International Health Program (PROSICS), Barcelona North Metropolitan Territorial Directorate for Infectious Diseases, Catalan Institute for Health, CAP La Salut, Passatge dels Encants S/N, 08916, Badalona, Spain.
Fundació Lluita contra les Infeccions, c/ Can Ruti s/n, 08916, Badalona, Spain.
Infect Dis Poverty. 2024 Mar 7;13(1):23. doi: 10.1186/s40249-024-01190-8.
Schistosomiasis is highly endemic in sub-Saharan Africa and frequently imported to Europe. Male urogenital manifestations are often neglected. We aimed to ascertain the prevalence of genitourinary clinical signs and symptoms among long-term African migrants in a non-endemic European country using a serology test.
We carried out a prospective, community-based cross-sectional study of adult male migrants from sub-Saharan Africa living in Spain. Schistosoma serology tests and microscopic urine examinations were carried out, and clinical data were obtained from an electronic medical record search and a structured questionnaire.
We included 388 adult males, mean age 43.5 years [Standard Deviation (SD) = 12.0, range: 18-76]. The median time since migration to the European Union was 17 [Interquartile range (IQR): 11-21] years. The most frequent country of origin was Senegal (N = 179, 46.1%). Of the 338, 147 (37.6%) tested positive for Schistosoma. Parasite eggs were present in the urine of only 1.3%. Nine genitourinary clinical items were significantly associated with positive Schistosoma serology results: pelvic pain (45.2%; OR = 1.57, 95% CI: 1.0-2.4), pain on ejaculation (14.5%; OR = 1.85, 95% CI: 1.0-3.5), dyspareunia (12.4%; OR = 2.45, 95% CI: 1.2-5.2), erectile dysfunction (9.5%; OR = 3.10, 95% CI: 1.3-7.6), self-reported episodes of infertility (32.1%; OR = 1.69, 95% CI: 1.0-2.8), haematuria (55.2%; OR = 2.37, 95% CI: 1.5-3.6), dysuria (52.1%; OR = 2.01, 95% CI: 1.3-3.1), undiagnosed syndromic STIs (5.4%), and orchitis (20.7%; OR = 1.81, 95% CI: 1.0-3.1). Clinical signs tended to cluster.
Urogenital clinical signs and symptoms are prevalent among male African long-term migrants with a positive Schistosoma serology results. Genital involvement can be frequent even among those with long periods of non-residence in their sub-Saharan African countries of origin. Further research is needed to develop diagnostic tools and validate therapeutic approaches to chronic schistosomiasis.
在撒哈拉以南非洲，血吸虫病高度流行，且经常传入欧洲。男性泌尿生殖系统表现常被忽视。我们旨在通过血清学检测，确定居住在非流行区的欧洲国家的长期非洲移民中存在的泌尿生殖系统临床体征和症状的流行情况。
我们开展了一项前瞻性、基于社区的撒哈拉以南非洲成年男性移民的横断面研究，这些移民居住在西班牙。进行了血吸虫血清学检测和显微镜下尿液检查，并通过电子病历检索和结构化问卷获得临床数据。
我们纳入了 388 名成年男性，平均年龄 43.5 岁（标准差[SD]=12.0，范围：18-76）。自移民到欧盟以来的中位时间为 17 年（四分位距[IQR]：11-21）。最常见的原籍国是塞内加尔（N=179，46.1%）。338 名男性中，有 147 名（37.6%）血清学检测血吸虫阳性。尿液中仅检出 1.3%的寄生虫卵。9 项泌尿生殖系统临床项目与血吸虫血清学阳性结果显著相关：盆腔痛（45.2%；比值比[OR] =1.57，95%置信区间[CI]：1.0-2.4）、射精痛（14.5%；OR=1.85，95%CI：1.0-3.5）、性交痛（12.4%；OR=2.45，95%CI：1.2-5.2）、勃起功能障碍（9.5%；OR=3.10，95%CI：1.3-7.6）、自述不孕（32.1%；OR=1.69，95%CI：1.0-2.8）、血尿（55.2%；OR=2.37，95%CI：1.5-3.6）、尿痛（52.1%；OR=2.01，95%CI：1.3-3.1）、未确诊的综合征性性传播感染（5.4%）和睾丸炎（20.7%；OR=1.81，95%CI：1.0-3.1）。临床体征往往呈簇状出现。
在血清学检测血吸虫阳性的非洲长期移民男性中，泌尿生殖系统临床体征和症状较为常见。即使在那些长期不在其撒哈拉以南非洲原籍国居住的人群中，也可能存在生殖器受累。需要进一步研究以开发诊断工具并验证慢性血吸虫病的治疗方法。
Zotero 插件
