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

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A Correction to this article was published on 04 March 2019

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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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Change history

  • 04 March 2019

    The original version of this article unfortunately contained a mistake. The given name and family name of Filippo Parretti was transposed in the original publication. The correct name is as shown above.

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Funding

This research did not receive any specific Grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy

    Marta Tilli, Francesca Rinaldi, Andrea Minervini, Marco Carini, Simone Sforza, Alessandro Bartoloni & Lorenzo Zammarchi

  2. IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy

    Federico Gobbi, Jacopo Testa, Dora Buonfrate, Monica Degani & Zeno Bisoffi

  3. Center for Clinical Ethics, Biotechnology and Life Sciences Department, Insubria University, Varese, Italy

    Jacopo Testa

  4. University Department of Infectious and Tropical Diseases, University of Brescia and Spedali Civili General Hospital, Brescia, Italy

    Silvio Caligaris, Paola Magro, Maurizio Gulletta & Francesco Castelli

  5. Department of Urology, Careggi University and Hospital, Florence, Italy

    Andrea Minervini, Marco Carini, Agostino Tuccio & Simone Sforza

  6. UNESCO Chair “Training and Empowering Human Resources for Health Development in Resource-Limited Countries, University of Brescia”, Brescia, Italy

    Francesco Castelli

  7. Radiology Unit, Careggi University and Hospital, Florence, Italy

    Simone Agostini & Filippo Parretti

  8. Institut für Tropenmedizin und Internationale Gesundheit Charité, Universitätsmedizin Berlin, Berlin, Germany

    Joachim Richter

  9. Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland

    Piero Olliaro

  10. Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford University, Oxford, UK

    Piero Olliaro

  11. Department of Diagnostics and Public Health, University of Verona, Verona, Italy

    Zeno Bisoffi

  12. Infectious and Tropical Diseases Unit, Careggi University and Hospital, Florence, Italy

    Alessandro Bartoloni & Lorenzo Zammarchi

  13. Referral Centre for Tropical Diseases of Tuscany, Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy

    Alessandro Bartoloni & Lorenzo Zammarchi

Authors
  1. Marta Tilli
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  2. Federico Gobbi
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  3. Francesca Rinaldi
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  4. Jacopo Testa
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  8. Monica Degani
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  9. Andrea Minervini
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  14. Francesco Castelli
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  15. Simone Agostini
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  16. Filippo Parretti
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  17. Joachim Richter
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  18. Piero Olliaro
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  19. Zeno Bisoffi
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  20. Alessandro Bartoloni
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  21. Lorenzo Zammarchi
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Corresponding author

Correspondence to Lorenzo Zammarchi.

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Additional information

The original version of this article was revised: The given name and family name of Filippo Parretti was transposed in the original publication. The correct name is as shown above.

The author is responsible for the choice and presentation of views contained in this article and for opinions expressed therein, which are not necessarily those of UNESCO and do not commit the Organization.

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Tilli, M., Gobbi, F., Rinaldi, F. et al. The diagnosis and treatment of urogenital schistosomiasis in Italy in a retrospective cohort of immigrants from Sub-Saharan Africa. Infection 47, 447–459 (2019). https://doi.org/10.1007/s15010-019-01270-0

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