Roade Luisa, Sulleiro Elena, Bocanegra Cristina, Salvador Fernando, Treviño Begoña, Zarzuela Francesc, Goterris Lidia, Serre-Delcor Nuria, Oliveira-Souto Inés, Aznar Maria Luisa, Pou Diana, Sánchez-Montalvà Adrián, Bosch-Nicolau Pau, Espinosa-Pereiro Juan, Molina Israel
Internal Medicine Department, University Hospital Vall d'Hebron, 08035 Barcelona, Spain.
Microbiology Department, University Hospital Vall d'Hebron, PROSICS Barcelona, 08035 Barcelona, Spain.
Trop Med Infect Dis. 2023 Jan 6;8(1):44. doi: 10.3390/tropicalmed8010044.
A consensus on the recommended screening algorithms for schistosomiasis in asymptomatic high-risk subjects in non-endemic areas is lacking. The objective of this study was to evaluate the real-life performance of direct microscopy and ELISA serology for schistosomiasis screening in a high-risk population in a non-endemic setting. A retrospective cohort study was conducted in two out-patient Tropical Medicine units in Barcelona (Spain) from 2014 to 2017. Asymptomatic adults arriving from the Sub-Saharan region were included. Schistosomiasis screening was conducted according to clinical practice following a different strategy in each setting: (A) feces and urine direct examination plus S. mansoni serology if non-explained eosinophilia was present and (B) S. mansoni serology plus uroparasitological examination as the second step in case of a positive serology. Demographic, clinical and laboratory features were collected. Schistosomiasis cases, clinical management and a 24 month follow-up were recorded for each group. Four-hundred forty individuals were included. The patients were mainly from West African countries. Fifty schistosomiasis cases were detected (11.5% group A vs. 4 % group B, p = 0.733). When both microscopic and serological techniques were performed, discordant results were recorded in 18.4% (16/88). Schistosomiasis cases were younger (p < 0.001) and presented eosinophilia and elevated IgE (p < 0.001) more frequently. Schistosomiasis is a frequent diagnosis among high-risk populations. Serology achieves a similar performance to direct diagnosis for the screening of schistosomiasis in a high-risk population.
在非流行地区，对于无症状高危人群中推荐的血吸虫病筛查算法尚未达成共识。本研究的目的是评估直接显微镜检查和ELISA血清学在非流行环境下高危人群中筛查血吸虫病的实际效果。2014年至2017年在巴塞罗那（西班牙）的两个热带医学门诊进行了一项回顾性队列研究。纳入了来自撒哈拉以南地区的无症状成年人。在每个机构中，根据临床实践采用不同策略进行血吸虫病筛查：（A）如果存在无法解释的嗜酸性粒细胞增多，则进行粪便和尿液直接检查以及曼氏血吸虫血清学检查；（B）如果血清学检查呈阳性，则第二步进行曼氏血吸虫血清学检查加尿液寄生虫学检查。收集了人口统计学、临床和实验室特征。记录了每组的血吸虫病病例、临床管理情况以及24个月的随访情况。共纳入440人。患者主要来自西非国家。检测到50例血吸虫病病例（A组为11.5%，B组为4%，p = 0.733）。当同时进行显微镜检查和血清学检查时，18.4%（16/88）的结果不一致。血吸虫病病例更年轻（p < 0.001），更频繁地出现嗜酸性粒细胞增多和IgE升高（p < 0.001）。血吸虫病在高危人群中是一种常见的诊断。在高危人群中筛查血吸虫病时，血清学检查与直接诊断的效果相似。
