Introduction: Schistosoma haematobium endemic areas are generally low-resource settings. Symptoms routinely used for cheap and easy proxy diagnosis of S. haematobium infection are haematuria, proteinuria, dysuria and pollakisuria, however these symptoms can also be invoked by urinary tract  pathogens making misdiagnosis probable. It is possible that local lesions and inflammation in relation with schistosome egg granulomas alter the ability of bacteria to establish infection foci either positively or negatively. Therefore it is of interest to clarify whether bacteriuria is a confounder for common S. haematobium diagnostic tests.
Materials and Methods: Urine samples from 1119 randomly selected female primary and high school students from Ugu district, KwaZulu-Natal, South Africa, were collected in a cross-sectional manner from May–August 2012. Samples were tested in the field for haematuria, proteinuria and leukocytes with Neotest4 dipsticks and 10ml urine was added to 1ml 5% formalin solution and preserved for later egg count microscopy. Furthermore samples were tested for bacteriuria with Uricult dipslides (cut-off point;105CFU/ml).
Results: The mean overall prevalence for S. haematobium was 18.3% and 10% for asymptomatic bacteriuria. No association was found (P = 0.172, n = 1039) between S. haematobium infection and bacteriuria. Micro-haematuria was strongly positively associated with schistosomiasis (P < 0.001) whereas for bacteriuria only a tendency was observed (P = 0.053). Only the presence of leukocytes was positively associated with bacteriuria (P = 0.002) probably due to detection of neutrophils rather than eosinophils with the dipstick. As expected, intensity of S. haematobium infection was positively correlated with degree of micro-haematuria (r = 0.505; P = 0.01). Proteinuria was positively associated both with bacteriuria (P = 0.002) and S. haematobium (P < 0.001).
Conclusions: No association between bacteriuria and uro-genital schistosomiasis was demonstrated. Bacteriuria appears not to be a confounder for using micro-haematuria as diagnostic measure for S. haematobium infection in this sample. Further studies should be performed on symptomatic populations and in clean-catch urines.