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Effectiveness of Screening and Treatment Approaches for Schistosomiasis and Strongyloidiasis in Newly-Arrived Migrants from Endemic Countries in the EU/EEA : A Systematic Review
Agbata, Eric N. (Universitat Autònoma de Barcelona. Departament de Pediatria, d’Obstetrícia i Ginecologia i Medicina Preventiva i Salut Publica)
Morton, Rachael L. (NHMRC Clinical Trials Centre, University of Sydney)
Bisoffi, Zeno (Department of Diagnostics and Public Health, University of Verona)
Bottieau, Emmanuel (Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium)
Greenaway, Christina (Division of Infectious Diseases and Clinical Epidemiology, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal)
Biggs, Beverley-A. (Victorian Infectious Diseases Service, The Royal Melbourne Hospital)
Montero, Nadia (Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad Tecnológica Equinoccial)
Tran, Anh (NHMRC Clinical Trials Centre, University of Sydney)
Rowbotham, Nick (NHMRC Clinical Trials Centre, University of Sydney)
Arevalo-Rodriguez, Ingrid (Hospital Universitario Ramon y Cajal (IRYCIS); CIBER Epidemiology and Public Health (CIBERESP))
Myran, Daniel T. (Bruyere Research Institute, University of Ottawa)
Noori, Teymur (European Centre for Disease Prevention and Control, Gustav III)
Alonso-Coello, Pablo (Institut d'Investigació Biomèdica Sant Pau)
Pottie, Kevin (Centre for Global Health Institute of Population Health, University of Ottawa)
Requena-Méndez, Ana (Institut de Salut Global de Barcelona)
Universitat Autònoma de Barcelona

Date: 2018
Abstract: We aimed to evaluate the evidence on screening and treatment for two parasitic infections—schistosomiasis and strongyloidiasis—among migrants from endemic countries arriving in the European Union and European Economic Area (EU/EEA). We conducted a systematic search of multiple databases to identify systematic reviews and meta-analyses published between 1 January 1993 and 30 May 2016 presenting evidence on diagnostic and treatment efficacy and cost-effectiveness. We conducted additional systematic search for individual studies published between 2010 and 2017. We assessed the methodological quality of reviews and studies using the AMSTAR, Newcastle–Ottawa Scale and QUADAS-II tools. Study synthesis and assessment of the certainty of the evidence was performed using GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. We included 28 systematic reviews and individual studies in this review. The GRADE certainty of evidence was low for the effectiveness of screening techniques and moderate to high for treatment efficacy. Antibody-detecting serological tests are the most effective screening tests for detection of both schistosomiasis and strongyloidiasis in low-endemicity settings, because they have higher sensitivity than conventional parasitological methods. Short courses of praziquantel and ivermectin were safe and highly effective and cost-effective in treating schistosomiasis and strongyloidiasis, respectively. Economic modelling suggests presumptive single-dose treatment of strongyloidiasis with ivermectin for all migrants is likely cost-effective, but feasibility of this strategy has yet to be demonstrated in clinical studies. The evidence supports screening and treatment for schistosomiasis and strongyloidiasis in migrants from endemic countries, to reduce morbidity and mortality.
Rights: 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. Creative Commons
Language: Anglès.
Document: article ; recerca ; publishedVersion
Subject: Migrant populations ; Schistosomiasis/schistosoma ; Strongyloidiasis/strongyloides ; Screening/diagnosis ; Treatment ; Public health ; GRADE
Published in: International Journal of Environmental Research and Public Health, Vol. 16 (december 2018) , ISSN 1660-4601

PMID: 30577567
DOI: 10.3390/ijerph16010011


41 p, 4.9 MB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (scientific output) > Health sciences and biosciences > Institut d'Investigació Biomèdica Sant Pau
Articles > Research articles
Articles > Published articles

 Record created 2019-05-06, last modified 2019-06-03



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