Haematuria and proteinuria as detected by chemical reagent strips correlated moderately (r=0·7) with prevalence and intensity of infection with Schistosoma haematobium in an area of Anambra State, Nigeria. Differences attributable to age and sex were also reflected in a similar pattern, all peaks occurring in the 5–14 year age group. The differences observed with varying levels of intensity and haematuria at both 10 and 50 erythrocytes/μl (p<0·001) and proteinuria at 0·3 g/dl (p<0·01) were statistically significant. At a proteinuria level of 1 g/dl, the observed differences were however not statistically significant (p>0·5). The percentage of specimens from children (1–14 years) positive for S. haematobium eggs and with at least traces of haematuria and proteinuria (63·4% and 95%, respectively) was higher than in adults (33·3% and 80·2%, respectively). All individuals with more than 50 eggs/10 ml of urine were correctly identified using both indices either separately or in combination. For egg counts of less than 50 egg/10 ml of urine, false diagnosis occurred in only 5% of all specimens examined. The sensitivity and specificity of haematuria and proteinuria at trace quantities was very high, hut haematuria had a higher predictive value for a positive test (PvPt) and was considered the overall better indicator. A combination of both indices did not significantly increase the PvPt. When trace haematuria and moderate proteinuria were combined, both the sensitivity, specificity and PvPt were all above 90%, giving the best overall values in all the combinations made.

The aim of this study was to assess the effect of two doses of 40 mg/kg praziquantel with 2 weeks interval versus a standard single dose of 40 mg/kg on cure rates, egg reduction, intensity of infection, and micro-haematuria in Schistosoma haematobium infections. A randomised controlled intervention study was carried out among school-aged children in two different endemic settings with follow-up at 3, 6 and 18 months following drug administration. Differences in cure rates between the two treatment regimens were not significant. However, in high transmission areas, the double treatment regimen was more effective in egg reduction than single treatment regimen and the difference in egg reduction between the two treatments was significant at 3 months (P<0·005), 6 months (P<0·0001) and 18 months (P<0·003) after treatment. There was a significant difference in the effect of the two treatments on prevalence of micro-haematuria at 18-month follow-up in both Koulikoro (P<0·001) and Selingue (P<0·003). The study shows that although no significant difference could be observed in the overall cure-rates between the two treatment regimens, the effect of double treatment was a significant reduction in infection intensity as well as micro-haematuria which may have a great impact in reducing subtle morbidity.

Primary hyperparathyroidism during pregnancy carries significant risks to both mother and fetus. Parathyroidectomy remains the only definitive treatment for the condition. The timing of surgery remains controversial, with ongoing debate regarding the safety of surgery during the third trimester. A case of symptomatic primary hyperparathyroidism treated by parathyroidectomy in the third trimester is described. The clinical features, investigations and treatment options are discussed.