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Salas-Coronas J, Luzón-García MP, Crego-Vicente B, Soriano-Pérez MJ, Febrer-Sendra B, Vázquez-Villegas J, Diego JGB, Cabeza-Barrera IM, Castillo-Fernández N, Muro A, Bargues MD, Fernández-Soto P. Evaluation of Loop-Mediated Isothermal Amplification (LAMP) in Urine Samples for the Diagnosis of Imported Schistosomiasis. Trop Med Infect Dis 2023; 8:518. [PMID: 38133450 PMCID: PMC10747415 DOI: 10.3390/tropicalmed8120518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/29/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023] Open
Abstract
Migratory flows and international travel are triggering an increase in imported cases of schistosomiasis in non-endemic countries. The present study aims to evaluate the effectiveness of the LAMP technique on patients' urine samples for the diagnosis of imported schistosomiasis in a non-endemic area in comparison to a commercial immunochromatographic test and microscopic examination of feces and urine. A prospective observational study was conducted in sub-Saharan migrants attending the Tropical Medicine Unit, Almería, Spain. For schistosomiasis diagnosis, serum samples were tested using an immunochromatographic test (Schistosoma ICT IgG-IgM). Stool and urine samples were examined by microcopy. Urine samples were evaluated by combining three LAMP assays for the specific detection of Schistosoma mansoni, S. haematobium, and for the genus Schistosoma. To evaluate the diagnostic accuracy, a latent class analysis (LCA) was performed. In total, 115 patients were included (92.2% male; median age: 28.3 years). Of these, 21 patients (18.3%) were diagnosed with schistosomiasis confirmed by microscopy, with S. haematobium being the most frequent species identified (18/115; 15.7%). The Schistosoma ICT IgG-IgM test result was 100% positive and Schistosoma-LAMP was 61.9% positive, reaching as high as 72.2% for S. haematobium. The sensitivity and specificity estimated by LCA, respectively, were: 92% and 76% for Schistosoma ICT IgG-IgM, 68% and 44% for Schistosoma-LAMP, and 46% and 97% for microscopy. In conclusion, the Schistosoma-LAMP technique presented a higher sensitivity than microscopy for the diagnosis of imported urinary schistosomiasis, which could improve the diagnosis of active infection, both in referral centers and in centers with limited experience or scarce resources and infrastructure.
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Affiliation(s)
- Joaquín Salas-Coronas
- Tropical Medicine Unit, Hospital Universitario Poniente, 04700 El Ejido, Almería, Spain; (M.P.L.-G.); (M.J.S.-P.); (I.M.C.-B.); (N.C.-F.)
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almería, 04120 La Cañada, Almería, Spain
| | - María Pilar Luzón-García
- Tropical Medicine Unit, Hospital Universitario Poniente, 04700 El Ejido, Almería, Spain; (M.P.L.-G.); (M.J.S.-P.); (I.M.C.-B.); (N.C.-F.)
| | - Beatriz Crego-Vicente
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Faculty of Pharmacy, University of Salamanca, 37007 Salamanca, Spain; (B.C.-V.); (B.F.-S.); (J.G.-B.D.); (A.M.)
| | - Manuel Jesús Soriano-Pérez
- Tropical Medicine Unit, Hospital Universitario Poniente, 04700 El Ejido, Almería, Spain; (M.P.L.-G.); (M.J.S.-P.); (I.M.C.-B.); (N.C.-F.)
| | - Begoña Febrer-Sendra
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Faculty of Pharmacy, University of Salamanca, 37007 Salamanca, Spain; (B.C.-V.); (B.F.-S.); (J.G.-B.D.); (A.M.)
| | - José Vázquez-Villegas
- Tropical Medicine Unit, Distrito Poniente de Almería, 04700 El Ejido, Almería, Spain;
| | - Juan García-Bernalt Diego
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Faculty of Pharmacy, University of Salamanca, 37007 Salamanca, Spain; (B.C.-V.); (B.F.-S.); (J.G.-B.D.); (A.M.)
| | - Isabel María Cabeza-Barrera
- Tropical Medicine Unit, Hospital Universitario Poniente, 04700 El Ejido, Almería, Spain; (M.P.L.-G.); (M.J.S.-P.); (I.M.C.-B.); (N.C.-F.)
| | - Nerea Castillo-Fernández
- Tropical Medicine Unit, Hospital Universitario Poniente, 04700 El Ejido, Almería, Spain; (M.P.L.-G.); (M.J.S.-P.); (I.M.C.-B.); (N.C.-F.)
| | - Antonio Muro
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Faculty of Pharmacy, University of Salamanca, 37007 Salamanca, Spain; (B.C.-V.); (B.F.-S.); (J.G.-B.D.); (A.M.)
| | - María Dolores Bargues
- Department of Parasitology, Faculty of Pharmacy, University of Valencia, 46100 Burjassot, Valencia, Spain;
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Pedro Fernández-Soto
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Faculty of Pharmacy, University of Salamanca, 37007 Salamanca, Spain; (B.C.-V.); (B.F.-S.); (J.G.-B.D.); (A.M.)
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Grzegorek K, Kroidl I, Prazeres da Costa C, Rothe C. Spectrum of Helminth Infections in Migrants from Sub-Saharan Africa to Europe: A Literature Review. Am J Trop Med Hyg 2023; 108:1096-1104. [PMID: 37094791 PMCID: PMC10540113 DOI: 10.4269/ajtmh.22-0354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 11/21/2022] [Indexed: 04/26/2023] Open
Abstract
Sub-Saharan Africa (SSA) is endemic to numerous neglected tropical diseases, including many helminth diseases. With the migration of people from this part of the world to Europe, as has been happening on a large scale since 2015, these diseases are becoming more relevant to European physicians. This work aims to summarize the recent literature on this topic and to raise awareness of helminth diseases afflicting SSA migrants. The databases PubMed, Embase, and MEDLINE were screened for literature published in English and German between January 1, 2015 and December 31, 2020. In total, 74 articles were included in this review. The spectrum of helminth infections in migrants from SSA found in the literature review is broad; current research, however, is particularly focused on infections with Schistosoma spp. and Strongyloides stercoralis. Both diseases are often characterized by a long course, with few or no symptoms, with the risk of long-term organ damage. Successful and reliable screening for schistosomiasis and strongyloidiasis is strongly recommended. However, the current diagnostic methods lack sensitivity and specificity, rendering the diagnosis challenging and reliable assessment of disease prevalence difficult. Novel diagnostic methods and a greater awareness of these diseases are urgently needed.
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Affiliation(s)
- Katharina Grzegorek
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Inge Kroidl
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
- German Center for Infection Research, Munich, Germany
| | - Clarissa Prazeres da Costa
- German Center for Infection Research, Munich, Germany
- Institute for Medical Microbiology, Immunology and Hygiene, Technical University Munich, Munich, Germany
- Center for Global Health, Technical University Munich, Munich, Germany
| | - Camilla Rothe
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
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Panzner U, Boissier J. Natural Intra- and Interclade Human Hybrid Schistosomes in Africa with Considerations on Prevention through Vaccination. Microorganisms 2021; 9:microorganisms9071465. [PMID: 34361901 PMCID: PMC8305539 DOI: 10.3390/microorganisms9071465] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 12/04/2022] Open
Abstract
Causal agents of schistosomiasis are dioecious, digenean schistosomes affecting mankind in 76 countries. Preventive measures are manifold but need to be complemented by vaccination for long-term protection; vaccine candidates in advanced pre-clinical/clinical stages include Sm14, Sm-TSP-2/Sm-TSP-2Al®, Smp80/SchistoShield®, and Sh28GST/Bilhvax®. Natural and anthropogenic changes impact on breaking species isolation barriers favoring introgressive hybridization, i.e., allelic exchange among gene pools of sympatric, interbreeding species leading to instant large genetic diversity. Phylogenetic distance matters, thus the less species differ phylogenetically the more likely they hybridize. PubMed and Embase databases were searched for publications limited to hybridale confirmation by mitochondrial cytochrome c oxidase (COX) and/or nuclear ribosomal internal transcribed spacer (ITS). Human schistosomal hybrids are predominantly reported from West Africa with clustering in the Senegal River Basin, and scattering to Europe, Central and Eastern Africa. Noteworthy is the dominance of Schistosoma haematobium interbreeding with human and veterinary species leading due to hybrid vigor to extinction and homogenization as seen for S. guineensis in Cameroon and S. haematobium in Niger, respectively. Heterosis seems to advantage S. haematobium/S. bovis interbreeds with dominant S. haematobium-ITS/S. bovis-COX1 profile to spread from West to East Africa and reoccur in France. S. haematobium/S. mansoni interactions seen among Senegalese and Côte d’Ivoirian children are unexpected due to their high phylogenetic distance. Detecting pure S. bovis and S. bovis/S. curassoni crosses capable of infecting humans observed in Corsica and Côte d’Ivoire, and Niger, respectively, is worrisome. Taken together, species hybridization urges control and preventive measures targeting human and veterinary sectors in line with the One-Health concept to be complemented by vaccination protecting against transmission, infection, and disease recurrence. Functional and structural diversity of naturally occurring human schistosomal hybrids may impact current vaccine candidates requiring further research including natural history studies in endemic areas targeted for clinical trials.
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Affiliation(s)
- Ursula Panzner
- Division of Infectious Diseases and Tropical Medicine, Ludwig Maximilian University of Munich, 80539 Munich, Germany
- Swiss Tropical and Public Health Institute, University of Basel, 4002 Basel, Switzerland
- Correspondence: ; Tel.: +49-176-6657-2910
| | - Jerome Boissier
- IHPE, University of Montpellier, CNRS, Ifremer, University of Perpignan, 66860 Perpignan, France;
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