Killington Kieran, Longley Nicky, Bowers Katherine, Chowdhury Humayra, Cinardo Paola, Nabarro Laura, Eisen Sarah
University College London Hospital, London, NW1 2BU, UK.
Hospital for Tropical Diseases, London, WC1E 6JD, UK.
BMC Glob Public Health. 2025 May 13;3(1):45. doi: 10.1186/s44263-025-00159-5.
Rodentolepis (Hymenolepis) nana (R. nana) is the most common cestode to infect humans, and whilst most infections are asymptomatic, those with a high burden of infection can present with abdominal pain, diarrhoea, or growth stunting. The Respond service, London, offers screening and treatment for common infections to people seeking asylum and refugees (PSAR), including testing for gastrointestinal parasites such as R. nana.
We present a retrospective observational analysis of all positive R. nana results in patients screened by the Respond service between April 2016 and July 2023. A positive result was defined by the presence of R. nana ova on stool microscopy for ova, cysts and parasites (OCP) or R. nana DNA detection using the Novodiag® Stool Parasite assay (NSP), a cartridge based multiplex molecular assay. We explore incidence of R. nana infection and efficacy of treatment in PSAR presenting to an integrated refugee health service.
R. nana was identified in 54/1797 (3%) of patients who had a stool sample collected in the Respond service. Median age of patients was 15 years (interquartile range [IQR] 9-17), and 38/54 (70%) were male, reflecting the sex demographic of the cohort. Coinfection with other parasites occurred in 28/54 (52%) of the cohort. Of the 27 patients who tested positive for R. nana where their family members were also tested, 11 patients (41%) had family members who were also infected with R. nana. Treatment failure (defined as failure to clear R. nana detected by OCP/NSP after treatment with praziquantel) occurred in 43% of the patients for whom a clearance sample was returned.
We show a significant prevalence of R. nana in people seeking asylum screened within the Respond cohort. We show significant clustering within family units and a relatively high treatment failure rate. We propose prompt treatment of positive cases to prevent transmission within families, and consideration of treatment of family units simultaneously to prevent re-infection.
微小膜壳绦虫（短膜壳绦虫属）是感染人类最常见的绦虫，虽然大多数感染无症状，但感染负荷高的患者可能出现腹痛、腹泻或生长发育迟缓。伦敦的Respond服务为寻求庇护者和难民提供常见感染的筛查和治疗，包括检测如微小膜壳绦虫等胃肠道寄生虫。
我们对2016年4月至2023年7月期间由Respond服务筛查的所有微小膜壳绦虫阳性结果患者进行了回顾性观察分析。阳性结果定义为粪便显微镜检查虫卵、囊肿和寄生虫（OCP）时发现微小膜壳绦虫卵，或使用Novodiag®粪便寄生虫检测法（NSP，一种基于试剂盒的多重分子检测法）检测到微小膜壳绦虫DNA。我们探讨了在综合难民健康服务中就诊的寻求庇护者中微小膜壳绦虫感染的发生率和治疗效果。
在Respond服务中采集粪便样本的1797名患者中，有54名（3%）被鉴定为微小膜壳绦虫感染。患者的中位年龄为15岁（四分位间距[IQR]9 - 17），38/54（70%）为男性，反映了该队列的性别构成。28/54（52%）的队列患者合并感染其他寄生虫。在27名微小膜壳绦虫检测呈阳性且其家庭成员也接受检测的患者中，11名患者（41%）的家庭成员也感染了微小膜壳绦虫。在有清除样本返回的患者中，43%出现治疗失败（定义为使用吡喹酮治疗后，OCP/NSP检测未能清除微小膜壳绦虫）。
我们发现Respond队列中筛查的寻求庇护者中微小膜壳绦虫感染率很高。我们发现家庭单位内存在明显的聚集现象，且治疗失败率相对较高。我们建议对阳性病例进行及时治疗以防止家庭内传播，并考虑同时对家庭单位进行治疗以防止再次感染。
