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Prætorius FA, Wagner T. Testikulær schistosomiasis. Ugeskr Laeger 2024; 186:V72026. [PMID: 38808760 DOI: 10.61409/v72026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Affiliation(s)
| | - Thomas Wagner
- Patologisk Afdeling, Københavns Universitetshospital - Herlev og Gentofte Hospital
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Kayuni SA, Alharbi MH, Shaw A, Fawcett J, Makaula P, Lampiao F, Juziwelo L, LaCourse EJ, Verweij JJ, Stothard JR. Detection of male genital schistosomiasis (MGS) by real-time TaqMan® PCR analysis of semen from fishermen along the southern shoreline of Lake Malawi. Heliyon 2023; 9:e17338. [PMID: 37539175 PMCID: PMC10394912 DOI: 10.1016/j.heliyon.2023.e17338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 06/06/2023] [Accepted: 06/14/2023] [Indexed: 08/05/2023] Open
Abstract
Background Male genital schistosomiasis (MGS) is an underappreciated complication of schistosomiasis, first described in 1911. However, its epidemiology, diagnostic testing and case management are not well understood in sub-Saharan Africa. To shed new light on MGS prevalence in Malawi, a longitudinal cohort study was conducted among adult fishermen along the southern shoreline of Lake Malawi using detection of schistosome DNA in participants' semen by real-time TaqMan® PCR analyses. Methods Upon recruitment of 376 participants, 210 submitted urine samples and 114 semen samples for parasitological tests. Thereafter, the available semen samples were subsequently analysed by real-time TaqMan® PCR. Praziquantel (PZQ) treatment was provided to all participants with follow-ups attempted at 1, 3, 6 and 12-months' intervals. Results At baseline, real-time PCR detected a higher MGS cohort prevalence of 26.6% (n = 64, Ct-value range: 18.9-37.4), compared to 10.4% by semen microscopy. In total, 21.9% of participants (n = 114) were detected with MGS either by semen microscopy and/or by real-time PCR. Subsequent analyses at 1-, 3-, 6- and 12-month follow-ups indicated variable detection dynamics. Conclusions This first application of a molecular method, to detect MGS in sub-Saharan Africa, highlights the need for development of such molecular diagnostic tests which should be affordable and locally accessible. Our investigation also notes the persistence of MGS over a calendar year despite praziquantel treatment.
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Affiliation(s)
- Sekeleghe A. Kayuni
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, United Kingdom
- MASM Medi Clinics Limited, Medical Society of Malawi (MASM), P. O. Box 31659, Lilongwe 3, Malawi
- Malawi Liverpool Wellcome (MLW) Clinical Research Programme, Kamuzu University Of Health Sciences (KUHeS), Queen Elizabeth Central Hospital campus, Chipatala Avenue, Blantyre, Malawi
| | - Mohammad H. Alharbi
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, United Kingdom
- Ministry of Health, Buraydah 52367, Saudi Arabia
| | - Alexandra Shaw
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, United Kingdom
| | - Joanna Fawcett
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, United Kingdom
| | - Peter Makaula
- Malawi Liverpool Wellcome (MLW) Clinical Research Programme, Kamuzu University Of Health Sciences (KUHeS), Queen Elizabeth Central Hospital campus, Chipatala Avenue, Blantyre, Malawi
- Research for Health, Environment and Development (RHED), Mangochi, Malawi
| | - Fanuel Lampiao
- Physiology Department, College of Medicine, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Lazarus Juziwelo
- National Schistosomiasis and STH Control Programme, Community Health Sciences Unit, Ministry of Health, Lilongwe, Malawi
| | - E. James LaCourse
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, United Kingdom
| | - Jaco J. Verweij
- Elisabeth TweeSteden Hospital Tilburg, Microvida Laboratory for Medical Microbiology and Immunology, Hilvarenbeekseweg 60, Tilburg, the Netherlands
| | - J. Russell Stothard
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, United Kingdom
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Ido F, Ouedraogo A, Savadogo I, Hafing T, Ouattara S. Epididymal bilharzia simulating a testicular tumor: A case report. IDCases 2023; 32:e01770. [PMID: 37131488 PMCID: PMC10149191 DOI: 10.1016/j.idcr.2023.e01770] [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: 03/30/2023] [Revised: 04/12/2023] [Accepted: 04/17/2023] [Indexed: 05/04/2023] Open
Abstract
Bilharzia or schistosomiasis is a parasitic disease due to infestation by a hematophagous trematode of the genus Schistosoma. It is the second most frequent parasitic endemic in the world after malaria. The most frequent tissue infections are intestinal and genitourinary. Testicular localizations of schistosoma are very rare. When lesions become chronic, they present as non-specific masses, bilharziomas, posing enormous problems of differential diagnosis with other benign and malignant pathologies, which impacts management. We report a case of epididymal schistosomiasis in a 37 years old patient simulating a malignant tumor. This case allowed us to review the diagnostic difficulties of this rare localization and the challenges of management.
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Affiliation(s)
- F.A.H.A. Ido
- Department of Anatomy and Pathological Cytology CHU, Tengandogo, Ouagadougou, Burkina Faso
- Correspondence to: 11 BP 104 CMS Ouagadougou 01, Burkina Faso.
| | - A.S. Ouedraogo
- Department of Anatomy and Pathological Cytology CHU, Bogododgo, Ouagadougou, Burkina Faso
| | - I. Savadogo
- Department of Anatomy and Pathological Cytology CHU-R of Ouahigouya, Burkina Faso
| | - T. Hafing
- Department of Urology CHU, Tengandogo, Ouagadougou, Burkina Faso
| | - S. Ouattara
- Department of Anatomy and Pathological Cytology CHU, Tengandogo, Ouagadougou, Burkina Faso
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Kayuni SA, Al-Harbi MH, Makaula P, Injesi B, Mainga B, Lampiao F, Juziwelo L, LaCourse EJ, Stothard JR. Pathological Abnormalities Observed on Ultrasonography among Fishermen Associated with Male Genital Schistosomiasis (MGS) along the South Lake Malawi Shoreline in Mangochi District, Malawi. Trop Med Infect Dis 2022; 7:tropicalmed7080169. [PMID: 36006261 PMCID: PMC9415567 DOI: 10.3390/tropicalmed7080169] [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: 07/07/2022] [Revised: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 11/16/2022] Open
Abstract
Schistosome eggs cause granulomata and pathological abnormalities, detectable with non-invasive radiological techniques such as ultrasonography which could be useful in male genital schistosomiasis (MGS). As part of our novel MGS study among fishermen along Lake Malawi, we describe pathologies observed on ultrasonography and praziquantel (PZQ) treatment over time. Fishermen aged 18+ years were recruited, submitted urine and semen for parasitological and molecular testing, and thereafter, transabdominal pelvic and scrotal ultrasonography, assessing pathologies in the prostate, seminal vesicles, epididymis and testes. Standard PZQ treatment and follow-up invitation at 1-, 3-, 6- and 12-months’ time-points were offered. A total of 130 recruited fishermen underwent ultrasonography at baseline (median age: 32.0 years); 27 (20.9%, n = 129) had S. haematobium eggs in urine (median: 1.0 egg/10 mL), 10 (12.3%, n = 81) in semen (defined as MGS, median: 2.9 eggs/mL ejaculate) and 16 (28.1%, n = 57) had a positive seminal Schistosoma real-time PCR. At baseline, 9 fishermen (6.9%, n = 130) had abnormalities, with 2 positive MGS having prostatic and testicular nodules. Fewer abnormalities were observed on follow-up. In conclusion, pathologies detected in male genitalia by ultrasonography can describe MGS morbidity in those with positive parasitological and molecular findings. Ultrasonography advances and accessibility in endemic areas can support monitoring of pathologies’ resolution after treatment.
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Affiliation(s)
- Sekeleghe A. Kayuni
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
- MASM Medi Clinics Limited, Medical Society of Malawi (MASM), Lilongwe P.O. Box 1254, Malawi
- Correspondence: ; Tel.: +265-888-367367
| | - Mohammad H. Al-Harbi
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Peter Makaula
- Research for Health, Environment and Development (RHED), Mangochi P.O. Box 345, Malawi
| | - Boniface Injesi
- MASM Medi Clinics Limited, Medical Society of Malawi (MASM), Lilongwe P.O. Box 1254, Malawi
| | - Bright Mainga
- Laboratory Department, Mangochi District Hospital, Mangochi District Assembly, Mangochi P.O. Box 1854, Malawi
| | - Fanuel Lampiao
- Physiology Department, School of Life Sciences and Allied Health Professions, Kamuzu University of Health Sciences, Mahatma Gandhi Road, Blantyre 312225, Malawi
| | - Lazarus Juziwelo
- National Schistosomiasis and Soil-Transmitted Helminths Control Programme, Community Health Sciences Unit, Ministry of Health, Lilongwe P.O. Box 30377, Malawi
| | - E. James LaCourse
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - J. Russell Stothard
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
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Jatsa HB, Femoe UM, Dongmo CN, Kamwa RIN, Fesuh BN, Tchuem Tchuente LA, Kamtchouing P. Reduction of testosterone levels in Schistosoma haematobium- or Schistosoma mansoni-infected men: a cross-sectional study in two schistosomiasis-endemic areas of the Adamawa region of Cameroon. BMC Infect Dis 2022; 22:230. [PMID: 35255836 PMCID: PMC8900354 DOI: 10.1186/s12879-022-07195-8] [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: 10/20/2021] [Accepted: 02/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The incidence of schistosomiasis-induced male reproductive dysfunction and infertility is probably underestimated compared to female genital schistosomiasis. This study aimed to investigate the impact of Schistosoma haematobium or S. mansoni infection on the reproductive function of men of reproductive age in Tibati and Wouldé, two endemic schistosomiasis areas in the Adamawa region of Cameroon. METHODS A total of 89 men of reproductive age (range 14-56 years) from two localities were enrolled in the study, with 51 in Tibati and 38 in Wouldé. Each participant was submitted to a questionnaire to document data on sociodemographic and stream contact behaviors. A medical examination was performed to measure the testes' circumference and evaluate genital tract pathologies. Stool and urine samples were collected and screened for the presence of S. haematobium or S. mansoni ova. Blood serum was used to assess the levels of transaminases and testosterone. RESULTS Schistosoma haematobium was present only in Tibati, with a prevalence of 31.37%. The S. mansoni prevalence was 3.92% at Tibati and 44.71% at Wouldé. The intensity of infection was 22.12 ± 9.57 eggs/10 mL for S. haematobium and 128.10 ± 3.76 epg for S. mansoni. Serum transaminase activity and the mean testicular circumference of Schistosoma-positive individuals were close to Schistosoma-negative individuals. However, the testes size was more prominent in S. mansoni-positive individuals than in S. haematobium-positive individuals (P < 0.05). The serum testosterone levels of S. haematobium- and S. mansoni-positive men were significantly reduced by 56.07% (P < 0.001) and 51.94% (P < 0.01), respectively, in comparison to those of Schistosoma-negative men. A significant and negative correlation was established between schistosomiasis and the low serum testosterone level. Male genital tract pathologies such as scrotal abnormalities, varicocele, nodular epididymis, inguinal hernia, and hydrocele were recorded in both Schistosoma-positive and Schistosoma-negative men. However, no significant link was established between schistosomiasis infection and these pathologies. CONCLUSION These results demonstrated that infection with S. haematobium or S. mansoni is associated with low production of the reproductive hormone testosterone and may be a significant cause of male infertility.
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Affiliation(s)
- Hermine Boukeng Jatsa
- Laboratory of Animal Physiology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, P.O. Box 812, Yaoundé, Cameroon. .,Centre for Schistosomiasis and Parasitology, P.O. Box 7244, Yaoundé, Cameroon.
| | - Ulrich Membe Femoe
- Laboratory of Animal Physiology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, P.O. Box 812, Yaoundé, Cameroon.,Centre for Schistosomiasis and Parasitology, P.O. Box 7244, Yaoundé, Cameroon
| | - Calvine Noumedem Dongmo
- Centre for Schistosomiasis and Parasitology, P.O. Box 7244, Yaoundé, Cameroon.,Laboratory of Parasitology and Ecology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, P.O. Box 812, Yaoundé, Cameroon
| | | | - Betrand Nono Fesuh
- Laboratory of Mathematical Engineering and Information System, Department of Mathematics, National Advances School of Engineering of Yaoundé, University of Yaoundé I, P.O. Box 8390, Yaoundé, Cameroon
| | - Louis-Albert Tchuem Tchuente
- Centre for Schistosomiasis and Parasitology, P.O. Box 7244, Yaoundé, Cameroon.,Laboratory of Parasitology and Ecology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, P.O. Box 812, Yaoundé, Cameroon
| | - Pierre Kamtchouing
- Laboratory of Animal Physiology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, P.O. Box 812, Yaoundé, Cameroon
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Kayuni SA, Alharbi MH, Makaula P, Lampiao F, Juziwelo L, LaCourse EJ, Stothard JR. Male Genital Schistosomiasis Along the Shoreline of Lake Malawi: Baseline Prevalence and Associated Knowledge, Attitudes and Practices Among Local Fishermen in Mangochi District, Malawi. Front Public Health 2021; 9:590695. [PMID: 34095041 PMCID: PMC8175656 DOI: 10.3389/fpubh.2021.590695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 04/27/2021] [Indexed: 11/13/2022] Open
Abstract
Male genital schistosomiasis (MGS) is an often-overlooked chronic consequence of urogenital schistosomiasis (UGS) associated with Schistosoma haematobium eggs and associated pathologies in the genital system of afflicted men. Despite the first formal description of MGS in 1911 by Madden, its epidemiology, diagnostic testing and case management of today are not well-described. However, since several interactions between MGS and the Human Immunodeficiency Virus (HIV) are known, there is renewed public health interest in MGS across sub-Saharan Africa (SSA). To shed new light upon MGS in Malawi, a longitudinal cohort study was set up among fishermen along the southern shoreline of Lake Malawi in Mangochi District, Malawi, to document its prevalence and assess mens' knowledge, attitudes and practices (KAP). After providing informed written consent, fishermen (n = 376) aged 18+ years (median age: 30 years, range: 18-70 years) were recruited and submitted urine and semen for point-of-care (POC) field and laboratory diagnostic parasitological tests. Individual questionnaires were administered to assess their KAP, with praziquantel (PZQ) treatment provided to all participants. Baseline prevalence of MGS (S. haematobium eggs in semen) was 10.4% (n = 114, median: 5.0 eggs per ml, range: 0.1-30.0) while for UGS (S. haematobium eggs in urine) was 17.1% (n = 210, median: 2.3 eggs per 10 ml, range: 0.1-186.0) and 3.8% were positive by POC circulating cathodic antigen (POC-CCA), indicative of a Schistosoma mansoni infection. Just under 10% of participants reported having experienced symptoms associated with MGS, namely genital or coital pain, or haemospermia. A total of 61.7% reported previous difficulties in accessing PZQ therapy, with 34.8% having received PZQ therapy before. There was a significant correlation between MGS infection and the frequency of fishing in a week (rho = -0.25, n = 100, p = 0.01). In conclusion, MGS is prevalent among local fishermen yet knowledge of the disease is poor. We therefore call for improved availability and accessibility to MGS diagnostics, PZQ treatment within ongoing control interventions. This will improve the lives and reproductive health of men, their partners and communities in this shoreline environment of Lake Malawi.
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Affiliation(s)
- Sekeleghe A Kayuni
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.,Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom.,MASM Medi Clinics Limited, Medical Aid Society of Malawi (MASM), Blantyre, Malawi
| | - Mohammad H Alharbi
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Peter Makaula
- Research for Health, Environment and Development (RHED), Mangochi, Malawi
| | - Fanuel Lampiao
- Physiology Department, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Lazarus Juziwelo
- National Schistosomiasis and STH Control Programme, Community Health Sciences Unit, Ministry of Health, Lilongwe, Malawi
| | - E James LaCourse
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - J Russell Stothard
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Oguntunde OA, Ikhisemojie S, Sonusi SE, Oyebode A, Abdulkareem B, Banjo AA. Testicular schistosomiasis mimicking hydrocele in a child: a case report. Pan Afr Med J 2020; 35:56. [PMID: 32537060 PMCID: PMC7250213 DOI: 10.11604/pamj.2020.35.56.16322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 01/19/2020] [Indexed: 12/04/2022] Open
Abstract
Schistosomiasis is a disease of profound public health importance worldwide. Testicular schistosomiasis (TS) is however still considered as a rare entity despite the burden of the disease. We report a case of a 9 year old male who presented with features suggestive of testicular hydrocele. The spermatic cord and testis were seen as thickened lesion on examination and a biopsy taken revealed calcified ova of Schistosoma haematobium. This is being reported to enhance increased suspicion amongst surgeons in cases of testicular masses within endemic settings like Nigeria.
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Affiliation(s)
- Olubanji Ajibola Oguntunde
- Department of Anatomic and Molecular Pathology, College of Medicine, University of Lagos, Lagos, Nigeria
| | | | - Sandra Esse Sonusi
- Department of Anatomic and Molecular Pathology, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Adeyemi Oyebode
- Maternal and Child Health, Randle General Hospital, Lagos, Nigeria
| | - Biade Abdulkareem
- Department of Anatomic and Molecular Pathology, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Adekunbiola Aina Banjo
- Department of Anatomic and Molecular Pathology, College of Medicine, University of Lagos, Lagos, Nigeria
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Lima CWR, Oliveira NMCD, Silva SVDD, Duarte MEL, Barbosa APF. Ectopic forms of schistosomiasis mansoni in the second macroregion of Alagoas: case series report and review of the literature. Rev Soc Bras Med Trop 2018; 50:812-818. [PMID: 29340459 DOI: 10.1590/0037-8682-0087-2017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Accepted: 11/30/2017] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Ectopic forms of schistosomiasis are those in which the parasitic element is localized outside the portal system, the natural habitat of the helminth. Although the prevalence rates of schistosomiasis are high in Brazil, clinical and epidemiological data on ectopic forms of the disease are still scarce. METHODS Cross-sectional, retrospective and descriptive epidemiological study in which cases with a confirmed histopathological diagnosis of an ectopic form of schistosomiasis were analyzed. The cases were selected from a database of the anatomic pathology files of a referral center. RESULTS Of the 21 cases identified, seven affected the female genital tract and five the male genital tract; four cases were identified in the peritoneum; two cases involved lymph nodes and two involved adipose tissue; and renal involvement was detected in one case. CONCLUSIONS The lack of knowledge of the clinical presentation of ectopic forms of schistosomiasis makes the early identification and treatment of this form difficult, with direct implications in the reduction of morbidity and mortality in endemic areas.
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