History of Schistosoma haematobium infection (positive ova in urine, positive serology, o...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`RF-SCHISTOSOMA-HAEMATOBIUM-BLADDER-PREVENTION`
Type	Red flag
Status	reviewed 2026-05-18 \| pending_clinical_signoff
Diseases	`DIS-UROTHELIAL`
Sources	`SRC-IARC-MONO-100B-2012` `SRC-NCCN-BLADDER-2025`

Red Flag Origin

Definition	History of Schistosoma haematobium infection (positive ova in urine, positive serology, or documented endemic-region exposure with suggestive urinary tract symptoms) in an individual without a current bladder cancer diagnosis. IARC Group 1 carcinogen (S. haematobium) — established etiological driver of bladder squamous cell carcinoma (SCC), the dominant histology in endemic regions (sub-Saharan Africa, Middle East, parts of South America). Praziquantel cures active infection but does NOT reverse chronic urothelial inflammation / squamous metaplasia from prior burden; surveillance (urinalysis, cytology, cystoscopy for any new hematuria) is the dominant prevention modality. Prevention-persona RedFlag (§20 ratification 2026-05-18).
Clinical direction	investigate
Category	other

Trigger Logic

{
  "any_of": [
    {
      "finding": "schistosoma_haematobium_history",
      "value": "positive"
    },
    {
      "finding": "schistosoma_haematobium_ova_urine",
      "value": "positive"
    },
    {
      "finding": "schistosoma_haematobium_serology",
      "value": "positive"
    }
  ],
  "type": "lab_value"
}

Notes

Prevention-persona RedFlag for S. haematobium-driven bladder SCC prevention. Fires on any documented exposure history with confirmatory testing. Engine routes to PreventionPlan recommending praziquantel (if active infection) + lifetime urinary surveillance (urinalysis q6-12mo, cytology + cystoscopy for any new hematuria). STUB pending Co-Lead review. Cancer scope: anchored to DIS-UROTHELIAL. S. haematobium-driven bladder cancers are predominantly SCC histology (distinct from urothelial / transitional cell carcinoma that dominates Western cohorts) — engine surfaces this distinction in the prevention rationale prose. Geographic context: Ukraine is non-endemic; this RF is relevant for patients with diaspora / refugee / travel / origin history from sub-Saharan Africa, Egypt, Sudan, Yemen, parts of South America.

Used By

Indications

IND-SCHISTOSOMA-HAEMATOBIUM-PREVENTION-OBSERVATION - IND-SCHISTOSOMA-HAEMATOBIUM-PREVENTION-OBSERVATION
IND-SCHISTOSOMA-HAEMATOBIUM-PREVENTION-TREATMENT - IND-SCHISTOSOMA-HAEMATOBIUM-PREVENTION-TREATMENT