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

OPG Nmorsi, NCD Ukwandu, OA Egwungenya, NU Obhiemi

Abstract

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 T4 Dynabead techniques. Data were analysed using MicroSoft Excel.

Results: The inhabitants with light infections of urinary schistosomiasis as indicated by <50 ova /10ml of urine had a mean CD4+:CD8+ ratio of 1.57 while those with heavy infections as shown by >50 ova/10ml 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/µL and the mean CD8+ count of 210.45cells/µL. 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.

Key words: CD4+, CD8+, urinary tract infections, urinary schistosomiasis, rural Nigerians