Malawi Liverpool Wellcome Programme, Kamuzu University of Health Sciences, Queen Elizabeth Central Hospital, campus, 1 Chipatala Avenue, Private Bag 360, Blantyre 3, Chichiri, Malawi.
Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, CTID Building, Pembroke Place, Liverpool, Merseyside, L3 5QA, UK.
BMC Infect Dis. 2024 Aug 19;24(1):839. doi: 10.1186/s12879-024-09732-z.
Male Genital Schistosomiasis (MGS) remains an often-overlooked chronic sequela of urogenital schistosomiasis in endemic areas of sub-Saharan Africa. As part of a 2-year longitudinal study on Hybridization of UroGenital Schistosomiasis (HUGS) in Malawi, a MGS sub-study was conducted to assess whether hybrid schistosomes were incriminated.
During recruitment, demographic, health and socio-economic data were collected through individual questionnaire interviews in Mthawira community from Nsanje District along Shire River and Samama community from Mangochi District along Lake Malawi shoreline. Urine and semen samples were collected and analysed to determine the identity of schistosome infection. Urine filtration and microscopy, direct microscopy of semen and its sediments (after centrifugation) were performed. Thereafter, the sediments were examined by molecular DNA analysis with a novel two-tube real-time PCR assay. The participants were also screened for Human papilloma virus (HPV) and other sexually transmitted infections (STIs).
Twenty-two men were recruited for the sub-study, 8 in Nsanje District and 14 in Mangochi District, with a median age of 22.0 years. By microscopy, ten (45.7%) participants had Schistosoma ova in their urine, 11 (50.0%) in semen while 16 (72.7%) were positive by real-time PCR. One participant had both S. haematobium and S. mattheei ova in his semen, three showed symptoms, and one had a mixed infection of S. mansoni and possible S. haematobium-S. mattheei hybrid. Twelve men had detectable high-risk HPV serotypes 16, 18 and others while six had Trichomonas vaginalis and other STIs.
Zoonotic and hybrid schistosomes can cause MGS similar to human schistosomes, which can be co-infected with HPV and STIs, thereby posing a new challenge in diagnosis, management and control measures in resource poor settings. Increased awareness of these infections among local communities and primary healthcare workers and improvement of disease management are needed and advocated.
在撒哈拉以南非洲流行地区，男性生殖器血吸虫病（MGS）仍然是泌尿生殖系统血吸虫病的一种常见慢性后遗症。作为马拉维杂交泌尿生殖系统血吸虫病（HUGS）的一项为期两年的纵向研究的一部分，进行了一项 MGS 子研究，以评估是否有杂交血吸虫被牵连。
在招募期间，通过在希雷河沿岸 Nsanje 区的 Mthawira 社区和马拉维湖沿岸 Mangochi 区的 Samama 社区进行个人问卷调查，收集人口统计学、健康和社会经济数据。收集尿液和精液样本并进行分析，以确定血吸虫感染的身份。进行尿液过滤和显微镜检查、精液直接显微镜检查及其沉淀物（离心后），然后使用新型双管实时 PCR 检测对沉淀物进行分子 DNA 分析。还对参与者进行了人乳头瘤病毒（HPV）和其他性传播感染（STI）的筛查。
该子研究共招募了 22 名男性，其中 8 名来自 Nsanje 区，14 名来自 Mangochi 区，中位年龄为 22.0 岁。通过显微镜检查，10 名（45.7%）参与者尿液中有血吸虫卵，11 名（50.0%）精液中有血吸虫卵，而 16 名（72.7%）实时 PCR 阳性。一名参与者的精液中同时有 S. haematobium 和 S. mattheei 卵，三名出现症状，一名混合感染了 S. mansoni 和可能的 S. haematobium-S. mattheei 杂交种。12 名男性检测到高危 HPV 血清型 16、18 和其他类型，6 名男性检测到阴道毛滴虫和其他 STI。
人畜共患和杂交血吸虫可引起与人类血吸虫相似的 MGS，也可能与 HPV 和 STI 合并感染，从而在资源匮乏的环境中对诊断、管理和控制措施构成新的挑战。需要并提倡提高当地社区和初级保健工作者对这些感染的认识，并改善疾病管理。
