Unit of Infectious Diseases, Department of Medical, Surgical and Experimental Science, University of Sassari, Sassari, Italy.
Department of Biomedical Sciences, University of Sassari, Sassari, Italy.
J Infect Dev Ctries. 2022 Aug 30;16(8):1359-1363. doi: 10.3855/jidc.15492.
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.
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.
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.
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.
曼氏血吸虫（S. haematobium）是撒哈拉以南非洲和中东地区泌尿生殖系统血吸虫病的病原体。镜下血尿与血吸虫病的诊断密切相关。吡喹酮（PZQ）是首选的治疗药物。
我们于 2017 年 1 月至 2018 年 12 月期间对来自非洲的移民进行了一项单中心调查。通过直接镜检尿液来诊断曼氏血吸虫感染。治疗方法为每天 40mg/kg 吡喹酮，连续 3 天。
我们共纳入了 91 名男性患者，中位年龄为 20.2 岁（IQR 18.9-23.4）。45 名（49.5%）患者描述了血尿史。16 名（17.6%）患者在尿液镜检中发现了红细胞（RBCs）。18 名（19.8%）患有泌尿生殖系统血吸虫病。他们的中位白细胞计数（WBC）为 5.15 x 109/L（IQR 4.45-6.08），治疗后 15 天为 6.37 x 109/L（IQR 5.14-8.27），p = 0.009。治疗前嗜酸性粒细胞计数为 0.5 x 109/L（IQR 0.3-0.6）和 0.7 x 109/L（IQR 0.2-1.9；p = 0.032）。根据单因素分析，来自马里的移民[比值比（OR）3.6（95%CI 1.2-10.9），p = 0.022]和尿液镜检 RBC 阳性[OR 10.7（95%CI 2.5-45.1），p = 0.001]是泌尿生殖系统血吸虫病诊断的主要预测因素。有 1 例（5.6%）治疗失败。3 例（16.7%）患者患有膀胱癌。
检测 RBC 是曼氏血吸虫感染的一个重要预测指标，可作为来自流行地区移民的筛查方法。早期诊断泌尿生殖系统血吸虫病并使用超声诊断工具对于降低潜在肿瘤演变的风险至关重要。
