Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Infection
Published in: Infection 3/2019

01-06-2019 | Ultrasound | Original Paper

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

Authors: 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

Published in: Infection | Issue 3/2019

Login to get access

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.
Appendix
Available only for authorised users
Literature
1.
2.
IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Biological agents. Volume 100 B. A review of human carcinogens. IARC Monogr Eval Carcinog Risks Hum. 2012;100:1–441.PubMedCentral
3.
Khalaf I, Shokeir A, Shalaby M. Urologic complications of genitourinary schistosomiasis. World J Urol. 2012;30:31–8. (ISSN 0724–4983).CrossRefPubMed
4.
Van der Werf MJ, et al. Quantification of clinical morbidity associated with schistosome infection in sub-Saharan Africa. Acta Trop. 2003;86:125–39. (ISSN 0001-706X (Print) 0001-706x).CrossRefPubMed
5.
El-Sebaie M, et al. Squamous cell carcinoma of the bilharzial and non-bilharzial urinary bladder: a review of etiological features, natural history, and management. Int J Clin Oncol. 2005;10:20–5. (ISSN 1341–9625 (Print) 1341–9625).CrossRefPubMed
6.
7.
Lingscheid T, et al. Schistosomiasis in European travelers and migrants: analysis of 14 years TropNet surveillance data. Am J Trop Med Hyg. 2017;97:567–74. (ISSN 0002–9637).CrossRefPubMedPubMedCentral
8.
Zammarchi L, et al. Spectrum and burden of neglected tropical diseases observed in an infectious and tropical diseases unit in Florence, Italy (2000–2015). Intern Emerg Med. 2017;12:467–77. (ISSN 1828–0447).CrossRefPubMed
9.
Martelli G, et al. Seroprevalence of five neglected parasitic diseases among immigrants accessing five infectious and tropical diseases units in Italy: a cross-sectional study. Clin Microbiol Infect. 2017;23:335. (ISSN 1198-743x).CrossRefPubMed
10.
11.
12.
Holtfreter MC, et al. Schistosoma haematobium infections acquired in Corsica, France, August 2013. Eurosurveillance. 2014;19:20821. (ISSN 1025-496x).CrossRefPubMed
13.
Beltrame A, et al. Schistosomiasis screening of travelers from Italy with possible exposure in Corsica, France. Emerg Infect Dis. 2015;21:1887–9. (ISSN 1080–6040).CrossRefPubMedPubMedCentral
14.
15.
Carrai P, Zammarchi L, Pollina LE, Giordani L, Mangano V, Iapoce R, Rinaldi F, Bartoloni A, Filipponi F, De Simone P, Bruschi F. Post-transplant liver graft schistosomiasis in a migrant from Sub-Saharan Africa. Transpl Infect Dis. 2018;20:e12950.CrossRefPubMed
16.
Bichler KH, et al. EAU guidelines for the management of urogenital schistosomiasis. Eur Urol. 2006;49:998–1003. (ISSN 0302–2838 (Print) 0302–2838 (Linking)).CrossRefPubMed
17.
Akpata R, et al. The WHO ultrasonography protocol for assessing morbidity due to Schistosoma haematobium. Acceptance and evolution over 14 years. Systematic review. Parasitol Res. 2015;114:1279–89. (ISSN 0932–0113).CrossRefPubMed
18.
Richter J, et al. Ultrasound assessment of schistosomiasis. Z Gastroenterol. 2016;54:653–60. (ISSN 1439–7803 (Electronic) 0044-2771 (Linking)).CrossRefPubMed
19.
Niamey Working Group, et al. Ultrasound in schistosomiasis. A practical guide to the standardized use of ultrasonography for the assessment of schistosomiasis-related morbidity. Geneva:World Health Organization;2000.
20.
Yong MK, et al. Long-term follow-up of schistosomiasis serology post-treatment in Australian travelers and immigrants. 2010;J Travel Med. 17:89–93. (ISSN 1195–1982).CrossRefPubMed
21.
22.
Zwang J, Olliaro PL. Clinical efficacy and tolerability of praziquantel for intestinal and urinary schistosomiasis-a meta-analysis of comparative and non-comparative clinical trials. PLoS Negl Trop Dis. 2014;8:e3286. (ISSN 1935–2727).CrossRefPubMedPubMedCentral
23.
24.
ISTITUTO NAZIONALE PER LA PROMOZIONE DELLA SALUTE DELLE POPOLAZIONI MIGRANTI E PER IL CONTRASTO DELLE MALATTIE DELLA POVERTÀ. I controlli alla frontiera. La frontiera dei controlli. Controlli sanitari all’arrivo e percorsi di tutela per i migranti ospiti nei centri di accoglienza. 2017. http://​www.​inmp.​it/​lg/​LG_​Migranti-web.​pdf. Accessed 6 Jan 2019.
25.
U.S. Department of Health and Human Services, et al. Intestinal parasite guidelines for domestic medical examination for newly arrived refugees. 2013.
26.
Chaves NJ, et al. The Australasian Society for Infectious Diseases and Refugee Health Network of Australia recommendations for health assessment for people from refugee-like backgrounds: an abridged outline. Med J Aust. 2017;206:310–315. (ISSN 1326–5377 (Electronic) 0025-729X (Linking)).CrossRefPubMed
27.
Pottie K, et al. Evidence-based clinical guidelines for immigrants and refugees. Cmaj. 2011;183:E824–925. (ISSN 1488–2329 (Electronic) 0820–3946 (Linking)).
28.
Beltrame A, et al. Accuracy of parasitological and immunological tests for the screening of human schistosomiasis in immigrants and refugees from African countries: an approach with Latent Class Analysis. PLoS Negl Trop Dis. 2017;11:e0005593. (ISSN 1935–2727).CrossRefPubMedPubMedCentral
29.
Soentjens P, et al. Late seroconversion of acute schistosomiasis. J Travel Med. 2014;21:219–20. (ISSN 1708–8305 (Electronic) 1195–1982 (Linking)).CrossRefPubMed
30.
Jones ME, Mitchell RG, Leen CL. Long seronegative window in schistosoma infection. Lancet.1992;340:1549–50. (ISSN 0140–6736 (Print) 0140–6736 (Linking)).CrossRefPubMed
31.
Ashton RA, et al. Accuracy of circulating cathodic antigen tests for rapid mapping of Schistosoma mansoni and S. haematobium infections in Southern Sudan. Trop Med Int Health. 2011;16:1099–103. (ISSN 1360–2276).CrossRefPubMed
32.
Sanneh B, et al. Field evaluation of a schistosome circulating cathodic antigen rapid test kit at point-of-care for mapping of schistosomiasis endemic districts in the Gambia. PLoS One. 2017;12:e0182003. (ISSN 1932–6203).CrossRefPubMedPubMedCentral
33.
Midzi N, et al. Use of circulating cathodic antigen strips for the diagnosis of urinary schistosomiasis. Trans R Soc Trop Med Hyg. 2009;103:45–51. (ISSN 0035–9203).CrossRefPubMed
34.
De Dood CJ, et al. Refining diagnosis of Schistosoma haematobium infections: antigen and antibody detection in urine. Front Immunol. 2018;9:2635. (ISSN 1664–3224).CrossRefPubMedPubMedCentral
35.
Checkley AM, et al. Eosinophilia in returning travellers and migrants from the tropics: UK recommendations for investigation and initial management. J Infect. 2010;60:1–20. (ISSN 1532–2742 (Electronic)0163–4453 (Linking)).CrossRefPubMed
36.
Zammarchi L, et al. Screening, diagnosis and management of human cysticercosis and Taenia solium taeniasis: technical recommendations by the COHEMI project study group. Trop Med Int Health. 2017;22:881–94. (ISSN 1365–3156 (Electronic)1360–2276 (Linking)).CrossRefPubMed
37.
Giboda M, Smith JM. Schistosoma mansoni eggs as a target for praziquantel: efficacy of oral application in mice. J Trop Med Hyg. 1994;97:98–102. (ISSN 0022–5304 (Print) 0022–5304).PubMed
38.
Richards F. JR. et al. Effect of praziquantel on the eggs of Schistosoma mansoni, with a note on the implications for managing central nervous system schistosomiasis. Ann Trop Med Parasitol. 1989;83:465–72. (ISSN 0003–4983 (Print) 0003–4983 (Linking)).CrossRefPubMed
39.
Richter J. Evolution of schistosomiasis-induced pathology after therapy and interruption of exposure to schistosomes: a review of ultrasonographic studies. Acta Trop. 2000;77:111–31. (ISSN 0001-706X (Print) 0001-706x).CrossRefPubMed
40.
Richter J. The impact of chemotherapy on morbidity due to schistosomiasis. Acta Trop. 2003;86:161–83. (ISSN 0001-706X (Print) 0001-706x).CrossRefPubMed
41.
Magak P, et al. Case–control study of posttreatment regression of urinary tract morbidity among adults in Schistosoma haematobium-endemic communities in Kwale County, Kenya. Am J Trop Med Hyg. 2015;93:371–6. (ISSN 0002–9637).CrossRefPubMedPubMedCentral
42.
Wagatsuma Y, et al. Resolution and resurgence of Schistosoma haematobium-induced pathology after community-based chemotherapy in ghana, as detected by ultrasound. J Infect Dis. 1999;179:1515–22. (ISSN 0022–1899 (Print) 0022–1899).CrossRefPubMed
43.
Ramarakoto CE, et al. Ultrasonographical findings in the urogenital organs in women and men infected with Schistosoma haematobium in northern Madagascar. Trans R Soc Trop Med Hyg. 2008;102:767–73. (ISSN 0035-9203 (Print) 0035–9203).CrossRefPubMed
44.
Cioli D, Pica-Mattoccia L. Praziquantel. Parasitol Res. 2003;90:S3–9. (ISSN 0932–0113 (Print) 0932–0113).
45.
Richter J, et al. Acute anuria after a family vacation to Corsica/France. Parasitol Res. 2016;115:1733–5. (ISSN 1432–1955 (Electronic) 0932–0113 (Linking)).CrossRefPubMed
Metadata
Title
The diagnosis and treatment of urogenital schistosomiasis in Italy in a retrospective cohort of immigrants from Sub-Saharan Africa
Authors
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
Publication date
01-06-2019
Publisher
Springer Berlin Heidelberg
Published in
Infection / Issue 3/2019
Print ISSN: 0300-8126
Electronic ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-019-01270-0

Other articles of this Issue 3/2019

Infection 3/2019 Go to the issue

Original Paper

Efficacy of teicoplanin monotherapy following initial standard therapy in Enterococcus faecalis infective endocarditis: a retrospective cohort study

Correction

Correction to: Recurrent cholera epidemics in Africa: which way forward? A literature review

Images in Infection

18F-FDG PET/CT monitoring of non-tuberculous mycobacterial infection in a child with interleukin-12 receptor β-1 deficiency

Original Paper

Urinary schistosomiasis in migrant population: a case series from a single centre in southern Italy

Original Paper

Appropriate use of antifungals: impact of an antifungal stewardship program on the clinical outcome of candidaemia in a French University Hospital

Review

Recurrent cholera epidemics in Africa: which way forward? A literature review
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits