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Rodríguez-Molino P, González Martínez S, Bustamante Amador J, Mellado-Sola I, Montes Martín L, Falces-Romero I, García López-Hortelano M, Hurtado-Gallego J, Mellado MJ, Grasa C, Sainz T. Schistosomiasis in migrant children and adolescents in a paediatric tropical referral unit in Spain: diagnosis and long-term management challenges. Eur J Pediatr 2024; 183:4457-4465. [PMID: 39143347 DOI: 10.1007/s00431-024-05623-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 03/28/2024] [Accepted: 05/19/2024] [Indexed: 08/16/2024]
Abstract
Globalisation and population movement have led to an increasing number of migrant children residing in areas non-endemic for schistosomiasis. However, diagnosing and managing schistosomiasis in children remain controversial. This study aims to investigate the prevalence of schistosomiasis in migrant children and to describe the diagnostic approach and management strategies, including long-term follow-up, to explore the potential role of serological tests in evaluating treatment response. We conducted a retrospective descriptive study spanning from January 2014-July 2021 at a referral unit for Paediatric Tropical Diseases in Madrid (Spain). The study included patients under 18 years diagnosed with schistosomiasis. Of 679 children screened for schistosomiasis, 73 (10.8%) tested positive. The median age was 16.3 years [IQR 9-17.6], 74% male. The majority originated from Sub-Saharan Africa (47%) and Asia (47%). Only 40% presented with symptoms, with gastrointestinal (18%) and cutaneous (17%) manifestations being the most common. Eosinophilia was observed in 43% (median [IQR]: 1103/mm3 [671-1536]), and ova were visualised in the urine of 2/50 (4.0%). Praziquantel treatment was administered to 92%, and 5 patients required retreatment. Follow-up data were available for 58 (80%) over a median period of 9 months [IQR 6-19.8], revealing a progressive decline in eosinophil count, IgE titres, and ELISA optical density. Conclusion: In this series, the prevalence of schistosomiasis among migrant children was significant (10%), highlighting the importance of including serological tests in migrant health screening. The disease is largely asymptomatic, eosinophilia is often absent, and visualisation of ova in urine is exceedingly rare. Eosinophil count, IgE titres, and ELISA optical density could prove valuable as an initial approach for monitoring inflammation during follow-up assessments. What is Known: • The burden of disease related to schistosomiasis is significant, particulary in children, and it is advisable to screen this vulnerable population. What is New: • Eosinophilia may not be present in parasitic infections, so serological tests are crucial for screening migrant children. • Serological monitoring facilitates long-term management of migrant children with schistosomiasis.
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Affiliation(s)
- Paula Rodríguez-Molino
- General Paediatrics, Infectious and Tropical Diseases Department, Hospital La Paz, Madrid, Spain
- La Paz Hospital Research Institute (IdiPAZ), Madrid, Spain
- Autonomous University of Madrid (UAM), Madrid, Spain
- Centro de Investigacion en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | | | - Jorge Bustamante Amador
- La Paz Hospital Research Institute (IdiPAZ), Madrid, Spain
- Hospital Paediatrics Department, Childhood Infections, El Escorial Hospital, Madrid, Spain
- Health Centre Guzmán el Bueno, SERMAS, Madrid, Spain
| | - Isabel Mellado-Sola
- General Paediatrics, Infectious and Tropical Diseases Department, Hospital La Paz, Madrid, Spain
- La Paz Hospital Research Institute (IdiPAZ), Madrid, Spain
- Autonomous University of Madrid (UAM), Madrid, Spain
| | | | - Iker Falces-Romero
- La Paz Hospital Research Institute (IdiPAZ), Madrid, Spain
- Centro de Investigacion en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Department of Microbiology and Parasitology, La Paz University Hospital, Madrid, Spain
| | - Milagros García López-Hortelano
- General Paediatrics, Infectious and Tropical Diseases Department, Hospital La Paz, Madrid, Spain
- La Paz Hospital Research Institute (IdiPAZ), Madrid, Spain
- Centro de Investigacion en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Translational Research Network in Paediatric Infectious Diseases (RITIP), Madrid, Spain
| | - Jara Hurtado-Gallego
- La Paz Hospital Research Institute (IdiPAZ), Madrid, Spain
- Centro de Investigacion en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - María José Mellado
- General Paediatrics, Infectious and Tropical Diseases Department, Hospital La Paz, Madrid, Spain
- La Paz Hospital Research Institute (IdiPAZ), Madrid, Spain
- Autonomous University of Madrid (UAM), Madrid, Spain
- Centro de Investigacion en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Translational Research Network in Paediatric Infectious Diseases (RITIP), Madrid, Spain
| | - Carlos Grasa
- General Paediatrics, Infectious and Tropical Diseases Department, Hospital La Paz, Madrid, Spain
- La Paz Hospital Research Institute (IdiPAZ), Madrid, Spain
- Autonomous University of Madrid (UAM), Madrid, Spain
- Centro de Investigacion en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Talía Sainz
- General Paediatrics, Infectious and Tropical Diseases Department, Hospital La Paz, Madrid, Spain.
- La Paz Hospital Research Institute (IdiPAZ), Madrid, Spain.
- Autonomous University of Madrid (UAM), Madrid, Spain.
- Centro de Investigacion en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain.
- Translational Research Network in Paediatric Infectious Diseases (RITIP), Madrid, Spain.
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Essien-Baidoo S, Essuman MA, Tee J, Ephraim RKD, Blay Mensah LB, Boakye Amponsah S, Afrifa J. Toward schistosomiasis control: Assessment of infection-associated voiding symptoms, quality of life and the impact of exercise coupled with water intake on egg recovery in an endemic community in Ghana. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002514. [PMID: 37983234 PMCID: PMC10659178 DOI: 10.1371/journal.pgph.0002514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 09/28/2023] [Indexed: 11/22/2023]
Abstract
Assessment of the burden of disease and techniques for clinical diagnosis could ultimately help in schistosomiasis control. This study assessed the impact of exercises and water intake on ova recovery during laboratory diagnosis and schistosomiasis-associated urinary symptoms and quality of life (QOL) among inhabitants of Dendo, an endemic community in Ghana. The clinical findings and responses of 400 randomly selected participants were used for the study. The International Prostate Symptoms Score (I-PSS) was used to collect information on participants' self-reported urinary symptoms and QOL. Finally, urine samples were collected on two consecutive days, initially without exercise and water intake and then after exercise and water intake, and about 10 ml of it were microscopically examined for the presence and quantification of ova. The data collected from the study were analyzed using IBM SPSS. Schistosoma haematobium egg recovery increased significantly (p < 0.001) from 206 (51.5%) to 220 (55.0%) after exercise and water intake with the highest increase being observed among participants less than 20 years (53.3% to 57.1% after exercise and water intake). As high as 90.3% and 56.8% of Schistosoma-positive participants reported IPSS>7 (symptomatic voiding disorders) and QOL≥4 (mostly dissatisfied or unhappy QOL) respectively. The commonest voiding symptoms reported were nocturia (98.9%) and incomplete emptying (79.6%). Positive correlations between egg count, IPSS score, and QOL were observed. This study provides important evidence for the inclusion of exercise and water intake in the microscopic diagnosis of Schistosoma haematobium and reveals that schistosomiasis significantly impacts the affected individuals' urinary health and overall quality of life.
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Affiliation(s)
- Samuel Essien-Baidoo
- Department of Medical Laboratory Science, School of Allied Health Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Mainprice Akuoko Essuman
- Department of Medical Laboratory Science, School of Allied Health Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Joseph Tee
- Department of Medical Laboratory Science, School of Allied Health Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Richard K. D. Ephraim
- Department of Medical Laboratory Science, School of Allied Health Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Loretta Betty Blay Mensah
- Department of Medical Laboratory Science, School of Allied Health Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Seth Boakye Amponsah
- Department of Medical Laboratory Science, School of Allied Health Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Justice Afrifa
- Department of Medical Laboratory Science, School of Allied Health Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
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Ismail HAHA, Ahmed AEAAERM, Cha S, Jin Y. The Life Histories of Intermediate Hosts and Parasites of Schistosoma haematobium and Schistosoma mansoni in the White Nile River, Sudan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031508. [PMID: 35162527 PMCID: PMC8835159 DOI: 10.3390/ijerph19031508] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 02/05/2023]
Abstract
Background: The epidemiology of schistosomiasis transmission varies depending on the circumstances of the surrounding water bodies and human behaviors. We aimed to explore cercarial emergence patterns from snails that are naturally affected by human schistosomiasis and non-human trematodes. In addition, this study aimed to explore how schistosomiasis infection affects snail survival, reproduction, and growth. Methods: We measured the survival rate, fecundity, and size of Biomphalaria pfeifferi snails and the cercarial rhythmicity of S. haematobium and S. mansoni. The number of egg masses, eggs per egg mass, and snail deaths were counted for 7 weeks. The survival rate and cumulative hazard were assessed for infected and non-infected snails. Results: S. haematobium and S. mansoni cercariae peaked at 9:00–11:00 a.m. Infection significantly reduced the survival rate of B. pfeifferi, which was 35% and 51% for infected and non-infected snails, respectively (p = 0.02), at 7 weeks after infection. The hazard ratio of death for infected snails compared to non-infected snails was 1.65 (95% confidence interval: 1.35–1.99; p = 0.01). Conclusions: An understanding of the dynamics of schistosomiasis transmission will be helpful for formulating schistosomiasis control and elimination strategies. Cercarial rhythmicity can be reflected in health education, and the reproduction and survival rate of infected snails can be used as parameters for developing disease modeling.
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Affiliation(s)
| | | | - Seungman Cha
- Department of Global Development and Entrepreneurship, Graduate School of Global Development and Entrepreneurship, Handong Global University, Pohang 37554, Korea;
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Yan Jin
- Department of Microbiology, College of Medicine, Dongguk University, Gyeongju 38066, Korea
- Correspondence: ; Tel.: +82-10-3375-3118
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Opio CK, Kazibwe F, Rejani L, Kabatereine NB, Ocama P. Hepatic schistosomiasis, upper gastrointestinal bleeding, and health related quality of life measurements from the Albert Nile Basin. J Patient Rep Outcomes 2021; 5:112. [PMID: 34718894 PMCID: PMC8557235 DOI: 10.1186/s41687-021-00389-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 10/17/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Health related quality of life measurements are vital elements of public health surveillance that uncover unmet health needs and predict the success of health interventions. We described health related quality of life measurements using the EuroQoL 5-dimension (EQ-VAS/EQ-5D) instrument and associated factors among patients with upper gastrointestinal bleeding (UGIB) and hepatic schistosomiasis at a rural health facility in the Albert Nile Basin, Uganda. METHODS AND MATERIALS This was a cross-sectional study at Pakwach Health Centre IV. Participants included adult inpatients and outpatients with a history of UGIB and ultrasound evidence of hepatic schistosomiasis. We evaluated and recorded each participant's medical history, physical examination, laboratory tests results, ultrasound results, and endoscopy findings. We also recorded health related quality of life measurements using the EuroQoL 5-dimension instrument and derived disability weights from EQ-VAS and EQ-5D measurements. These were our dependent variables. Descriptive and inferential statistics were generated summarizing our findings. RESULTS We found 103 participants had a history of upper gastrointestinal bleeding and hepatosplenic schistosomiasis. Sixty percent were between the ages of 30-49 years, 59% were females, 74% were farmers, 92% had splenomegaly, 88% had varices at endoscopy, 22% were medical emergencies with acute variceal upper gastrointestinal bleeding, and 62% had anemia. Measures of the different dimensions of health from 101 participants with patient reported outcomes revealed 77 (76%) participants experienced problems in self-care, 89 (88%) participants reported anxiety or depression, and 89 (88%) participants experienced pain or discomfort. The median EQ-VAS derived disability weights and median EQ-5D index-derived disability weights were 0.3 and 0.34, respectively. Acute upper gastrointestinal bleeding, praziquantel drug treatment, and age by decade predicted higher EQ-VAS derived disability weights (p value < 0.05). Under weight (Body mass index ≤ 18.5), acute upper gastrointestinal bleeding, ascites, age by decade, female gender, and praziquantel drug treatment predicted higher EQ-5D index- derived disability weights (p value < 0.05). CONCLUSION Adult patients with upper gastrointestinal bleeding and hepatic schistosomiasis from this primary health facility experience poor health and considerable health loss. Several factors predicted increased health loss. These factors probably represent key areas of health intervention towards mitigating increased health loss in this population.
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Affiliation(s)
- Christopher K. Opio
- Aga Khan University Hospital, 3rd Parkland Avenue, PO Box 30270-00100, Nairobi, Kenya
| | - Francis Kazibwe
- Public Health Department, Bishop Stuart University, PO Box 9, Mbarara, Uganda
| | - Lalitha Rejani
- Makerere University College of Health Sciences, PO Box 7072, Kampala, Uganda
| | | | - Ponsiano Ocama
- Makerere University College of Health Sciences, PO Box 7072, Kampala, Uganda
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