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Leblanc C, Brun S, Bouchaud O, Izri A, Ok V, Caseris M, Sorge F, Pham LL, Paugam A, Paris L, Jaureguiberry S, Bloch-Queyrat C, Boubaya M, Faye A, Mariani P, de Pontual L. Imported schistosomiasis in Paris region of France: A multicenter study of prevalence and diagnostic methods. Travel Med Infect Dis 2021; 41:102041. [PMID: 33785455 DOI: 10.1016/j.tmaid.2021.102041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 03/18/2021] [Accepted: 03/22/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND There are few data on imported schistosomiasis - especially in children. The objectives of the present study were to estimate the prevalence of imported schistosomiasis in at-risk children in the greater Paris region of France and to compare diagnostic methods. METHOD Children at risk of schistosomiasis who consulted or were hospitalized in four hospitals in the greater Paris region were prospectively included. Clinical and laboratory data were collected. Urine and feces samples were screened for Schistosoma spp. using microscopy, a point-of-care circulating cathodic antigen and a real-time polymerase chain reaction assay. Serum samples were screened using Western blot, ELISA, indirect hemagglutination, and immunochromatographic assays. The diagnosis was characterized as confirmed (positive microscopy analysis) and as suspected (positive ELISA and Western blot assays). The prevalence of schistosomiasis and the tests' performances were estimated using the latent class method. RESULTS A total of 114 children were included. Most of the children were newly arrived migrants from sub-Saharan Africa. The mean age was 13.2 years-old. There were 12 (10.5%) confirmed cases and 13 (11.4%) suspected cases. Half of the confirmed and suspected cases were asymptomatic. The prevalence was 24.3%. The ELISA and the Western blot assays presented the same sensitivity (83%) and specificity (99%). The serum immunochromatographic assay also showed good performance. CONCLUSIONS The high prevalence of imported schistosomiasis among at-risk children in the greater Paris region confirms the need for systematic screening. A serum immunochromatographic assay appears to be one of the most effective screening methods for a low cost.
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Affiliation(s)
- Claire Leblanc
- Department of Pediatrics, AP-HP University Paris 13, Jean Verdier Hospital, Bondy, France.
| | - Sophie Brun
- Department of Parasitology-Mycology, AP-HP University Paris 13, Avicenne Hospital, Bobigny, France
| | - Olivier Bouchaud
- Department of Infectious and Tropical Diseases, AP-HP University Paris 13, Avicenne Hospital, Bobigny, France
| | - Arezki Izri
- Department of Parasitology-Mycology, AP-HP University Paris 13, Avicenne Hospital, Bobigny, France
| | - Vichita Ok
- Department of Parasitology-Mycology, AP-HP University Paris 13, Avicenne Hospital, Bobigny, France
| | - Marion Caseris
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP University Paris Diderot, Robert Debré Hospital, Paris, France
| | - Fréderic Sorge
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP University Paris Descartes, Necker-Enfants Malades Hospital, Paris, France
| | - Luu-Ly Pham
- Department of Pediatrics, AP-HP University Paris 13, Jean Verdier Hospital, Bondy, France
| | - André Paugam
- Department of Parasitology-Mycology, AP-HP University Paris Descartes, Cochin Hospital, Paris, France
| | - Luc Paris
- Department of Parasitology-Mycology, AP-HP Sorbonne Université, Pitié-Salpétrière Hospital, Paris, France
| | - Stéphane Jaureguiberry
- Department of Infectious and Tropical Diseases, AP-HP University Paris -Sud Saclay, Kremlin Bicêtre Hospital, Le Kremlin Bicêtre, France
| | - Coralie Bloch-Queyrat
- Department of Clinical Research, AP-HP University Paris 13, Avicenne Hospital, Bobigny, France
| | - Marouane Boubaya
- Department of Clinical Research, AP-HP University Paris 13, Avicenne Hospital, Bobigny, France
| | - Albert Faye
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP University Paris Diderot, Robert Debré Hospital, Paris, France
| | - Patricia Mariani
- Department of Microbiology, AP-HP University Paris Diderot, Robert Debré Hospital, Paris, France
| | - Loïc de Pontual
- Department of Pediatrics, AP-HP University Paris 13, Jean Verdier Hospital, Bondy, France
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How can schistosome circulating antigen assays be best applied for diagnosing male genital schistosomiasis (MGS): an appraisal using exemplar MGS cases from a longitudinal cohort study among fishermen on the south shoreline of Lake Malawi. Parasitology 2019; 146:1785-1795. [PMID: 31452477 PMCID: PMC6939168 DOI: 10.1017/s0031182019000969] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
We provide an update on diagnostic methods for the detection of urogenital schistosomiasis (UGS) in men and highlight that satisfactory urine-antigen diagnostics for UGS lag much behind that for intestinal schistosomiasis, where application of a urine-based point-of-care strip assay, the circulating cathodic antigen (CCA) test, is now advocated. Making specific reference to male genital schistosomiasis (MGS), we place greater emphasis on parasitological detection methods and clinical assessment of internal genitalia with ultrasonography. Unlike the advances made in defining a clinical standard protocol for female genital schistosomiasis, MGS remains inadequately defined. Whilst urine filtration with microscopic examination for ova of Schistosoma haematobium is a convenient but error-prone proxy of MGS, we describe a novel low-cost sampling and direct visualization method for the enumeration of ova in semen. Using exemplar clinical cases of MGS from our longitudinal cohort study among fishermen along the shoreline of Lake Malawi, the portfolio of diagnostic needs is appraised including: the use of symptomatology questionnaires, urine analysis (egg count and CCA measurement), semen analysis (egg count, circulating anodic antigen measurement and real-time polymerase chain reaction analysis) alongside clinical assessment with portable ultrasonography.
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Ajibola O, Gulumbe BH, Eze AA, Obishakin E. Tools for Detection of Schistosomiasis in Resource Limited Settings. Med Sci (Basel) 2018; 6:medsci6020039. [PMID: 29789498 PMCID: PMC6024580 DOI: 10.3390/medsci6020039] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 05/15/2018] [Accepted: 05/16/2018] [Indexed: 12/20/2022] Open
Abstract
Schistosomiasis is a debilitating disease affecting over 200 million people, with the highest burden of morbidity and mortality in African countries. Despite its huge impact on the health and socio-economic burden of the society, it remains a neglected tropical disease, with limited attention from governments and stakeholders in healthcare. One of the critical areas that is hugely under-developed is the development of accurate diagnostics for both intestinal and urogenital schistosomiasis. Diagnosis of schistosomiasis is important for the detection and treatment of disease in endemic and non-endemic settings. A conclusive detection method is also an indispensable part of treatment, both in the clinic and during mass drug administration (MDA), for the monitoring efficacy of treatment. Here, we review the available diagnostic methods and discuss the challenges encountered in diagnosis in resource limited settings. We also present the available diagnostics and cost implications for deployment in resource limited settings. Lastly, we emphasize the need for more funding directed towards the development of affordable diagnostic tools that is affordable for endemic countries as we work towards the elimination of the disease.
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Affiliation(s)
- Olumide Ajibola
- Department of Microbiology, Federal University Birnin Kebbi, P.M.B. 1157 Kalgo Road, Birnin Kebbi 860222, Kebbi State, Nigeria.
| | - Bashar Haruna Gulumbe
- Department of Microbiology, Federal University Birnin Kebbi, P.M.B. 1157 Kalgo Road, Birnin Kebbi 860222, Kebbi State, Nigeria.
| | - Anthonius Anayochukwu Eze
- Department of Medical Biochemistry, University of Nigeria, Enugu Campus, Enugu 400241, Enugu State, Nigeria.
| | - Emmanuel Obishakin
- Biotechnology Division, National Veterinary Research Institute, P.M.B. 001, Vom, Jos, 930281, Plateau State, Nigeria.
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