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Seaman JA, Bracamonte E, Kim S. A unique case of Schistosoma-related ureteral stricture: Diagnosis and surgical reconstruction. IJU Case Rep 2023; 6:325-328. [PMID: 37928292 PMCID: PMC10622224 DOI: 10.1002/iju5.12605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 06/26/2023] [Indexed: 11/07/2023] Open
Abstract
Background Chronic infection with Schistosoma haematobium can lead to pathology of the upper and lower urinary tracts. While well known as a cause of squamous cell carcinoma of the bladder, relatively little research exists on ureteral involvement. Here, we present a unique case of bilateral ureteral obstruction from schistosomiasis with concomitant ureteral stone disease. Case presentation A 43-year-old male Somalian immigrant was diagnosed with a right proximal ureteral stone and bilateral multifocal ureteral narrowing causing obstruction with preserved renal function. He underwent a staged repair with right robotic pyelolithotomy and non-transecting ureteroureterostomy, followed by left robotic ureteroureterostomy with stricture excision. Pathology revealed Schistosoma ova. Conclusion Ureteral stricture from schistosomiasis represents a rare diagnosis for urologists in non-endemic countries. Bilateral ureteral narrowing and concomitant ureteral stone burden presented both diagnostic and reconstructive challenges, requiring a staged repair. Minimally invasive reconstruction was achieved using robotic assistance with good functional outcome.
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Affiliation(s)
- Jonathan A Seaman
- Department of Urology University of Arizona College of Medicine Tucson Arizona USA
| | - Erika Bracamonte
- Department of Pathology University of Arizona College of Medicine Tucson Arizona USA
| | - Sunchin Kim
- Department of Urology University of Arizona College of Medicine Tucson Arizona USA
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2
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Manciulli T, Marangoni D, Salas-Coronas J, Bocanegra C, Richter J, Gobbi F, Motta L, Minervini A, Bartoloni A, Zammarchi L. Diagnosis and management of complicated urogenital schistosomiasis: a systematic review of the literature. Infection 2023; 51:1185-1221. [PMID: 37466786 PMCID: PMC10545601 DOI: 10.1007/s15010-023-02060-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/31/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Currently, there are no standardized guidelines for the diagnosis or management of the complications of urogenital schistosomiasis (UGS). This systematic review of the literature aims to investigate the state of the art in reference to diagnostic approaches and the clinical management of this condition. METHODS A systematic review of literature published between January 1990 and January 2021 was conducted in the MEDLINE database, scoping for articles regarding diagnostic means or therapeutic options for the complications of UGS, namely obstructive uropathy, bladder cancer, abortion, ectopic pregnancy, infertility, kidney failure, urolithiasis and the need for invasive procedures. Relevant data were then extracted from the articles deemed eligible according to the inclusion criteria. MAIN RESULTS In total, 3052 articles were identified by the research query, of which 167 articles fulfilling inclusion criteria after title/abstract screening and full-text evaluation were included, 35% on both diagnostic and therapeutic aspects, and 51% on diagnosis and 14% on therapy. Ultrasound was the most frequently tool employed for the diagnosis of UGS complications showing a good performance. Concerning the management of hydronephrosis, the majority of available evidences came from community-based studies where universal treatment with praziquantel was used leading to decrease of prevalence of obstructive uropathy. Concerning studies on surgical procedures, laser endoureterotomy followed by stenting was mostly employed in adult patients leading to a crude cure rate of 60% (43 of 71 patients). In the case of severe hydronephrosis, surgery consisting of ureteral re-implantation showed excellent results with a crude cure rate of 98% (157 cured patients of 160 treated). Concerning bladder cancer, data on 93 patients with a clear diagnosis of UGS-related bladder were available reporting a variable and sometime combined approach based on disease stage. Available data on diagnosis and management of abortion, ectopic pregnancy, infertility, kidney failure, urolithiasis and the need for invasive procedures due to UGS are also presented. CONCLUSIONS The review produced a complete picture of the diagnostic and therapeutic options currently available for complicated UGS. These results can be useful both for guiding clinicians towards correct management and for tracing the direction of future research.
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Affiliation(s)
- Tommaso Manciulli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Davide Marangoni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | - Cristina Bocanegra
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Joachim Richter
- Institute of Tropical Medicine and International Health, Charité Universitätsmedizin, Corporate Member of Free University and Humboldt University Berlin and Berlin Health Institute, Berlin, Germany
| | - Federico Gobbi
- Infectious-Tropical Diseases and Microbiology Department, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Verona, Italy
| | - Leonardo Motta
- Infectious-Tropical Diseases and Microbiology Department, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Verona, Italy
| | - Andrea Minervini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Department of Infectious and Tropical Diseases, Azienda Ospedaliero Universitaria Careggi, Largo Giovanni Alessandro Brambilla, 3, 50134, Florence, Italy
| | - Lorenzo Zammarchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
- Department of Infectious and Tropical Diseases, Azienda Ospedaliero Universitaria Careggi, Largo Giovanni Alessandro Brambilla, 3, 50134, Florence, Italy.
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3
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Grech M, Busuttil G, Gauci CD, Milic M. Urinary schistosomiasis: a case of late presentation. BMJ Case Rep 2022; 15:e246966. [PMID: 35232737 PMCID: PMC8889155 DOI: 10.1136/bcr-2021-246966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2022] [Indexed: 11/03/2022] Open
Abstract
A man in his early 20s, originally from north-central Africa, presented with a high incidental serum creatinine level. A non-contrast CT scan was taken which was suggestive of urinary schistosomiasis. The diagnosis was confirmed on obtaining biopsies from the bladder. Due to bilateral hydronephrosis, an attempt at bilateral renal decompression was made. This failed to improve renal function. He eventually underwent a right nephrectomy. He is in end-stage renal failure, undergoing long-term dialysis, and has been placed on the waiting list for renal transplant.
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Affiliation(s)
- Marc Grech
- Urology Ward 2, Mater Dei Hospital, Msida, Malta
| | | | | | - Miljan Milic
- Department of Surgery, Mater Dei Hospital, Msida, Malta
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4
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Couture F, Desjardins A, Richard PO. Urinary schistosomiasis in a child from Central Africa. CMAJ 2021; 193:E1843. [PMID: 34872956 PMCID: PMC8648366 DOI: 10.1503/cmaj.210510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Félix Couture
- Division of Urology, Department of Surgery, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Que
| | - Audrey Desjardins
- Division of Urology, Department of Surgery, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Que
| | - Patrick O Richard
- Division of Urology, Department of Surgery, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Que.
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5
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Olaru ID, Chisenga M, Yeung S, Mabey D, Marks M, Chonzi P, Masunda KP, Machiha A, Ferrand RA, Kranzer K. Sexually transmitted infections and prior antibiotic use as important causes for negative urine cultures among adults presenting with urinary tract infection symptoms to primary care clinics in Zimbabwe: a cross-sectional study. BMJ Open 2021; 11:e050407. [PMID: 34380730 PMCID: PMC8359455 DOI: 10.1136/bmjopen-2021-050407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Urinary tract infections (UTIs) are common in primary care. The yield of urine cultures in patients with UTI symptoms can be considerably different between high-income and low-income settings. This study aimed to explore possible causes of negative urine cultures in patients presenting with symptoms of UTI to primary health clinics in Harare. DESIGN Cross-sectional study. SETTING Nine primary health clinics in Harare, Zimbabwe. PARTICIPANTS Adults presenting with symptoms of UTIs between March and July 2020. PRIMARY OUTCOME MEASURES Urine samples underwent dipstick testing, microscopy, culture, and testing for sexually transmitted infections (STIs) using GeneXpert and for the presence of antibiotic residues using an antibiotic bioassay. The primary outcomes were the number and proportion of participants with evidence of STIs, prior antibiotic exposure, leucocyturia and UTIs. RESULTS The study included 425 participants with a median age of 37.3 years, of whom 275 (64.7%) were women. Leucocyturia was detected in 130 (30.6%, 95% CI 26.2% to 35.2%) participants, and 96 (22.6%, 95% CI 18.7% to 26.9%) had a positive urine culture for a uropathogen. Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis were detected in 43/425 (10.1%, 95% CI 7.4% to 13.4%), 37/425 (8.7%, 95% CI 6.2% to 11.8%) and 14/175 (8.0%, 95% CI 4.4% to 13.1%) participants, respectively. Overall, 89 (20.9%, 95% CI 17.2% to 25.1%) participants reported either having taken prior antibiotics or having had a positive urine bioassay. In 170 (40.0%, 95% CI 35.3% to 44.8%) participants, all of the tests that were performed were negative. CONCLUSIONS This study found a high prevalence of STIs and evidence of prior antimicrobial use as possible explanations for the low proportion of positive urine cultures.
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Affiliation(s)
- Ioana D Olaru
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | | | - Shunmay Yeung
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
- Department of Paediatric Infectious Disease, St Mary's Hospital, London, UK
| | - David Mabey
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Michael Marks
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Prosper Chonzi
- Department of Health, City of Harare Health Services Department, Harare, Zimbabwe
| | - Kudzai Pe Masunda
- Department of Health, City of Harare Health Services Department, Harare, Zimbabwe
| | - Anna Machiha
- AIDS and TB Unit, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Rashida A Ferrand
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Katharina Kranzer
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
- Biomedical Research and Training Institute, Harare, Zimbabwe
- Division of Infectious and Tropical Medicine, Medical Centre of the University of Munich, Munich, Germany
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6
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Sforza S, Tuccio A, Zammarchi L, Verrienti P, Rinaldi F, Tilli M, Di Maida F, Mari A, Masieri L, Carini M, Bartoloni A, Minervini A. Urological management and surgical procedures in migrants from Sub-Saharan Africa with urogenital schistosomiasis. Actas Urol Esp 2021; 45:309-319. [PMID: 33685664 DOI: 10.1016/j.acuro.2020.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 03/12/2020] [Accepted: 03/22/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND OBJECTIVES An increasing number of urogenital schistosomiasis (UGS) is being diagnosed in Europe following the unprecedented migratory flux from Sub-Saharan Africa (SSA). This phenomenon represent a challenge for urologists working in a non-endemic area. The aim of this study is to describe the urological management and the surgical procedures of patients with UGS in a tertiary referral centre. PATIENTS All subjects from SAA diagnosed with UGS from January 2011 to November 2018 were enrolled retrospectively. Detailed data of patients with UGS undergoing to urological procedures were collected and analysed. RESULTS Thirty patients were diagnosed with UGS, among them 12 (42.8%) were submitted to surgery. The most common surgical procedure was trans urethral resection of bladder (TURB) for suspected lesions persisted after praziquantel treatment performed in 7cases (58%). Other surgical procedure were TURB and concomitant ureteroscopy with laser fragmentation for suspected bladder neoplasm with renal stone, endoscopic lithotripsy and percutaneous nephrolithotomy for bladder and renal stones, laparoscopic nephrectomy for end-stage kidney disease, placement of bilateral nephrostomy for hydroureteronephrosis, explorative testicular surgery for a suspected testicular torsion in one case each. Four patients (33%) were lost at the follow up. CONCLUSION An increasing number of migrants from SSA diagnosed with UGS has been observed. Some patients required a surgical intervention for suspected neoplastic lesions or end-stage organ damage. It was particularly difficult to perform a regular follow-up in several patients. Further multicentric studies are needed to reach a proper standard in diagnosis, treatment and follow-up of subjects with UGS.
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Affiliation(s)
- S Sforza
- Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florencia, Italia
| | - A Tuccio
- Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florencia, Italia.
| | - L Zammarchi
- Infectious and Tropical Diseases Unit, Careggi Hospital, University of Florence, Florencia, Italia; Referral Centre for Tropical Diseases of Tuscany, Infectious and Tropical Diseases Unit, University of Florence, Florencia, Italia
| | - P Verrienti
- Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florencia, Italia
| | - F Rinaldi
- Infectious and Tropical Diseases Unit, Careggi Hospital, University of Florence, Florencia, Italia; Referral Centre for Tropical Diseases of Tuscany, Infectious and Tropical Diseases Unit, University of Florence, Florencia, Italia
| | - M Tilli
- Infectious and Tropical Diseases Unit, Careggi Hospital, University of Florence, Florencia, Italia; Referral Centre for Tropical Diseases of Tuscany, Infectious and Tropical Diseases Unit, University of Florence, Florencia, Italia
| | - F Di Maida
- Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florencia, Italia
| | - A Mari
- Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florencia, Italia
| | - L Masieri
- Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florencia, Italia
| | - M Carini
- Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florencia, Italia
| | - A Bartoloni
- Infectious and Tropical Diseases Unit, Careggi Hospital, University of Florence, Florencia, Italia; Referral Centre for Tropical Diseases of Tuscany, Infectious and Tropical Diseases Unit, University of Florence, Florencia, Italia
| | - A Minervini
- Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florencia, Italia
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7
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Midzi N, Bärenbold O, Manangazira P, Phiri I, Mutsaka-Makuvaza MJ, Mhlanga G, Utzinger J, Vounatsou P. Accuracy of different diagnostic techniques for Schistosoma haematobium to estimate treatment needs in Zimbabwe: Application of a hierarchical Bayesian egg count model. PLoS Negl Trop Dis 2020; 14:e0008451. [PMID: 32817650 PMCID: PMC7462259 DOI: 10.1371/journal.pntd.0008451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 09/01/2020] [Accepted: 06/04/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Treatment needs for Schistosoma haematobium are commonly evaluated using urine filtration with detection of parasite eggs under a microscope. A common symptom of S. haematobium is hematuria, the passing of blood in urine. Hence, the use of hematuria-based diagnostic techniques as a proxy for the assessment of treatment needs has been considered. This study evaluates data from a national survey in Zimbabwe, where three hematuria-based diagnostic techniques, that is microhematuria, macrohematuria, and an anamnestic questionnaire pertaining to self-reported blood in urine, have been included in addition to urine filtration in 280 schools across 70 districts. METHODOLOGY We developed an egg count model, which evaluates the infection intensity-dependent sensitivity and the specificity of each diagnostic technique without relying on a 'gold' standard. Subsequently, we determined prevalence thresholds for each diagnostic technique, equivalent to a 10% urine filtration-based prevalence and compared classification of districts according to treatment strategy based on the different diagnostic methods. PRINCIPAL FINDINGS A 10% urine filtration prevalence threshold corresponded to a 17.9% and 13.3% prevalence based on questionnaire and microhematuria, respectively. Both the questionnaire and the microhematuria showed a sensitivity and specificity of more than 85% for estimating treatment needs at the above thresholds. For diagnosis at individual level, the questionnaire showed the highest sensitivity (70.0%) followed by urine filtration (53.8%) and microhematuria (52.2%). CONCLUSIONS/SIGNIFICANCE The high sensitivity and specificity of a simple questionnaire to estimate treatment needs of S. haematobium suggests that it can be used as a rapid, low-cost method to estimate district prevalence. Our modeling approach can be expanded to include setting-dependent specificity of the technique and should be assessed in relation to other diagnostic methods due to potential cross-reaction with other diseases.
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Affiliation(s)
- Nicholas Midzi
- National Institute of Health Research, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Oliver Bärenbold
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- Faculty of Science, University of Basel, Basel, Switzerland
| | - Portia Manangazira
- National Institute of Health Research, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Isaac Phiri
- National Institute of Health Research, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Masceline J. Mutsaka-Makuvaza
- National Institute of Health Research, Ministry of Health and Child Care, Harare, Zimbabwe
- Department of Medical Microbiology, University of Zimbabwe, Harare, Zimbabwe
| | - Gibson Mhlanga
- National Institute of Health Research, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- Faculty of Science, University of Basel, Basel, Switzerland
| | - Penelope Vounatsou
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- Faculty of Science, University of Basel, Basel, Switzerland
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8
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Cozzi D, Bertelli E, Savi E, Verna S, Zammarchi L, Tilli M, Rinaldi F, Pradella S, Agostini S, Miele V. Ultrasound findings in urogenital schistosomiasis: a pictorial essay. J Ultrasound 2020; 23:195-205. [PMID: 31494862 PMCID: PMC7242546 DOI: 10.1007/s40477-019-00405-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 08/27/2019] [Indexed: 02/01/2023] Open
Abstract
Urogenital schistosomiasis is a parasitic disease caused by S. haematobium which is endemic in tropical and sub-tropical areas but is increasingly diagnosed in temperate non-endemic countries due to migration and international travels. Early identification and treatment of the disease are fundamental to avoid associated severe sequelae such as bladder carcinoma, hydronephrosis leading to kidney failure and reproductive complications. Radiologic imaging, especially through ultrasound examination, has a fundamental role in the assessment of organ damage and follow-up after treatment. Imaging findings of urinary tract schistosomiasis are observed mainly in the ureters and bladder. The kidneys usually appear normal until a late stage of the disease.
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Affiliation(s)
- Diletta Cozzi
- Department of Radiology, Careggi University Hospital, AOU Careggi, L.go Brambilla 3, 50134 Florence, Italy
| | - Elena Bertelli
- Department of Radiology, Careggi University Hospital, AOU Careggi, L.go Brambilla 3, 50134 Florence, Italy
| | - Elena Savi
- Department of Radiology, Careggi University Hospital, AOU Careggi, L.go Brambilla 3, 50134 Florence, Italy
| | - Silvia Verna
- Department of Radiology, Careggi University Hospital, AOU Careggi, L.go Brambilla 3, 50134 Florence, Italy
| | - Lorenzo Zammarchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Marta Tilli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Francesca Rinaldi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Silvia Pradella
- Department of Radiology, Careggi University Hospital, AOU Careggi, L.go Brambilla 3, 50134 Florence, Italy
| | - Simone Agostini
- Department of Radiology, Careggi University Hospital, AOU Careggi, L.go Brambilla 3, 50134 Florence, Italy
| | - Vittorio Miele
- Department of Radiology, Careggi University Hospital, AOU Careggi, L.go Brambilla 3, 50134 Florence, Italy
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9
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Fabiano M, Califano A, Chiancone F, D'Antonio A, Maiorino F, Simeone D, Silvestre G, Altieri V. Bladder schistosomiasis in Italy: A case report. Urologia 2020; 87:191-193. [PMID: 32133929 DOI: 10.1177/0391560320910647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Human schistosomiasis is a snail-borne disease caused by parasitic blood-dwelling flukes. A long-term infection can lead to the risk of liver damage, kidney failure, infertility, or bladder cancer. The most common sign is hematuria with the blood first seen in the terminal urine, but in severe cases the whole urine sample can be dark colored. We analyze the case of a healthy African child living in Italy since birth, harboring a hidden debilitating disease that was picked up during ultrasonography. CASE REPORT A 11-year-old African child was admitted to our emergency department with macroscopic hematuria, dysuria, and frequency for 2 months. Ultrasonography revealed a solid mass involving bladder's right wall. Non-contrast and contrast-enhanced scans of computerized tomography showed a mass of 45 mm x 15 mm on the right bladder wall. A bipolar transurethral resection of bladder was performed. The pathological examination showed findings consistent with Schistosoma haematobium. DISCUSSION The clinical manifestations of schistosomiasis depend on the inflammatory response to the parasitic infection. In particular, it can manifest in the bladder as painless dysuria, urinary incontinence and urinary frequency, hematuria, or even urinary retention if the trigone is involved. Utilization of ultrasonography for diagnostic evaluation of schistosomiasis is mandatory. For treatment, the World Health Organization recommends praziquantel which has an efficacy of up to 90%.
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Affiliation(s)
- Marco Fabiano
- Department of Urology, University of Salerno, Salerno, Italy
| | | | | | - Antonio D'Antonio
- SS. Giovanni di Dio e Ruggi d'Aragona Hospital, Schola Medica Salernitana, University of Salerno, Salerno, Italy
| | | | - Davide Simeone
- Department of Urology, University of Salerno, Salerno, Italy
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10
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Agbata EN, Padilla PF, Agbata IN, Armas LH, Solà I, Pottie K, Alonso-Coello P. Migrant Healthcare Guidelines: A Systematic Quality Assessment. J Immigr Minor Health 2019; 21:401-413. [PMID: 29785690 DOI: 10.1007/s10903-018-0759-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Significant international and cross-border migration has led to a growing availability of migrant healthcare guidelines (MHGs), which we systematically reviewed for quality. PubMed, MEDLINE, CINHAL, PsychINFO and guideline developer/guideline databases were searched for MHGs published 2006-2016. Three independent reviewers assessed eligible MHGs using the Appraisal of Guidelines, Research and Evaluation II instrument (AGREE II). MHGs were identified as high quality if they had a score of ≥ 60% in at least three of the six domains, including "rigour of development", and overall quality was assessed on a seven-point Likert scale. We included 32 MHGs. Overall agreement between reviewers was very good. Mean scores for each AGREE II domain were as follows: 85 ± 19.0% for "scope and purpose"; 51 ± 30.5% for "stakeholder involvement"; 34 ± 31.9% for "rigour of development"; 86 ± 7.3% for "clarity of presentation"; 40 ± 23.6% for "applicability"; and 27 ± 38.5% for "editorial independence". Nine and six MHGs were deemed "recommended" or "recommended with modifications", respectively, and 17 were "not recommended". Our review of MHGs has highlighted critical deficiencies in rigour of development, applicability, editorial independence and stakeholder involvement that point to the need for improvements in future MHGs.
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Affiliation(s)
- Eric Nwachukwu Agbata
- Faculty of Health and Psychology, Master of Public Health (MPH) programme, University of Roehampton, London, UK. .,Methodology of Biomedical Research and Public Health, Department of Paediatrics, Obstetrics, Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Paulina Fuentes Padilla
- Iberoamerican Cochrane Centre, Barcelona, Spain.,Faculty of Medicine and Dentistry, Universidad de Antofagasta, Antofagasta, Chile
| | - Ifeoma Nwando Agbata
- The Wicklow Mental Health Service, Newcastle Hospital, Greystones, Wicklow, Ireland
| | | | - Ivan Solà
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Kevin Pottie
- Centre for Global Health Institute of Population Health, University of Ottawa, Ottawa, ON, Canada.,C.T. Lamont Primary Health Care Research Centre, Bruyere Research Institute, Ottawa, Canada
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Centre, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Biomedical Research Institute, Sant Pau (IIB Sant Pau), Barcelona, Spain
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11
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Pinto SZ, Friedman R, Van Den Berg EJ. A case of paediatric bladder bilharzioma in Johannesburg, South Africa. Clin Case Rep 2019; 7:1890-1894. [PMID: 31624603 PMCID: PMC6787791 DOI: 10.1002/ccr3.2382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 08/02/2019] [Indexed: 01/22/2023] Open
Abstract
On cystoscopy, a polypoidal tumor was observed and biopsied, and histology confirmed it to be an inflammatory mass with schistosoma eggs called a bilharzioma. We highlight this case to emphasize the silent destructive potential of schistosomiasis which the World Health Organization considers a Neglected Tropical Disease (NTD). A high degree of suspicion is often needed at the primary health care level to prevent morbidity.
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Affiliation(s)
- Sohan Zane Pinto
- Chris Hani Baragwanath HospitalUniversity of WitwatersrandJohannesburgSouth Africa
| | - Robin Friedman
- Chris Hani Baragwanath HospitalUniversity of WitwatersrandJohannesburgSouth Africa
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12
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The diagnosis and treatment of urogenital schistosomiasis in Italy in a retrospective cohort of immigrants from Sub-Saharan Africa. Infection 2019; 47:447-459. [PMID: 30666616 DOI: 10.1007/s15010-019-01270-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Accepted: 01/09/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To evaluate ultrasound and praziquantel to, respectively, assess and reduce urogenital schistosomiasis (UGS)-associated morbidity in migrants from Sub-Saharan Africa (SSA). METHODS Migrants from SSA with UGS attending three Italian centres for tropical diseases during 2011-2016 were retrospectively enrolled. Data on clinical symptoms, routine laboratory, parasitological tests, and ultrasound reported as per the WHO-Niamey protocol were collected at baseline and at available follow-up visits after treatment with praziquantel 40 mg/kg/day for 3 days. RESULTS One hundred and seventy patients with UGS were enrolled and treated with praziquantel. Baseline ultrasonography showed urinary tract abnormalities in 115/169 patients (68%); the mean global Schistosoma haematobium score was 2.29 (SD 2.84, IQR 0-2), the mean urinary bladder intermediate score 1.75 (SD 1.73, IQR 0-2), and the mean upper urinary tract intermediate score 0.54 (SD 2.37, IQR 1-10). Abnormalities were more common among the 111 (65%) who were symptomatic (p < 0.02; OR 2.53; 95% CI 1.19-5.35). Symptoms started in 94/111 (85%) before arriving (median 63 months, IQR 12-119). At follow-up, we observed a significant reduction in the prevalence of UGS-related symptoms, blood, urine, and ultrasound abnormalities. CONCLUSIONS Our study results support the use of ultrasound and praziquantel for assessing and reducing UGS-associated morbidity in migrants. Health-seeking behaviour, diagnostic, and treatment delays contribute to the advanced pathology and qualified treatment success. To ensure earlier treatment, based on our findings, clinical experience, and available literature, we propose an algorithm for the diagnosis and clinical management of UGS. Multicentre studies are needed to improve the management of subjects with UGS in non-endemic countries.
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Hostiou T, Vergnolles M, Robert G, Malvy D. An Unusual Finding During Robotic-Assisted Laparoscopic Radical Prostatectomy. Clin Infect Dis 2018; 67:802-804. [PMID: 30124824 DOI: 10.1093/cid/ciy081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Thomas Hostiou
- Department of Urology, Bordeaux Pellegrin University Hospital
| | - Marc Vergnolles
- Department of Urology, Bordeaux Pellegrin University Hospital
| | - Grégoire Robert
- Department of Urology, Bordeaux Pellegrin University Hospital
| | - Denis Malvy
- Service de Médecine Interne et des Maladies Tropicales, Hôpital St-André, CHU Bordeaux, France
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Pal PO, Smith RD, Allen S, Ratynska M, Edwards S, Gothard P, Logan S. Schistosomiasis-A Disobedient Ureter, a Disobedient Diagnosis. J Endourol Case Rep 2017; 3:114-118. [PMID: 29082328 PMCID: PMC5628567 DOI: 10.1089/cren.2017.0042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Schistosomiasis is rare in western countries, but remains a potentially serious disease. It is known to result in severe urogenital complications; prompt diagnosis can therefore significantly affect outcomes. Case Presentation: We report the case of a 41-year-old male with pleuritic chest pain and visible hematuria who had emigrated from Zimbabwe to the United Kingdom 20 years previously. CT imaging revealed a hydronephrotic right pelvicaliceal system, with a dilated ureter to its distal portion. Preliminary tests for schistosomiasis, including terminal urine microscopy and serology, were negative. An initial ureteroscopy was challenging owing to a tight ureteral stricture such that a retrograde stent insertion and not ureteroscopic visualization or biopsy was carried out. A relook ureteroscopy after 6 weeks revealed a dense distal ureteral stricture, biopsies were taken, the stricture was ablated with LASER, and a retrograde stent was placed. Microscopic examination of the biopsies confirmed Schistosomiasis haematobium. Treatment consisted of a divided dose of praziquantel and a reducing dose of steroids. At a third look ureteroscopy the stricture was ablated with LASER again, and the stent was removed. Subsequent renograms indicated recurrent obstruction despite LASER treatment and a retrograde ureteral stent was replaced. The patient ultimately had a Boari flap ureteral reimplant with good results. Conclusion: This case illustrates the clinical challenges of diagnosing and treating ureteral schistosomiasis. It shows that all the initial tests can be negative, but where the clinical picture points toward schistosomiasis it is worth persevering and a good tissue biopsy may be the only way to verify an otherwise elusive diagnosis.
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Affiliation(s)
- Pallavi Olivia Pal
- Division of Surgery and Interventional Science, Department of Urology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Richard Daron Smith
- Division of Surgery and Interventional Science, Department of Urology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Sian Allen
- Division of Surgery and Interventional Science, Department of Urology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Marzena Ratynska
- Department of Histopathology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Simon Edwards
- Department of Infectious Diseases, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Philip Gothard
- Department of Infectious Diseases, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Sarah Logan
- Department of Infectious Diseases, University College London Hospitals NHS Foundation Trust, London, United Kingdom
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Sheele JM, Baddorf S, Kihara JH. Schistosoma haematobium infection is associated with increased urine foam. Pediatr Int 2016; 58:1243-1245. [PMID: 27882738 DOI: 10.1111/ped.13108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 07/14/2016] [Indexed: 11/27/2022]
Abstract
We compared urine microscopy and dipstick results for urine foam from 59 children in a Schistosoma haematobium-endemic area in a blinded manner. The sensitivity and specificity, respectively, for diagnosing S. haematobium compared with microscopy was: 74% and 72% for the shake test; 61% and 97% for microscopic hematuria; and 43% and 83% for proteinuria. When >17 eggs/10 mL urine was detected on microscopy, the sensitivity and specificity, respectively, were: 100% and 72% for the shake test; 90% and 97% for microscopic hematuria; and 80% and 83% for proteinuria. Urine foam height >34 mL was significantly more likely to have S. haematobium eggs detected on microscopy (P = 0.001) than urine foam ≤34 mL, indicating that S. haematobium-infected urine is associated with increased urine foam.
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Affiliation(s)
- Johnathan M Sheele
- Department of Emergency Medicine, University Hospitals Case Medical Center and Case Western Reserve University, Cleveland, Ohio, USA
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Ochodo EA, Gopalakrishna G, Spek B, Reitsma JB, van Lieshout L, Polman K, Lamberton P, Bossuyt PMM, Leeflang MMG. Circulating antigen tests and urine reagent strips for diagnosis of active schistosomiasis in endemic areas. Cochrane Database Syst Rev 2015; 2015:CD009579. [PMID: 25758180 PMCID: PMC4455231 DOI: 10.1002/14651858.cd009579.pub2] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Point-of-care (POC) tests for diagnosing schistosomiasis include tests based on circulating antigen detection and urine reagent strip tests. If they had sufficient diagnostic accuracy they could replace conventional microscopy as they provide a quicker answer and are easier to use. OBJECTIVES To summarise the diagnostic accuracy of: a) urine reagent strip tests in detecting active Schistosoma haematobium infection, with microscopy as the reference standard; and b) circulating antigen tests for detecting active Schistosoma infection in geographical regions endemic for Schistosoma mansoni or S. haematobium or both, with microscopy as the reference standard. SEARCH METHODS We searched the electronic databases MEDLINE, EMBASE, BIOSIS, MEDION, and Health Technology Assessment (HTA) without language restriction up to 30 June 2014. SELECTION CRITERIA We included studies that used microscopy as the reference standard: for S. haematobium, microscopy of urine prepared by filtration, centrifugation, or sedimentation methods; and for S. mansoni, microscopy of stool by Kato-Katz thick smear. We included studies on participants residing in endemic areas only. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data, assessed quality of the data using QUADAS-2, and performed meta-analysis where appropriate. Using the variability of test thresholds, we used the hierarchical summary receiver operating characteristic (HSROC) model for all eligible tests (except the circulating cathodic antigen (CCA) POC for S. mansoni, where the bivariate random-effects model was more appropriate). We investigated heterogeneity, and carried out indirect comparisons where data were sufficient. Results for sensitivity and specificity are presented as percentages with 95% confidence intervals (CI). MAIN RESULTS We included 90 studies; 88 from field settings in Africa. The median S. haematobium infection prevalence was 41% (range 1% to 89%) and 36% for S. mansoni (range 8% to 95%). Study design and conduct were poorly reported against current standards. Tests for S. haematobium Urine reagent test strips versus microscopyCompared to microscopy, the detection of microhaematuria on test strips had the highest sensitivity and specificity (sensitivity 75%, 95% CI 71% to 79%; specificity 87%, 95% CI 84% to 90%; 74 studies, 102,447 participants). For proteinuria, sensitivity was 61% and specificity was 82% (82,113 participants); and for leukocyturia, sensitivity was 58% and specificity 61% (1532 participants). However, the difference in overall test accuracy between the urine reagent strips for microhaematuria and proteinuria was not found to be different when we compared separate populations (P = 0.25), or when direct comparisons within the same individuals were performed (paired studies; P = 0.21).When tests were evaluated against the higher quality reference standard (when multiple samples were analysed), sensitivity was marginally lower for microhaematuria (71% vs 75%) and for proteinuria (49% vs 61%). The specificity of these tests was comparable. Antigen assayCompared to microscopy, the CCA test showed considerable heterogeneity; meta-analytic sensitivity estimate was 39%, 95% CI 6% to 73%; specificity 78%, 95% CI 55% to 100% (four studies, 901 participants). Tests for S. mansoni Compared to microscopy, the CCA test meta-analytic estimates for detecting S. mansoni at a single threshold of trace positive were: sensitivity 89% (95% CI 86% to 92%); and specificity 55% (95% CI 46% to 65%; 15 studies, 6091 participants) Against a higher quality reference standard, the sensitivity results were comparable (89% vs 88%) but specificity was higher (66% vs 55%). For the CAA test, sensitivity ranged from 47% to 94%, and specificity from 8% to 100% (4 studies, 1583 participants). AUTHORS' CONCLUSIONS Among the evaluated tests for S. haematobium infection, microhaematuria correctly detected the largest proportions of infections and non-infections identified by microscopy.The CCA POC test for S. mansoni detects a very large proportion of infections identified by microscopy, but it misclassifies a large proportion of microscopy negatives as positives in endemic areas with a moderate to high prevalence of infection, possibly because the test is potentially more sensitive than microscopy.
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Affiliation(s)
- Eleanor A Ochodo
- Academic Medical Center, University of AmsterdamDepartment of Clinical Epidemiology, Biostatistics and BioinformaticsAmsterdamNetherlands1100 DD
- Stellenbosch UniversityCentre for Evidence‐based Health Care, Faculty of Medicine and Health SciencesCape TownSouth Africa
| | - Gowri Gopalakrishna
- Academic Medical Center, University of AmsterdamDepartment of Clinical Epidemiology, Biostatistics and BioinformaticsAmsterdamNetherlands1100 DD
| | - Bea Spek
- Academic Medical Center, University of AmsterdamDepartment of Clinical Epidemiology, Biostatistics and BioinformaticsAmsterdamNetherlands1100 DD
- Hanze University GroningenDepartment of Speech and Language PathologyEyssoniuspleinGroningenNetherlands
| | - Johannes B Reitsma
- University Medical Center UtrechtJulius Center for Health Sciences and Primary CarePO Box 85500UtrechtNetherlands3508 GA Utrecht
| | - Lisette van Lieshout
- Leiden University Medical CenterDepartment of ParasitologyPO Box 9600LeidenNetherlands2300 RC
| | - Katja Polman
- Institute of Tropical MedicineDepartment of Biomedical SciencesNationalestraat 155AntwerpBelgium2000
| | - Poppy Lamberton
- Imperial College LondonDepartment of Infectious Disease EpidemiologySt. Mary's Campus, Norfolk PlaceLondonUKW2 1PG
| | - Patrick MM Bossuyt
- Academic Medical Center, University of AmsterdamDepartment of Clinical Epidemiology, Biostatistics and BioinformaticsAmsterdamNetherlands1100 DD
| | - Mariska MG Leeflang
- Academic Medical Center, University of AmsterdamDepartment of Clinical Epidemiology, Biostatistics and BioinformaticsAmsterdamNetherlands1100 DD
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Abstract
Schistosomiasis is the second most common socio-economically devastating parasitic disease after malaria, affecting about 240 million residents of developing countries. In Africa, it predominantly manifests as urogenital disease, and the main infective agent is Schistosoma hematobium. Endemicity is propagated by poor socio-economic status and environmental degradation due to rapid urbanization. Recreational swimming is a potent medium for the spread of disease in children and adolescents. Most affected individuals are asymptomatic. The male and female worms are equipped with an extraordinary capacity for immune evasion and are able to co-habit for several decades within the pelvic venous plexus. Eggs deposited in the bladder wall resist elimination by type 1 T lymphocytes. Instead, they are sustained by pro-fibrogenic encapsulation (as modulated by type 2 helper cells). Progressive bladder disease results in obstructive uropathy and predisposes to (mostly) squamous cell carcinoma. Schistosomal glomerulopathy manifests as a clinical spectrum of asymptomatic proteinuria, nephrosis and/or nephritic syndrome. Findings on renal biopsy may be influenced by co-morbidity with Salmonella bacteria, amyloidosis and hepatitis C infection. Potentially fatal Katayama fever and spinal radiculopathy may ensue in tourists visiting an endemic zone. Early detection by urine microscopy is hampered by low urinary excretion rates of the parasite eggs. Although useful in travelers with newly acquired disease, the results of the serological antibody assay may be false positive in residents of an endemic zone. Cystoscopy, however, may be invaluable. Due to its safety, effectiveness and once-daily dosing, praziquantel is the drug of choice. An integrated approach that includes mass chemotherapy, environmental health programs and public health education is the most cost-effective preventive strategy.
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Affiliation(s)
- Oluwatoyin F Bamgbola
- Division of Pediatric Nephrology, Children's Hospital of New Orleans, Louisiana State University Health Science Center, 200 Henry Clay Avenue, New Orleans, LA, 70118, USA,
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Ramarokoto CE, Kildemoes AO, Randrianasolo BS, Ravoniarimbinina P, Ravaoalimalala VE, Leutscher P, Kjetland EF, Vennervald BJ. Eosinophil granule proteins ECP and EPX as markers for a potential early-stage inflammatory lesion in female genital schistosomiasis (FGS). PLoS Negl Trop Dis 2014; 8:e2974. [PMID: 25033206 PMCID: PMC4102437 DOI: 10.1371/journal.pntd.0002974] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 05/09/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Genital granulomas induced by Schistosoma haematobium eggs can manifest as different lesion types visible by colposcopy; rubbery papules (RP), homogenous sandy patches (HSP) and grainy sandy patches (GSP). Pronounced tissue eosinophilia is a candidate marker for active S. haematobium pathology, as viable schistosome egg granulomas often are eosinophil rich. Here it was investigated whether eosinophil granule proteins ECP (eosinophil cationic protein) and EPX (eosinophil protein-X) in urine and genital lavage can be used as markers for active FGS lesions. METHODS Uro-genital samples from 118 Malagasy women were analysed for ECP and EPX by standard sandwich avidin/biotin amplified ELISA. PRINCIPAL FINDINGS The women with RP lesions had significantly higher levels of ECP and EPX in both lavage and urine. Furthermore, women with RP lesions were significantly younger than those with GSP. This could indicate that RP lesions might be more recently established and thus represent an earlier inflammatory lesion stage. CONCLUSION ECP in genital lavage might be a future tool aiding the identification of FGS pathology at a stage where reversibility remains a possibility following praziquantel treatment.
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Affiliation(s)
| | - Anna Overgaard Kildemoes
- Section for Parasitology and Aquatic Diseases, Faculty for Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Pascaline Ravoniarimbinina
- Helminthiasis Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
- Ministry of Public Health, Madagascar, Antananarivo, Madagascar
| | | | - Peter Leutscher
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - Eyrun Floerecke Kjetland
- Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases, Oslo University Hospital Ulleval, Oslo, Norway
- School of Public Health Medicine, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Birgitte Jyding Vennervald
- Section for Parasitology and Aquatic Diseases, Faculty for Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Pereira J, Calleja E, Marne C, Borque A. Vesical schistosomiasis with terminal hematuria in sub-Saharan patients. Actas Urol Esp 2014; 38:133-7. [PMID: 24099825 DOI: 10.1016/j.acuro.2013.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Accepted: 04/15/2013] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To know the characteristics of vesical schistosomiasis caused by schistosoma hematobium in immigrant patients. MATERIAL AND METHODS The retrospective study of 41 cases microbiologically diagnosed in our hospital over the last 16 years is presented. Data was collected on origin, age, presentation form, diagnostic tests and treatment. RESULTS All were African patients whose ages ranged from 4 to 32 years and who had terminal macroscopic hematuria. Most of the patients (85%) were men. In all of the cases, diagnosis was by a urinary microbiological study and in one case, cystoscopy with a biopsy of a typical vesical lesion. Terminal hematuria is the most representative clinical sign. They were treated with praziquantel. CONCLUSIONS The epidemiology and intermittent terminal hematuria in African patients should lead to the suspicion of vesical schistosomiasis as the first diagnostic option. Urinary microbiological study is a rapid, non-invasive, test with high diagnostic yield that would avoid performing invasive studies. Its simple treatment assures high level of compliance and consequent efficacy.
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Bruyère F, Desoubeaux G, Malavaud S, Fourcade C, Chandenier J, Lachaud L, Guy L, Karsenty G, Bastide C, Lavigne JP, Sotto A. [Non-antibiotic anti-infectious treatments in urology]. Prog Urol 2013; 23:1342-56. [PMID: 24183092 DOI: 10.1016/j.purol.2013.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 09/05/2013] [Accepted: 09/06/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To define the terms of use of pesticides, antifungal, antiviral and antiseptic treatments in urology. MATERIALS AND METHODS A literature search was conducted on MEDLINE for all these treatments used in urology. The molecules were classified by family. Modes of action, indications in urology and adverse effects have been detailed. Authorisation files were consulted and then complemented by a literature analysis. RESULTS Although parasitic or viral diseases are uncommon in urology, their specific treatment deserves a thorough knowledge of pesticide and antiviral molecules. Antifungal treatments are regularly used in urology with special features to know to improve the efficacy/safety ratio. Antiseptics are used daily in urology and a better understanding of these molecules allows better use. CONCLUSION Beyond antibiotics, antiviral, antiparasitic and antifungal deserve a thorough knowledge. Antiseptic although used daily have features little known.
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Affiliation(s)
- F Bruyère
- Service d'urologie, CHRU Bretonneau, 2, boulevard Tonnellé, 37044 Tours cedex, France; Université François-Rabelais de Tours, PRES Centre Val-de-Loire université, 37000 Tours, France.
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Sheele JM, Kihara JH, Baddorf S, Byrne J, Ravi B. Evaluation of a novel rapid diagnostic test forSchistosoma haematobiumbased on the detection of human immunoglobulins bound to filteredSchistosoma haematobiumeggs. Trop Med Int Health 2013; 18:477-84. [DOI: 10.1111/tmi.12063] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Johnathan M. Sheele
- Department of Emergency Medicine; Eastern Virginia Medical School; Norfolk; VA; USA
| | | | - Sarah Baddorf
- Department of Emergency Medicine; Eastern Virginia Medical School; Norfolk; VA; USA
| | - Jonathan Byrne
- Department of Emergency Medicine; Eastern Virginia Medical School; Norfolk; VA; USA
| | - Bhaskara Ravi
- Department of Mathematics and Statistics; Old Dominion University; Norfolk; VA; USA
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A Case of Squamous Cell Carcinoma of the Renal Pelvis in association with Schistosoma hematobium. Case Rep Oncol Med 2013; 2012:352401. [PMID: 23320219 PMCID: PMC3535740 DOI: 10.1155/2012/352401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2012] [Accepted: 10/30/2012] [Indexed: 11/30/2022] Open
Abstract
A 72-year-old man presented with painless frank haematuria. Investigations included intravenous urogram and abdominal/pelvic CT which revealed a marked focal thickening of the wall of the inferior aspect of the left renal pelvis extending into the lower pole calyx and into the pelviureteric junction resulting in left hydronephrosis. Urine cytology demonstrated clusters of malignant keratinised squamous cells and schistosome ova. He underwent left laparoscopic radical nephroureterectomy and histology revealed moderately differentiated keratinising squamous cell carcinoma in the renal pelvis.
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Khalaf I, Shokeir A, Shalaby M. Urologic complications of genitourinary schistosomiasis. World J Urol 2011; 30:31-8. [PMID: 21909645 DOI: 10.1007/s00345-011-0751-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Accepted: 08/12/2011] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To provide systematic review of the literature on the long-standing complications of genitourinary schistosomiasis. MATERIALS AND METHODS The PubMed literature database was searched from inception to December 2010. The following keywords were used: schistosomiasis, bilharziasis, and genitourinary. Only English language publications were utilized. RESULTS Variable tissue reactions to bilharzial eggs with subsequent healing or progression and complications in the urinary tract mainly affect the urinary bladder and pelvic segments of the ureters. These lesions may assume an atrophic, proliferative, or neoplastic pattern. Although the pathology is usually extensive in the submucosal, all layers from the mucous membrane through deep to the perivesical or periureteral tissues may be involved. Main fixed bilharzial urologic sequelae include chronic bladder ulcers, leucoplakia, vesical granuloma, contracted bladder, bladder neck contracture, stricture ureters, and bladder carcinoma. These sequelae may lead to marked morphologic and functional changes of the urinary tract, and ultimately, mortality can follow from renal failure or bladder cancer. CONCLUSIONS Urinary schistosomiasis is a preventable disease through nationwide snail control and mass therapy with oral antibilharzial drugs. If not properly treated, long-standing urinary complications may result in serious sequelae that may lead to mortality from renal failure or bladder cancer.
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Affiliation(s)
- Ismail Khalaf
- Department of Urology, Al-Azhar Faculty of Medicine, P O Box 2477, Elhorria, Heliopolis, Cairo, 11361, Egypt.
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Naber KG. Urogenital Infections: The Pivotal Role of the Urologist. Eur Urol 2006; 50:657-9. [PMID: 16647804 DOI: 10.1016/j.eururo.2006.03.056] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2006] [Accepted: 03/28/2006] [Indexed: 11/30/2022]
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