Tropical Medicine Unit, Hospital del Poniente, Ctra. de Almerimar, 31, 04700, El Ejido, Almería, Spain.
Tropical Medicine Unit, Distrito Sanitario Poniente de Almería, Calle Jesús de Perceval, 22, 04700, El Ejido, Almería, Spain.
Travel Med Infect Dis. 2020 May-Jun;35:101508. doi: 10.1016/j.tmaid.2019.101508. Epub 2019 Nov 5.
Chronic schistosomiasis silently leads to severe organ-specific disorders, such as hydroureter, bladder cancer or portal hypertension in around 10% of infected people in endemic zones. However, in non-endemic areas, information on schistosomiasis' severe complications and their actual prevalence is scarce because diagnosis is usually reached when such complications are well established.
Retrospective observational study of data obtained from a screening protocol designed for sub-Saharan migrants including search for stool parasites and schistosoma serology. After screening 3090 sub-Saharans, 326 (10.5%) confirmed cases of schistosomiasis were found, based on detection of ova in feces, urine or in biopsy samples. Another 830 patients (26.9%) were diagnosed of probable schistosomiasis (positive serology and/or suggestive imaging findings).
Only patients with confirmed schistosomiasis were included in the final analysis. Among them, 13 (4%) presented severe complications at the time of diagnosis. Depending on the location, they account for 5% of patients with hepatointestinal schistosomiasis and 3.5% of patients with urogenital infection.
Targeted systematic screening could reduce the prevalence of severe complications by enabling early diagnosis and treatment. Having indigenous transmission been demonstrated in southern Europe, prevention of future cases in non-endemic countries might be another sound reason supporting such screening.
慢性血吸虫病会悄然导致严重的器官特异性疾病，在流行地区约有 10%的感染者会出现输尿管积水、膀胱癌或门静脉高压等并发症。然而，在非流行地区，由于此类并发症通常在确立后才被诊断，因此有关血吸虫病严重并发症及其实际流行率的信息较为匮乏。
对一项针对撒哈拉以南移民的筛查方案的数据进行回顾性观察研究，该方案包括粪便寄生虫搜索和血吸虫血清学检查。在筛查了 3090 名撒哈拉以南移民后，根据粪便、尿液或活检样本中发现的虫卵，发现了 326 例（10.5%）确诊的血吸虫病病例。另有 830 例患者（26.9%）被诊断为可能的血吸虫病（血清学阳性和/或提示性影像学发现）。
只有确诊的血吸虫病患者被纳入最终分析。在这些患者中，有 13 例（4%）在诊断时出现严重并发症。根据部位不同，这部分患者占肝肠型血吸虫病患者的 5%，占泌尿生殖系感染患者的 3.5%。
有针对性的系统筛查可以通过早期诊断和治疗来降低严重并发症的发生率。鉴于在欧洲南部已经发现了本地传播，因此在非流行国家预防未来的病例可能是支持这种筛查的另一个合理理由。
