Background

Chronic schistosomiasis silently leads to severe organ-specific disorders, such as hydroureter, bladder cancer or portal hypertension in around 10% of infected people in endemic zones. However, in non-endemic areas, information on schistosomiasis' severe complications and their actual prevalence is scarce because diagnosis is usually reached when such complications are well established.

Methods

Retrospective observational study of data obtained from a screening protocol designed for sub-Saharan migrants including search for stool parasites and schistosoma serology. After screening 3090 sub-Saharans, 326 (10.5%) confirmed cases of schistosomiasis were found, based on detection of ova in feces, urine or in biopsy samples. Another 830 patients (26.9%) were diagnosed of probable schistosomiasis (positive serology and/or suggestive imaging findings).

Results

Only patients with confirmed schistosomiasis were included in the final analysis. Among them, 13 (4%) presented severe complications at the time of diagnosis. Depending on the location, they account for 5% of patients with hepatointestinal schistosomiasis and 3.5% of patients with urogenital infection.

Conclusions

Targeted systematic screening could reduce the prevalence of severe complications by enabling early diagnosis and treatment. Having indigenous transmission been demonstrated in southern Europe, prevention of future cases in non-endemic countries might be another sound reason supporting such screening.

中文翻译：

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西班牙进口血吸虫病的严重并发症：一项回顾性观察研究。

背景

慢性血吸虫病在地方性地区的大约10％感染人群中无声地导致了严重的器官特异性疾病，例如输尿管输尿管癌，膀胱癌或门静脉高压症。但是，在非流行地区，关于血吸虫病严重并发症及其实际患病率的信息很少，因为通常在充分确定这些并发症后才能进行诊断。

方法

对为撒哈拉以南非洲移民设计的筛查方案获得的数据的回顾性观察研究，包括寻找粪便寄生虫和血吸虫血清学。在筛查3090个撒哈拉以南非洲地区后，根据粪便，尿液或活检样本中的卵子检测，发现了326例（10.5％）确诊为血吸虫病的病例。另有830名患者（26.9％）被诊断为可能的血吸虫病（阳性血清学和/或暗示性影像学发现）。

结果

最终分析仅包括确诊为血吸虫病的患者。其中13例（4％）在诊断时出现严重并发症。根据位置的不同，它们占肝肠血吸虫病患者的5％和泌尿生殖系统感染患者的3.5％。

结论

有针对性的系统筛查可以通过早期诊断和治疗降低严重并发症的发生率。在南欧已证明有土著传播的情况，在非流行国家预防今后的病例可能是支持这种筛查的另一个合理原因。