González-Sanz Marta, Martín-Rubio Irene, Martín Oihane, Muriel Alfonso, de la Fuente-Hernanz Sagrario, Crespillo-Andújar Clara, Chamorro-Tojeiro Sandra, Monge-Maíllo Begoña, Norman Francesca F, Pérez-Molina José A
National Reference Centre for Imported Tropical Diseases, Infectious Diseases Department, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain.
Departamento de Medicina y Especialidades Médicas, Programa de Ciencias de la Salud, Universidad de Alcalá, 28801 Alcalá de Henares, Spain.
Trop Med Infect Dis. 2025 Jan 14;10(1):22. doi: 10.3390/tropicalmed10010022.
Chronic schistosomiasis can lead to significant morbidity. Serology is highly sensitive; however, its role in assessing treatment response is controversial. This study aimed to analyze serological values following treatment of chronic imported schistosomiasis.
A retrospective observational study was performed including patients treated for chronic imported schistosomiasis from 2018 to 2022 who had at least one serological result at baseline and during follow-up. Demographic, clinical, and laboratory data were evaluated. Generalized estimating equation (GEE) models and Kaplan-Meier curves were used to analyze the evolution of serological values.
Of the 83 patients included, 72 (86.7%) were male, and the median age was 26 years (IQR 22-83). Most patients, 76 (91.6%), were migrants from sub-Saharan Africa. While 24 cases (28.9%) presented with urinary symptoms, the majority (59; 71.1%) were asymptomatic. eggs were observed in five cases (6.2%). Eosinophilia was present in 34 participants (40.9%). All patients had an initial positive ELISA serology, median ODI 2.3 (IQR 1.5-4.4); the indirect hemagglutination (IHA) test was positive/indeterminate in 34 cases (43.1%). Following treatment with praziquantel, serology values significantly decreased: -0.04 (IC95% -0.073, -0.0021) and -5.73 (IC95% -9.92, -1.53) units per month for ELISA and IHA, respectively. A quarter of patients (25%) had negative ELISA results 63 weeks after treatment. All symptomatic cases were clinically cured.
Serial serological determinations could be helpful for monitoring chronic schistosomiasis in non-endemic regions. The ideal timing for these follow-up tests is yet to be determined. Further research is needed to determine the factors that influence a negative result during follow-up.
慢性血吸虫病可导致严重发病。血清学检测高度敏感；然而，其在评估治疗反应中的作用存在争议。本研究旨在分析慢性输入性血吸虫病治疗后的血清学指标。
进行了一项回顾性观察研究，纳入2018年至2022年期间接受慢性输入性血吸虫病治疗的患者，这些患者在基线和随访期间至少有一次血清学检测结果。对人口统计学、临床和实验室数据进行了评估。使用广义估计方程（GEE）模型和Kaplan-Meier曲线分析血清学指标的变化。
纳入的83例患者中，72例（86.7%）为男性，中位年龄为26岁（四分位间距22 - 83岁）。大多数患者，76例（91.6%）是来自撒哈拉以南非洲的移民。24例（28.9%）出现泌尿系统症状，大多数（59例；71.1%）无症状。5例（6.2%）观察到虫卵。34名参与者（40.9%）出现嗜酸性粒细胞增多。所有患者初始ELISA血清学均为阳性，中位光密度指数（ODI）为2.3（四分位间距1.5 - 4.4）；间接血凝试验（IHA）在34例（43.1%）中呈阳性/不确定。使用吡喹酮治疗后，血清学指标显著下降：ELISA和IHA分别每月下降-0.04（95%置信区间-0.073，-0.0021）和-5.73（95%置信区间-9.92，-1.53）个单位。四分之一的患者（25%）在治疗63周后ELISA结果为阴性。所有有症状的病例临床均治愈。
系列血清学检测有助于监测非流行地区的慢性血吸虫病。这些随访检测的理想时间尚未确定。需要进一步研究以确定随访期间影响阴性结果的因素。
