Epidemiological, clinical, diagnostic and economic features of an immigrant population of chronic schistosomiasis sufferers with long-term residence in a nonendemic country (North Metropolitan area of Barcelona, 2002-2016)
Roure, Sílvia (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Valerio, Lluís (Servei Atenció Primària, Santa Coloma de Gramenet)
Pérez-Quílez, Olga (Servei Atenció Primària, Santa Coloma de Gramenet)
Fernádez-Rivas, Gema (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Martínez-Cuevas, Octavio (Servei Atenció Primària, Santa Coloma de Gramenet)
Alcántara-Román, Albert (Servei Atenció Primària, Santa Coloma de Gramenet)
Viasus, Diego (Hospital Universidad del Norte (Barranquilla))
Pedro-Botet, M. Luisa (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Sabriá-Leal, M (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Clotet Sala, Bonaventura (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Universitat Autònoma de Barcelona

Fecha:	2017
Resumen:	Background. Schistosomiasis, one of the neglected tropical diseases (NTD) listed by the WHO, is an acute and chronic parasitic disease caused by blood flukes (trematode worms) of the genus Schistosoma. Complications of long-term infestation include liver cirrhosis, bladder tumors and kidney failure. The objective of this study was to carry out a clinical and epidemiological characterization of a schistosomiasis-diagnosed immigrant population with long-term residencein the EU as well as to evaluate the diagnostic methods available to date. Methods and results. A total of 61 individuals with Schistosoma infection who received medical attention between June 2002 and June 2016 at the North Metropolitan International Health Unit in Barcelona (Catalonia, Spain), were included in the study. All patients were sub-Saharan African immigrants. The majority were male (91. 8%) with a median age of 34 years. Symptoms attributable to infection such as haematuria, abdominal pain and dysuria were recorded in up to 90% of patients. The percentage of eosinophils decreased amongst older patients (p = 0. 002) and those with symptoms associated with urinary tract infections (p = 0. 017). Serology was used for diagnosis in 80. 3% of the cases, with microscopic examination showingthe remaining 9. 8% positive for parasite eggs. Direct microbiological diagnosis was more useful in patients with less than 5 years of residence in the EU (p = 0. 05). Chronic complications were present in 22 (36%) of the patients, with renal failure affecting 20 (33%). Of these 20, 6(10%) developed terminal renal failure and required hemodialysis, while 3 (5%) received a renal transplantation. Conclusion. Morbidity associated with chronic long-term schistosomiasis is frequent among African immigrants in non-endemic countries. Better diagnostic tools and appropriate early treatment would prevent the development of visceral damage. Thorough screening in selected patients would also be useful to avoid chronic complications.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Publicado en:	PloS one, Vol. 12 Núm. 9 (september 2017) , p. 1-12, ISSN 1932-6203

DOI: 10.1371/journal.pone.0185245
PMID: 28953954

12 p, 1.2 MB

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