Human urogenital schistosomiasis in West and Sub-Saharan Africa migrants in Sardinia, Italy: A retrospective monocentric study

  • Nicholas Geremia Unit of Infectious Diseases, Department of Medical, Surgical and Experimental Science, University of Sassari, Sassari, Italy
  • Andrea De Vito Department of Biomedical Sciences, University of Sassari, Sassari, Italy
  • Vincenzo Lai Mediterranean Center for Disease Control (MCDC), University of Sassari, Sassari, Italy
  • Vito Fiore Unit of Infectious Diseases, Department of Medical, Surgical and Experimental Science, University of Sassari, Sassari, Italy
  • Elija Princic Unit of Infectious Diseases, Department of Medical, Surgical and Experimental Science, University of Sassari, Sassari, Italy
  • Paola Rappelli Department of Biomedical Sciences, University of Sassari, Sassari, Italy
  • Giordano Madeddu Unit of Infectious Diseases, Department of Medical, Surgical and Experimental Science, University of Sassari, Sassari, Italy
  • Sergio Babudieri Unit of Infectious Diseases, Department of Medical, Surgical and Experimental Science, University of Sassari, Sassari, Italy
Keywords: Schistosomiasis, neglected diseases, refugees, migrants, praziquantel

Abstract

Introduction: Schistosoma (S.) haematobium is the aetiological agent of urogenital schistosomiasis endemic in Sub-Saharan Africa and the Middle East. Microhaematuria is strongly associated with schistosomiasis diagnosis. Praziquantel (PZQ) is the treatment of choice.

Methodology: We conducted a monocentric survey among African migrants from January 2017 to December 2018. The diagnosis of S. haematobium was performed by direct microscopic examination of urine. The treatment was PZQ 40 mg/Kg/die for three days.

Results: We enrolled 91 male patients with a median age of 20.2 years (IQR 18.9-23.4)]. Forty-five (49.5%) described a history of haematuria. Sixteen (17.6%) evidenced the presence of red blood cells (RBCs) during urine microscopy. Eighteen (19.8%) had urogenital schistosomiasis. Their median white blood count (WBC) was 5.15 x 109/L (IQR 4.45-6.08) and it was 6.37 x 109 /L (IQR 5.14-8.27), p = 0.009, after 15 days from treatment. Baseline eosinophil count was 0.5 x 109/L (IQR 0.3-0.6) and 0.7 x 109/L (IQR 0.2-1.9; p = 0.032). According to the univariate analysis, origin from Mali [odds ratio (OR) 3.6 (CI 1.2-10.9), p = 0.022] and microscopic evidence of RBCs [OR of 10.7 (CI 2.5-45.1), p = 0.001] were main predictors of urogenital schistosomiasis diagnosis. One (5.6%) treatment failure was registered. Three (16.7%) patients had bladder cancer.

Conclusions: Detection of RBCs was a significant predictor of S. haematobium infection and could be used as a screening method in migrants coming from endemic areas. Early urogenital schistosomiasis diagnosis and ultrasound diagnostic tools are crucial for reducing the risk of potential neoplastic evolution.

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Published
2022-08-30
How to Cite
1.
Geremia N, De VitoA, Lai V, Fiore V, Princic E, Rappelli P, Madeddu G, Babudieri S (2022) Human urogenital schistosomiasis in West and Sub-Saharan Africa migrants in Sardinia, Italy: A retrospective monocentric study. J Infect Dev Ctries 16:1359-1363. doi: 10.3855/jidc.15492
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Original Articles

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