Management of imported complicated urogenital schistosomiasis in Europe : a TropNet retrospective study
© International Society of Travel Medicine 2022. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissionsoup.com..
BACKGROUND: Schistosomiasis is a neglected tropical disease caused by trematodes of the genus Schistosoma. Schistosoma haematobium causes urogenital schistosomiasis (UGS), a chronic disease characterized by pathology of the urogenital tract leading to potentially severe morbidity for which the treatment is poorly standardized. We conducted a survey in TropNet centres on the clinical presentations and management strategies of complicated urogenital schistosomiasis (cUGS).
METHODS: We reviewed the clinical records of patients seen at TropNet centres over a 20-year timespan (January 2001-December 2020). Case definition for cUGS included the presence of urogenital cancer, obstructive uropathy, kidney insufficiency of all grades and female or male genital involvement leading to infertility. Collected data included demographic information, patient category (traveller or migrant), imaging data, microbiological data (serology results and presence/absence of eggs in urine), histological features and outcome at last visit recorded.
RESULTS: Eight centres contributed with at least one case. Overall, 31 patients matched the inclusion criteria. Sub-Saharan Africa was the most likely place of infection for included patients. Median age was 30.6 years (range 21-46, interquartile ranges, IQR 27-33). Most patients (28/31, 90.3%) were males. Hydronephrosis was the most frequent complication, being present in 18 (58.1%) patients, followed by cancer, present in 5 patients (16.1%); 27 patients (87.1%) required surgical management of some sort. Use of praziquantel varied across centres, with six different regimens employed.
DISCUSSION: Very few cases of cUGSs were found in our survey, possibly indicating underdiagnosis of this condition. Hydronephrosis was the most frequently observed urogenital complication, and most patients required invasive procedures. Infection by S. haematobium can result in considerable morbidity, resulting in clinically challenging presentations requiring a multidisciplinary approach. As such, development of common protocols for early diagnosis and treatment is urgently needed.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:30 |
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| Enthalten in: |
Journal of travel medicine - 30(2023), 1 vom: 18. Feb. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Basile, Gregorio [VerfasserIn] |
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| Links: |
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| Themen: |
Genital schistosomiasis |
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| Anmerkungen: |
Date Completed 06.03.2023 Date Revised 22.03.2023 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/jtm/taac150 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM350587736 |
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| 100 | 1 | |a Basile, Gregorio |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Management of imported complicated urogenital schistosomiasis in Europe |b a TropNet retrospective study |
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| 500 | |a Date Revised 22.03.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © International Society of Travel Medicine 2022. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissionsoup.com. | ||
| 520 | |a BACKGROUND: Schistosomiasis is a neglected tropical disease caused by trematodes of the genus Schistosoma. Schistosoma haematobium causes urogenital schistosomiasis (UGS), a chronic disease characterized by pathology of the urogenital tract leading to potentially severe morbidity for which the treatment is poorly standardized. We conducted a survey in TropNet centres on the clinical presentations and management strategies of complicated urogenital schistosomiasis (cUGS) | ||
| 520 | |a METHODS: We reviewed the clinical records of patients seen at TropNet centres over a 20-year timespan (January 2001-December 2020). Case definition for cUGS included the presence of urogenital cancer, obstructive uropathy, kidney insufficiency of all grades and female or male genital involvement leading to infertility. Collected data included demographic information, patient category (traveller or migrant), imaging data, microbiological data (serology results and presence/absence of eggs in urine), histological features and outcome at last visit recorded | ||
| 520 | |a RESULTS: Eight centres contributed with at least one case. Overall, 31 patients matched the inclusion criteria. Sub-Saharan Africa was the most likely place of infection for included patients. Median age was 30.6 years (range 21-46, interquartile ranges, IQR 27-33). Most patients (28/31, 90.3%) were males. Hydronephrosis was the most frequent complication, being present in 18 (58.1%) patients, followed by cancer, present in 5 patients (16.1%); 27 patients (87.1%) required surgical management of some sort. Use of praziquantel varied across centres, with six different regimens employed | ||
| 520 | |a DISCUSSION: Very few cases of cUGSs were found in our survey, possibly indicating underdiagnosis of this condition. Hydronephrosis was the most frequently observed urogenital complication, and most patients required invasive procedures. Infection by S. haematobium can result in considerable morbidity, resulting in clinically challenging presentations requiring a multidisciplinary approach. As such, development of common protocols for early diagnosis and treatment is urgently needed | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Schistosoma haematobium | |
| 650 | 4 | |a genital schistosomiasis | |
| 650 | 4 | |a hydronephrosis | |
| 650 | 4 | |a squamocellular carcinoma | |
| 650 | 4 | |a travel-related schistosomiasis | |
| 650 | 4 | |a urogenital schistosomiasis | |
| 700 | 1 | |a Tamarozzi, Francesca |e verfasserin |4 aut | |
| 700 | 1 | |a Salas-Coronas, Joaquín |e verfasserin |4 aut | |
| 700 | 1 | |a Soriano-Pérez, Manuel Jesús |e verfasserin |4 aut | |
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| 700 | 1 | |a Bartoloni, Alessandro |e verfasserin |4 aut | |
| 700 | 1 | |a Tomasoni, Lina Rachele |e verfasserin |4 aut | |
| 700 | 1 | |a Gobbi, Federico Giovanni |e verfasserin |4 aut | |
| 700 | 1 | |a Köhler, Carsten |e verfasserin |4 aut | |
| 700 | 1 | |a Salvador, Fernando |e verfasserin |4 aut | |
| 700 | 1 | |a Bocanegra, Cristina |e verfasserin |4 aut | |
| 700 | 1 | |a Zammarchi, Lorenzo |e verfasserin |4 aut | |
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