Kayuni Sekeleghe A, Alharbi Mohammad H, Shaw Alexandra, Fawcett Joanna, Makaula Peter, Lampiao Fanuel, Juziwelo Lazarus, LaCourse E James, Verweij Jaco J, Stothard J Russell
Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, United Kingdom.
MASM Medi Clinics Limited, Medical Society of Malawi (MASM), P. O. Box 31659, Lilongwe 3, Malawi.
Heliyon. 2023 Jun 21;9(7):e17338. doi: 10.1016/j.heliyon.2023.e17338. eCollection 2023 Jul.
Male genital schistosomiasis (MGS) is an underappreciated complication of schistosomiasis, first described in 1911. However, its epidemiology, diagnostic testing and case management are not well understood in sub-Saharan Africa. To shed new light on MGS prevalence in Malawi, a longitudinal cohort study was conducted among adult fishermen along the southern shoreline of Lake Malawi using detection of schistosome DNA in participants' semen by real-time TaqMan® PCR analyses.
Upon recruitment of 376 participants, 210 submitted urine samples and 114 semen samples for parasitological tests. Thereafter, the available semen samples were subsequently analysed by real-time TaqMan® PCR. Praziquantel (PZQ) treatment was provided to all participants with follow-ups attempted at 1, 3, 6 and 12-months' intervals.
At baseline, real-time PCR detected a higher MGS cohort prevalence of 26.6% (n = 64, Ct-value range: 18.9-37.4), compared to 10.4% by semen microscopy. In total, 21.9% of participants (n = 114) were detected with MGS either by semen microscopy and/or by real-time PCR. Subsequent analyses at 1-, 3-, 6- and 12-month follow-ups indicated variable detection dynamics.
This first application of a molecular method, to detect MGS in sub-Saharan Africa, highlights the need for development of such molecular diagnostic tests which should be affordable and locally accessible. Our investigation also notes the persistence of MGS over a calendar year despite praziquantel treatment.
男性生殖器血吸虫病（MGS）是血吸虫病一种未得到充分认识的并发症，于1911年首次被描述。然而，在撒哈拉以南非洲，其流行病学、诊断检测及病例管理尚不清楚。为进一步了解马拉维MGS的流行情况，在马拉维湖南岸成年渔民中开展了一项纵向队列研究，采用实时TaqMan®PCR分析法检测参与者精液中的血吸虫DNA。
招募376名参与者，其中210人提交尿液样本，114人提交精液样本进行寄生虫学检测。随后，对可用的精液样本进行实时TaqMan®PCR分析。为所有参与者提供吡喹酮（PZQ）治疗，并尝试在1、3、6和12个月的间隔进行随访。
在基线时，实时PCR检测到MGS队列患病率较高，为26.6%（n = 64，Ct值范围：18.9 - 37.4），而精液显微镜检查的患病率为10.4%。总共21.9%的参与者（n = 114）通过精液显微镜检查和/或实时PCR检测到MGS。在1、3、6和12个月随访时的后续分析表明检测动态存在差异。
这种分子方法在撒哈拉以南非洲首次应用于检测MGS，凸显了开发此类分子诊断检测的必要性，这些检测应价格可承受且在当地可获得。我们的调查还指出，尽管进行了吡喹酮治疗，MGS在一历年中仍持续存在。
