Morbidity burden of imported chronic schistosomiasis among West African migrants
Background: Past exposure to schistosomiasis is frequent among migrants from endemic countries, and chronic untreated infection may lead to long-term morbidities. Methods: We carried out a prospective population-based cross-sectional study among migrants from endemic Sub-Saharan countries living in...
| Autores: | , , , , , , , , , , , , , , |
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| Tipo de recurso: | artículo |
| Fecha de publicación: | 2024 |
| País: | España |
| Institución: | Universitat Politècnica de Catalunya (UPC) |
| Repositorio: | UPCommons. Portal del coneixement obert de la UPC |
| Idioma: | inglés |
| OAI Identifier: | oai:upcommons.upc.edu:2117/415475 |
| Acceso en línea: | https://hdl.handle.net/2117/415475 https://dx.doi.org/10.1016/j.jinf.2024.106234 |
| Access Level: | acceso abierto |
| Palabra clave: | Schistosomiasis Epidemiology Sub-saharan migrants Screening Migrants Non-endemic countries Esquistosomiasi Epidemiologia Àrees temàtiques de la UPC::Ciències de la salut::Medicina::Medicina comunitària i salut pública |
| Sumario: | Background: Past exposure to schistosomiasis is frequent among migrants from endemic countries, and chronic untreated infection may lead to long-term morbidities. Methods: We carried out a prospective population-based cross-sectional study among migrants from endemic Sub-Saharan countries living in Barcelona, Spain. Participants had not been previously diagnosed or treated for schistosomiasis. Clinical signs and symptoms were scrutinised through a systematic revision of electronic medical records and an on-site standardised questionnaire, and blood and urine samples were screened for Schistosoma. Findings: We recruited 522 eligible participants, 74.3% males, mean age 42.7 years (SD=11.5, range 18–76), Overall, 46.4% were from Senegal and 23.6% from Gambia. They had lived in the European Union for a median of 16 years (IQR 10–21). The prevalence of a Schistosoma-positive serology was 35.8%. S. haematobium eggs were observed in urine samples in 6 (1.2%) participants. The most prevalent symptoms among Schistosoma-positive participants were chronic abdominal pain (68.8%, OR=1.79; 95%CI 1.2–2.6), eosinophilia (44.9%, OR=2.69; 95%CI 1.8–4.0) and specific symptoms associated with urinary schistosomiasis, like self-reported episodes of haematuria (37.2%; OR=2.47; 95%CI 1.6–3.8), dysuria (47.9%, OR=1.84; 95%CI=1.3–2.7) and current renal insufficiency (13.4%; OR=2.35; 95%CI=1.3–4.3). We found a significant prevalence of gender-specific genital signs and symptoms among females (mainly menstrual disorders) and males (erectile dysfunction and pelvic pain). Individuals typically presented with a multitude of interconnected symptoms, most commonly chronic abdominal pain, which are often disregarded. Conclusions: Despite the lack of urine parasite identification, the high incidence of clinical signs and symptoms strongly correlated with a positive schistosomiasis serology suggests the existence of a heavy clinical burden among long-term West African migrants living for years/decades in the study region. More research is urgently required to determine whether these symptoms are the result of long-term sequelae or a persistent active Schistosoma infection. |
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