Severity of urinary tract morbidity increases with intensity and duration of Schistosoma haematobium
infection. We assessed the ability of yearly
drug therapy to control infection intensity and reduce S. haematobium-associated disease in children 5-21 years old in an endemic area of Kenya. In year 1,
therapy resulted in reduced prevalence (66% to 22%, P < 0.001) and intensity of S. haematobium
infection (20 to 2 eggs/10 mL urine), with corresponding reductions in the prevalence of
hematuria (52% to 19%, P < 0.001). There was not, however, a significant first-year effect on prevalence of urinary tract abnormalities detected by ultrasound. Repeat
therapy in years 2 and 3 resulted in significant regression of
hydronephrosis and bladder abnormalities (41% to 6% prevalence, P < 0.01), and further reductions in
proteinuria. Repeat age-targeted
therapy was associated with decreased prevalence of
infection among young children (< 5 yr) entering into the targeted age group. Two years after discontinuation of
therapy, intensity of S. haematobium
infection and ultrasound abnormalities remained suppressed, but
hematuria prevalence began to increase (to 33% in 1989). Reinstitution of annual
therapy in 1989 and 1990 reversed this trend. We conclude that annual oral
therapy provides an effective strategy for control of morbidity due to S. haematobium on a population basis, both through regression of disease in treated individuals, and prevention of
infection in untreated subjects.