Therapeutic response to an empirical praziquantel treatment in long-staying sub-Saharan African migrants with positive Schistosoma serology and chronic symptoms: A prospective cohort study in Spain

Le résumé fourni par la source

• Imported Schistosomiasis can evolve into chronic schistosomiasis • We assessed treatment response to 149 migrants with probable chronic infection • Most of participants were long-term residents in Spain (median 17 years) • 70.3% showed resolution of symptoms; rates of clearance of serology was 54.7% • These results suggest that participants have active infection of Schistosoma spp • These observations should be confirmed with placebo-controlled clinical trial Background Sub-Saharan African migrants may be suffering from imported Schistosomiasis, which can evolve into chronic schistosomiasis. Positive response to empiric treatment with praziquantel may indicate the presence of persistent infection. Methods We tested response to praziquantel in a cohort of sub-Saharan African migrants with probable chronic schistosomiasis. Tests were administered at baseline and 6 and 12 months. Results Among 187 were eligible participants 149 completed follow-up. Of these 119 (79.9%) were males and 65 (43.6%) from Senegal. Median age was 43 years (IQR 35–51) and duration of residence in Europe was 17 years (IQR 12–21). The most prevalent clinical symptom was chronic abdominal pain (N=96, 64.4%), pelvic pain among males (N=55, 46.6%), and dysmenorrhea (N=21; 70.0%) among females. We observed a significant decrease (p<0.001) in the number of signs and symptoms at 12 months, and 70.3% showed a total resolution of the symptoms, and significant decreases in transaminase levels, eosinophilia and abnormal glomerular filtration rates. The rates of clearance in positive ELISA and ICT tests were 54.7% and 24.3%. Conclusions The positive response to praziquantel suggests that chronic schistosomiasis is a prevalent condition among long-staying African migrants. These results need to be confirmed in randomized clinical trials.

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