Human urogenital schistosomiasis in West and Sub-Saharan Africa migrants in Sardinia, Italy: A retrospective monocentric study

Introduction: Schistosoma (S.) haematobium is the aetiological agent of urogenital schistosomiasis endemic in Sub-Saharan Africa and the Middle East. Microhaematuria is strongly associated with schistosomiasis diagnosis. Praziquantel (PZQ) is the treatment of choice. Methodology: We conducted a...

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Main Authors: Nicholas Geremia, Andrea De Vito, Vincenzo Lai, Vito Fiore, Elija Princic, Paola Rappelli, Giordano Madeddu, Sergio Babudieri
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2022-08-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/15492
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author Nicholas Geremia
Andrea De Vito
Vincenzo Lai
Vito Fiore
Elija Princic
Paola Rappelli
Giordano Madeddu
Sergio Babudieri
author_facet Nicholas Geremia
Andrea De Vito
Vincenzo Lai
Vito Fiore
Elija Princic
Paola Rappelli
Giordano Madeddu
Sergio Babudieri
author_sort Nicholas Geremia
collection DOAJ
description Introduction: Schistosoma (S.) haematobium is the aetiological agent of urogenital schistosomiasis endemic in Sub-Saharan Africa and the Middle East. Microhaematuria is strongly associated with schistosomiasis diagnosis. Praziquantel (PZQ) is the treatment of choice. Methodology: We conducted a monocentric survey among African migrants from January 2017 to December 2018. The diagnosis of S. haematobium was performed by direct microscopic examination of urine. The treatment was PZQ 40 mg/Kg/die for three days. Results: We enrolled 91 male patients with a median age of 20.2 years (IQR 18.9-23.4)]. Forty-five (49.5%) described a history of haematuria. Sixteen (17.6%) evidenced the presence of red blood cells (RBCs) during urine microscopy. Eighteen (19.8%) had urogenital schistosomiasis. Their median white blood count (WBC) was 5.15 x 109/L (IQR 4.45-6.08) and it was 6.37 x 109 /L (IQR 5.14-8.27), p = 0.009, after 15 days from treatment. Baseline eosinophil count was 0.5 x 109/L (IQR 0.3-0.6) and 0.7 x 109/L (IQR 0.2-1.9; p = 0.032). According to the univariate analysis, origin from Mali [odds ratio (OR) 3.6 (CI 1.2-10.9), p = 0.022] and microscopic evidence of RBCs [OR of 10.7 (CI 2.5-45.1), p = 0.001] were main predictors of urogenital schistosomiasis diagnosis. One (5.6%) treatment failure was registered. Three (16.7%) patients had bladder cancer. Conclusions: Detection of RBCs was a significant predictor of S. haematobium infection and could be used as a screening method in migrants coming from endemic areas. Early urogenital schistosomiasis diagnosis and ultrasound diagnostic tools are crucial for reducing the risk of potential neoplastic evolution.
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spelling doaj-art-18e277afa3df4b06ac0f619cbca8896d2025-08-20T02:57:13ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802022-08-01160810.3855/jidc.15492Human urogenital schistosomiasis in West and Sub-Saharan Africa migrants in Sardinia, Italy: A retrospective monocentric studyNicholas Geremia0Andrea De Vito1Vincenzo Lai2Vito Fiore3Elija Princic4Paola Rappelli5Giordano Madeddu6Sergio Babudieri7Unit of Infectious Diseases, Department of Medical, Surgical and Experimental Science, University of Sassari, Sassari, ItalyDepartment of Biomedical Sciences, University of Sassari, Sassari, ItalyMediterranean Center for Disease Control (MCDC), University of Sassari, Sassari, ItalyUnit of Infectious Diseases, Department of Medical, Surgical and Experimental Science, University of Sassari, Sassari, ItalyUnit of Infectious Diseases, Department of Medical, Surgical and Experimental Science, University of Sassari, Sassari, ItalyDepartment of Biomedical Sciences, University of Sassari, Sassari, ItalyUnit of Infectious Diseases, Department of Medical, Surgical and Experimental Science, University of Sassari, Sassari, ItalyUnit of Infectious Diseases, Department of Medical, Surgical and Experimental Science, University of Sassari, Sassari, Italy Introduction: Schistosoma (S.) haematobium is the aetiological agent of urogenital schistosomiasis endemic in Sub-Saharan Africa and the Middle East. Microhaematuria is strongly associated with schistosomiasis diagnosis. Praziquantel (PZQ) is the treatment of choice. Methodology: We conducted a monocentric survey among African migrants from January 2017 to December 2018. The diagnosis of S. haematobium was performed by direct microscopic examination of urine. The treatment was PZQ 40 mg/Kg/die for three days. Results: We enrolled 91 male patients with a median age of 20.2 years (IQR 18.9-23.4)]. Forty-five (49.5%) described a history of haematuria. Sixteen (17.6%) evidenced the presence of red blood cells (RBCs) during urine microscopy. Eighteen (19.8%) had urogenital schistosomiasis. Their median white blood count (WBC) was 5.15 x 109/L (IQR 4.45-6.08) and it was 6.37 x 109 /L (IQR 5.14-8.27), p = 0.009, after 15 days from treatment. Baseline eosinophil count was 0.5 x 109/L (IQR 0.3-0.6) and 0.7 x 109/L (IQR 0.2-1.9; p = 0.032). According to the univariate analysis, origin from Mali [odds ratio (OR) 3.6 (CI 1.2-10.9), p = 0.022] and microscopic evidence of RBCs [OR of 10.7 (CI 2.5-45.1), p = 0.001] were main predictors of urogenital schistosomiasis diagnosis. One (5.6%) treatment failure was registered. Three (16.7%) patients had bladder cancer. Conclusions: Detection of RBCs was a significant predictor of S. haematobium infection and could be used as a screening method in migrants coming from endemic areas. Early urogenital schistosomiasis diagnosis and ultrasound diagnostic tools are crucial for reducing the risk of potential neoplastic evolution. https://jidc.org/index.php/journal/article/view/15492Schistosomiasisneglected diseasesrefugeesmigrantspraziquantel
spellingShingle Nicholas Geremia
Andrea De Vito
Vincenzo Lai
Vito Fiore
Elija Princic
Paola Rappelli
Giordano Madeddu
Sergio Babudieri
Human urogenital schistosomiasis in West and Sub-Saharan Africa migrants in Sardinia, Italy: A retrospective monocentric study
Journal of Infection in Developing Countries
Schistosomiasis
neglected diseases
refugees
migrants
praziquantel
title Human urogenital schistosomiasis in West and Sub-Saharan Africa migrants in Sardinia, Italy: A retrospective monocentric study
title_full Human urogenital schistosomiasis in West and Sub-Saharan Africa migrants in Sardinia, Italy: A retrospective monocentric study
title_fullStr Human urogenital schistosomiasis in West and Sub-Saharan Africa migrants in Sardinia, Italy: A retrospective monocentric study
title_full_unstemmed Human urogenital schistosomiasis in West and Sub-Saharan Africa migrants in Sardinia, Italy: A retrospective monocentric study
title_short Human urogenital schistosomiasis in West and Sub-Saharan Africa migrants in Sardinia, Italy: A retrospective monocentric study
title_sort human urogenital schistosomiasis in west and sub saharan africa migrants in sardinia italy a retrospective monocentric study
topic Schistosomiasis
neglected diseases
refugees
migrants
praziquantel
url https://jidc.org/index.php/journal/article/view/15492
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