Background Schistosomiasis is highly endemic in sub-Saharan Africa and frequently imported to Europe.Male urogenital manifestations are often neglected.We aimed to ascertain the prevalence of genitourinary clinical si...Background Schistosomiasis is highly endemic in sub-Saharan Africa and frequently imported to Europe.Male urogenital manifestations are often neglected.We aimed to ascertain the prevalence of genitourinary clinical signs and symptoms among long-term African migrants in a non-endemic European country using a serology test.Methods We carried out a prospective,community-based cross-sectional study of adult male migrants from sub-Saharan Africa living in Spain.Schistosoma serology tests and microscopic urine examinations were carried out,and clinical data were obtained from an electronic medical record search and a structured questionnaire.Results We included 388 adult males,mean age 43.5 years[Standard Deviation(SD)=12.0,range:18-76].The median time since migration to the European Union was 17[Interquartile range(IQR):11-21]years.The most frequent country of origin was Senegal(N=179,46.1%).Of the 338,147(37.6%)tested positive for Schistosoma.Parasite eggs were present in the urine of only 1.3%.Nine genitourinary clinical items were significantly associated with positive Schistosoma serology results:pelvic pain(45.2%;OR=1.57,95%CI:1.0-2.4),pain on ejaculation(14.5%;OR=1.85,95%CI:1.0-3.5),dyspareunia(12.4%;OR=2.45,95%CI:1.2-5.2),erectile dysfunction(9.5%;OR=3.10,95%CI:1.3-7.6),self-reported episodes of infertility(32.1%;OR=1.69,95%CI:1.0-2.8),haematuria(55.2%;OR=2.37,95%CI:1.5-3.6),dysuria(52.1%;OR=2.01,95%CI:1.3-3.1),undiagnosed syndromic STIs(5.4%),and orchitis(20.7%;OR=1.81,95%CI:1.0-3.1).Clinical signs tended to cluster.Conclusions Urogenital clinical signs and symptoms are prevalent among male African long-term migrants with a positive Schistosoma serology results.Genital involvement can be frequent even among those with long periods of non-residence in their sub-Saharan African countries of origin.Further research is needed to develop diagnostic tools and validate therapeutic approaches to chronic schistosomiasis.展开更多
基金Fight Infections Foundation,Badalona,Spain.Unspecified Grant
文摘Background Schistosomiasis is highly endemic in sub-Saharan Africa and frequently imported to Europe.Male urogenital manifestations are often neglected.We aimed to ascertain the prevalence of genitourinary clinical signs and symptoms among long-term African migrants in a non-endemic European country using a serology test.Methods We carried out a prospective,community-based cross-sectional study of adult male migrants from sub-Saharan Africa living in Spain.Schistosoma serology tests and microscopic urine examinations were carried out,and clinical data were obtained from an electronic medical record search and a structured questionnaire.Results We included 388 adult males,mean age 43.5 years[Standard Deviation(SD)=12.0,range:18-76].The median time since migration to the European Union was 17[Interquartile range(IQR):11-21]years.The most frequent country of origin was Senegal(N=179,46.1%).Of the 338,147(37.6%)tested positive for Schistosoma.Parasite eggs were present in the urine of only 1.3%.Nine genitourinary clinical items were significantly associated with positive Schistosoma serology results:pelvic pain(45.2%;OR=1.57,95%CI:1.0-2.4),pain on ejaculation(14.5%;OR=1.85,95%CI:1.0-3.5),dyspareunia(12.4%;OR=2.45,95%CI:1.2-5.2),erectile dysfunction(9.5%;OR=3.10,95%CI:1.3-7.6),self-reported episodes of infertility(32.1%;OR=1.69,95%CI:1.0-2.8),haematuria(55.2%;OR=2.37,95%CI:1.5-3.6),dysuria(52.1%;OR=2.01,95%CI:1.3-3.1),undiagnosed syndromic STIs(5.4%),and orchitis(20.7%;OR=1.81,95%CI:1.0-3.1).Clinical signs tended to cluster.Conclusions Urogenital clinical signs and symptoms are prevalent among male African long-term migrants with a positive Schistosoma serology results.Genital involvement can be frequent even among those with long periods of non-residence in their sub-Saharan African countries of origin.Further research is needed to develop diagnostic tools and validate therapeutic approaches to chronic schistosomiasis.
