samples at r = 0.0108 and r = 0.516 respectively. The bacteriuria, urinary schistosomiasis and urinary tract co-infections, namely: Escherichia coli, Proteus, Pseudomonas aeroginosa, Staphylococcus epidermidis and Staph. Saprophyticus were reported in the urine cultures of 48(22.0%) volunteers. CONCLUSION The mean overall CD4(+):CD8(+) ratio of urinary schistosomiasis infected persons is 1.23 which is above the normal CD4(+):CD8(+) ratio of 1. The CD4(+):CD8(+) ratio and counts of the urinary schistosomiasis infected inhabitants were lower than the uninfected inhabitants. The positive correlation between the CD4(+):CD8(+) and the S. haematobium ova shows a relationship which indicate an increase of the CD4(+):CD8(+) as the intensity of infection increases. We report polyparasitism of S. haematobium and urinary tracts co-infections among some rural inhabitants in Ikpeshi, Nigeria. It is therefore imperative to incorporate the management of urinary tract infections in urinary schistosomiasis control programme.