International Health Program (PROSICS), Direcció Territorial de Malalties Infeccioses Metropolitana Nord, Institut Català de la Salut, Badalona 08914, Spain; Fundació Lluita contra les Infeccions, Badalona, Spain; Infectious Diseases Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
International Health Program (PROSICS), Direcció Territorial de Malalties Infeccioses Metropolitana Nord, Institut Català de la Salut, Badalona 08914, Spain; Fundació Lluita contra les Infeccions, Badalona, Spain; Germans Trias i Pujol Research Institute, Badalona, Spain.
J Infect. 2024 Oct;89(4):106234. doi: 10.1016/j.jinf.2024.106234. Epub 2024 Aug 3.
Past exposure to schistosomiasis is frequent among migrants from endemic countries, and chronic untreated infection may lead to long-term morbidities.
We carried out a prospective population-based cross-sectional study among migrants from endemic Sub-Saharan countries living in Barcelona, Spain. Participants had not been previously diagnosed or treated for schistosomiasis. Clinical signs and symptoms were scrutinised through a systematic revision of electronic medical records and an on-site standardised questionnaire, and blood and urine samples were screened for Schistosoma.
We recruited 522 eligible participants, 74.3% males, mean age 42.7 years (SD=11.5, range 18-76), Overall, 46.4% were from Senegal and 23.6% from Gambia. They had lived in the European Union for a median of 16 years (IQR 10-21). The prevalence of a Schistosoma-positive serology was 35.8%. S. haematobium eggs were observed in urine samples in 6 (1.2%) participants. The most prevalent symptoms among Schistosoma-positive participants were chronic abdominal pain (68.8%, OR=1.79; 95%CI 1.2-2.6), eosinophilia (44.9%, OR=2.69; 95%CI 1.8-4.0) and specific symptoms associated with urinary schistosomiasis, like self-reported episodes of haematuria (37.2%; OR=2.47; 95%CI 1.6-3.8), dysuria (47.9%, OR=1.84; 95%CI=1.3-2.7) and current renal insufficiency (13.4%; OR=2.35; 95%CI=1.3-4.3). We found a significant prevalence of gender-specific genital signs and symptoms among females (mainly menstrual disorders) and males (erectile dysfunction and pelvic pain). Individuals typically presented with a multitude of interconnected symptoms, most commonly chronic abdominal pain, which are often disregarded.
Despite the lack of urine parasite identification, the high incidence of clinical signs and symptoms strongly correlated with a positive schistosomiasis serology suggests the existence of a heavy clinical burden among long-term West African migrants living for years/decades in the study region. More research is urgently required to determine whether these symptoms are the result of long-term sequelae or a persistent active Schistosoma infection.
来自流行地区的移民常患有血吸虫病既往史，而慢性未治疗感染可能导致长期发病。
我们在西班牙巴塞罗那对来自撒哈拉以南流行地区的移民进行了一项前瞻性基于人群的横断面研究。参与者此前未被诊断或治疗过血吸虫病。通过系统地查阅电子病历和现场标准化问卷，对临床症状和体征进行了仔细检查，并对血液和尿液样本进行了筛查以检测血吸虫。
我们招募了 522 名符合条件的参与者，其中 74.3%为男性，平均年龄为 42.7 岁（标准差为 11.5，范围为 18-76）。总体而言，46.4%来自塞内加尔，23.6%来自冈比亚。他们在欧盟的平均居住时间为 16 年（IQR 10-21）。血清学阳性的血吸虫病患病率为 35.8%。6 名（1.2%）参与者的尿液样本中发现了血吸虫卵。血清学阳性参与者中最常见的症状是慢性腹痛（68.8%，OR=1.79；95%CI 1.2-2.6）、嗜酸性粒细胞增多症（44.9%，OR=2.69；95%CI 1.8-4.0）和与尿路血吸虫病相关的特定症状，如自述血尿发作（37.2%；OR=2.47；95%CI 1.6-3.8）、尿痛（47.9%，OR=1.84；95%CI=1.3-2.7）和目前的肾功能不全（13.4%，OR=2.35；95%CI=1.3-4.3）。我们发现，女性（主要是月经紊乱）和男性（勃起功能障碍和骨盆疼痛）存在显著的与性别相关的生殖器体征和症状。个体通常表现出多种相互关联的症状，最常见的是慢性腹痛，这些症状通常被忽视。
尽管未鉴定尿液寄生虫，但与阳性血吸虫病血清学强烈相关的临床体征和症状的高发率表明，在该研究地区生活多年/几十年的长期西非移民中存在沉重的临床负担。迫切需要进一步研究以确定这些症状是否是长期后遗症的结果还是持续存在的活动性血吸虫感染。
