Zacarias Mateus, Pizzol Damiano, de Miranda Helder, Colangelo Anna Claudia, Veronese Nicola, Smith Lee
Department of Surgery, Central Hospital of Beira, Beira, Mozambique.
Italian Agency for Development Cooperation, Khartoum, Sudan.
PLoS Negl Trop Dis. 2021 Jun 24;15(6):e0009478. doi: 10.1371/journal.pntd.0009478. eCollection 2021 Jun.
Globally, schistosomiasis affects at least 240 million people each year with a high proportion of cases in sub-Saharan Africa. The infection presents a wide range of symptoms mainly at the gastrointestinal and urogenital level. Cases of schistosomiasis-related appendicitis are seldom reported. The aim of the present study is to identify the prevalence of schistosomiasis-related appendicitis in Beira, Mozambique and compare to global prevalence.
We retrospectively reviewed all cases of appendicitis recorded from January 2017 to March 2020 at a single pathology department located in Beira in order to assess the prevalence of schistosomiasis. Moreover, we performed a systematic review on the prevalence of schistosomiasis-related appendicitis in all countries.
A total of 145 appendicitis cases in Beira showed a 13.1% prevalence of schistosomal-related appendicitis. The mean age of patients was 29.1 years, and 14 (73.7%) were male. The systematic review identified 20 studies with 34,790 inpatients with schistosomiasis-related appendicitis with a global prevalence of 1.31% (95% confidence interval (CI): 0.72 to 2.06); a high heterogeneity (I2 = 96.0%) was observed. Studies carried out in Africa reported a significantly higher prevalence of schistosomiasis-related appendicitis (2.75%; 95% CI: 1.28 to 4.68) than those in Middle East (0.49%; 95% CI: 0.18 to 0.95) (p for interaction < 0.0001).
Schistosomiasis infection should be considered as possible cause of appendicitis not only in endemic areas but also in developed countries. Considering that prevention is the best way to control the infection, more efforts should be put in place in order to increase the prevention coverage and avoid the cascading implications for health. This is even more so important in this Coronavirus Disease 2019 (COVID-19) era where the majority of attention and funds are used to fight the pandemic.
在全球范围内，血吸虫病每年至少影响2.4亿人，其中撒哈拉以南非洲的病例占比很高。该感染主要在胃肠道和泌尿生殖系统层面呈现出广泛的症状。与血吸虫病相关的阑尾炎病例鲜有报道。本研究的目的是确定莫桑比克贝拉地区与血吸虫病相关的阑尾炎的患病率，并与全球患病率进行比较。
我们回顾性分析了2017年1月至2020年3月期间位于贝拉的一个病理科记录的所有阑尾炎病例，以评估血吸虫病的患病率。此外，我们对所有国家与血吸虫病相关的阑尾炎的患病率进行了系统评价。
贝拉地区总共145例阑尾炎病例显示，与血吸虫相关的阑尾炎患病率为13.1%。患者的平均年龄为29.1岁，其中14例（73.7%）为男性。系统评价确定了20项研究，涉及34790例与血吸虫病相关的阑尾炎住院患者，全球患病率为1.31%（95%置信区间（CI）：0.72至2.06）；观察到高度异质性（I² = 96.0%）。在非洲进行的研究报告的与血吸虫病相关的阑尾炎患病率（2.75%；95%CI：1.28至4.68）显著高于中东地区（0.49%；95%CI：0.18至0.95）（交互作用p<0.0001）。
不仅在流行地区，而且在发达国家，血吸虫病感染都应被视为阑尾炎的可能病因。鉴于预防是控制感染的最佳方法，应做出更多努力以提高预防覆盖率，并避免对健康产生连锁影响。在2019年冠状病毒病（COVID-19）时代，这一点尤为重要，因为大部分注意力和资金都用于抗击这一流行病。
