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Infection
Erschienen in: Infection 3/2019

21.01.2019 | Original Paper

The diagnosis and treatment of urogenital schistosomiasis in Italy in a retrospective cohort of immigrants from Sub-Saharan Africa

verfasst von: Marta Tilli, Federico Gobbi, Francesca Rinaldi, Jacopo Testa, Silvio Caligaris, Paola Magro, Dora Buonfrate, Monica Degani, Andrea Minervini, Marco Carini, Agostino Tuccio, Simone Sforza, Maurizio Gulletta, Francesco Castelli, Simone Agostini, Filippo Parretti, Joachim Richter, Piero Olliaro, Zeno Bisoffi, Alessandro Bartoloni, Lorenzo Zammarchi

Erschienen in: Infection | Ausgabe 3/2019

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Abstract

Objectives

To evaluate ultrasound and praziquantel to, respectively, assess and reduce urogenital schistosomiasis (UGS)-associated morbidity in migrants from Sub-Saharan Africa (SSA).

Methods

Migrants from SSA with UGS attending three Italian centres for tropical diseases during 2011–2016 were retrospectively enrolled. Data on clinical symptoms, routine laboratory, parasitological tests, and ultrasound reported as per the WHO–Niamey protocol were collected at baseline and at available follow-up visits after treatment with praziquantel 40 mg/kg/day for 3 days.

Results

One hundred and seventy patients with UGS were enrolled and treated with praziquantel. Baseline ultrasonography showed urinary tract abnormalities in 115/169 patients (68%); the mean global Schistosoma haematobium score was 2.29 (SD 2.84, IQR 0–2), the mean urinary bladder intermediate score 1.75 (SD 1.73, IQR 0–2), and the mean upper urinary tract intermediate score 0.54 (SD 2.37, IQR 1–10). Abnormalities were more common among the 111 (65%) who were symptomatic (p < 0.02; OR 2.53; 95% CI 1.19–5.35). Symptoms started in 94/111 (85%) before arriving (median 63 months, IQR 12–119). At follow-up, we observed a significant reduction in the prevalence of UGS-related symptoms, blood, urine, and ultrasound abnormalities.

Conclusions

Our study results support the use of ultrasound and praziquantel for assessing and reducing UGS-associated morbidity in migrants. Health-seeking behaviour, diagnostic, and treatment delays contribute to the advanced pathology and qualified treatment success. To ensure earlier treatment, based on our findings, clinical experience, and available literature, we propose an algorithm for the diagnosis and clinical management of UGS. Multicentre studies are needed to improve the management of subjects with UGS in non-endemic countries.
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Metadaten
Titel
The diagnosis and treatment of urogenital schistosomiasis in Italy in a retrospective cohort of immigrants from Sub-Saharan Africa
verfasst von
Marta Tilli
Federico Gobbi
Francesca Rinaldi
Jacopo Testa
Silvio Caligaris
Paola Magro
Dora Buonfrate
Monica Degani
Andrea Minervini
Marco Carini
Agostino Tuccio
Simone Sforza
Maurizio Gulletta
Francesco Castelli
Simone Agostini
Filippo Parretti
Joachim Richter
Piero Olliaro
Zeno Bisoffi
Alessandro Bartoloni
Lorenzo Zammarchi
Publikationsdatum
21.01.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Infection / Ausgabe 3/2019
Print ISSN: 0300-8126
Elektronische ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-019-01270-0

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