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

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 ret...

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Publicado en:Infection Vol. 47; no. 3; pp. 447 - 460
Autores principales: Tilli, Marta, Rinaldi, Francesca, Bartoloni, Alessandro, Zammarchi, Lorenzo, Minervini, Andrea, Carini, Marco, Sforza, Simone, Gobbi, Federico, Buonfrate, Dora, Degani, Monica, Bisoffi, Zeno, Testa, Jacopo, Caligaris, Silvio, Magro, Paola, Gulletta, Maurizio, Castelli, Francesco, Tuccio, Agostino, Agostini, Simone, Parretti, Filippo, Richter, Joachim
Formato: research tables/charts Journal Article
Publicado: Springer Nature Jun2019
Acceso en línea:Ver este registro en EBSCOhost
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        10.1007/s15010-019-01270-0
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        atl: The diagnosis and treatment of urogenital schistosomiasis in Italy in a retrospective cohort of immigrants from Sub-Saharan Africa.
      aug:
        au:
          Tilli, Marta
          Rinaldi, Francesca
          Bartoloni, Alessandro
          Zammarchi, Lorenzo
          Minervini, Andrea
          Carini, Marco
          Sforza, Simone
          Gobbi, Federico
          Buonfrate, Dora
          Degani, Monica
          Bisoffi, Zeno
          Testa, Jacopo
          Caligaris, Silvio
          Magro, Paola
          Gulletta, Maurizio
          Castelli, Francesco
          Tuccio, Agostino
          Agostini, Simone
          Parretti, Filippo
          Richter, Joachim
        affil: Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
      sug:
        subj:
          Immigrants
          Male Urogenital Diseases
          Female Urogenital Diseases
          Schistosomiasis Ultrasonography
          Schistosomiasis Prevention and Control
          Isoquinolines Administration and Dosage
          Morbidity Prevention and Control
          Human
          Italy
          Retrospective Design
          Africa South of the Sahara
          Parasitology
          Descriptive Statistics
          Health Behavior
          Algorithms
          Multicenter Studies
      ab: 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.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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