The diagnosis and treatment of urogenital schistosomiasis in Italy in a retrospective cohort of immigrants from Sub-Saharan Africa

Marta Tilli, Federico Gobbi, Francesca Rinaldi, Jacopo Testa, Silvio Caligaris, Paola Magro, Dora Buonfrate, Monica Degani, Andrea Minervini, Marco Carini, Agostino Tuccio, Simone Sforza, Maurizio Gulletta, Francesco Castelli, Simone Agostini, Filippo Parretti, Joachim Richter, Piero Olliaro, Zeno Bisoffi, Alessandro BartoloniLorenzo Zammarchi

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)447-459
Number of pages13
JournalInfection
Volume47
Issue number3
DOIs
Publication statusPublished - Jun 1 2019

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Schistosomiasis haematobia
Africa South of the Sahara
Italy
Praziquantel
Urinary Tract
Therapeutics
Schistosoma haematobium
Morbidity
Multicenter Studies
Ultrasonography
Urinary Bladder
Urine
Pathology
Health

Keywords

  • Migrant
  • Praziquantel
  • Schistosoma
  • Schistosomiasis
  • Ultrasonography
  • Ultrasound

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

The diagnosis and treatment of urogenital schistosomiasis in Italy in a retrospective cohort of immigrants from Sub-Saharan Africa. / Tilli, Marta; Gobbi, Federico; Rinaldi, Francesca; Testa, Jacopo; Caligaris, Silvio; Magro, Paola; Buonfrate, Dora; Degani, Monica; Minervini, Andrea; Carini, Marco; Tuccio, Agostino; Sforza, Simone; Gulletta, Maurizio; Castelli, Francesco; Agostini, Simone; Parretti, Filippo; Richter, Joachim; Olliaro, Piero; Bisoffi, Zeno; Bartoloni, Alessandro; Zammarchi, Lorenzo.

In: Infection, Vol. 47, No. 3, 01.06.2019, p. 447-459.

Research output: Contribution to journalArticle

Tilli, M, Gobbi, F, Rinaldi, F, Testa, J, Caligaris, S, Magro, P, Buonfrate, D, Degani, M, Minervini, A, Carini, M, Tuccio, A, Sforza, S, Gulletta, M, Castelli, F, Agostini, S, Parretti, F, Richter, J, Olliaro, P, Bisoffi, Z, Bartoloni, A & Zammarchi, L 2019, 'The diagnosis and treatment of urogenital schistosomiasis in Italy in a retrospective cohort of immigrants from Sub-Saharan Africa', Infection, vol. 47, no. 3, pp. 447-459. https://doi.org/10.1007/s15010-019-01270-0
Tilli, Marta ; Gobbi, Federico ; Rinaldi, Francesca ; Testa, Jacopo ; Caligaris, Silvio ; Magro, Paola ; Buonfrate, Dora ; Degani, Monica ; Minervini, Andrea ; Carini, Marco ; Tuccio, Agostino ; Sforza, Simone ; Gulletta, Maurizio ; Castelli, Francesco ; Agostini, Simone ; Parretti, Filippo ; Richter, Joachim ; Olliaro, Piero ; Bisoffi, Zeno ; Bartoloni, Alessandro ; Zammarchi, Lorenzo. / The diagnosis and treatment of urogenital schistosomiasis in Italy in a retrospective cohort of immigrants from Sub-Saharan Africa. In: Infection. 2019 ; Vol. 47, No. 3. pp. 447-459.
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AU - Tilli, Marta

AU - Gobbi, Federico

AU - Rinaldi, Francesca

AU - Testa, Jacopo

AU - Caligaris, Silvio

AU - Magro, Paola

AU - Buonfrate, Dora

AU - Degani, Monica

AU - Minervini, Andrea

AU - Carini, Marco

AU - Tuccio, Agostino

AU - Sforza, Simone

AU - Gulletta, Maurizio

AU - Castelli, Francesco

AU - Agostini, Simone

AU - Parretti, Filippo

AU - Richter, Joachim

AU - Olliaro, Piero

AU - Bisoffi, Zeno

AU - Bartoloni, Alessandro

AU - Zammarchi, Lorenzo

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