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Costescu Strachinaru DI, Nyandwaro JN, Stoefs A, Dooms E, Vanbrabant P, François PM, Strachinaru M, Van Esbroeck M, Bottieau E, Soentjens P. Schistosomiasis in the Military-A Narrative Review. Trop Med Infect Dis 2024; 9:221. [PMID: 39330910 PMCID: PMC11436125 DOI: 10.3390/tropicalmed9090221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Revised: 09/15/2024] [Accepted: 09/18/2024] [Indexed: 09/28/2024] Open
Abstract
Schistosomiasis is a parasitosis caused by trematodes of the genus Schistosoma. Humans are infected when coming into contact with freshwater containing the parasites' infective stages, which are amplified through freshwater-dwelling snails acting as intermediate hosts. Schistosomiasis has posed significant problems for troops exposed to freshwater in endemic regions ever since the Napoleonic wars. Schistosomiasis has substantial differences in clinical presentation, depending on the type of parasite, intensity of infection and reinfection, clinical form, and disease stage. It can remain undiagnosed for long periods of time, with well-known long-term morbidity and mortality risks. The diagnosis of schistosomiasis depends on its stage and relays on several tests, all with limitations in sensitivity and specificity. The diagnostic gold standard is the detection of eggs in urine, feces, or tissue biopsies, but this can raise problems in patients such as military personnel, in which the worm burden is usually low. Praziquantel is the drug of choice for schistosomiasis. Currently, there is no available commercial vaccine against any Schistosoma parasite. Avoiding freshwater exposure is the best prevention. Herein, we review the clinical presentation, diagnosis, treatment, and prevention of schistosomiasis in the military. This information may decrease the impact of schistosomiasis on this particular professional group.
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Affiliation(s)
| | - Jemima Nyaboke Nyandwaro
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (J.N.N.); (M.V.E.); (E.B.)
| | - Anke Stoefs
- Department of Microbiology, Queen Astrid Military Hospital, 1120 Brussels, Belgium;
| | - Eric Dooms
- Center for Infectious Diseases, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (E.D.); (P.V.); (P.S.)
| | - Peter Vanbrabant
- Center for Infectious Diseases, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (E.D.); (P.V.); (P.S.)
| | - Pierre-Michel François
- Medical Component Operational Command, Queen Astrid Military Hospital, 1120 Brussels, Belgium;
| | - Mihai Strachinaru
- Department of Cardiology, Brussels University Hospital—Erasme Hospital, Université Libre de Bruxelles, 1070 Brussels, Belgium;
| | - Marjan Van Esbroeck
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (J.N.N.); (M.V.E.); (E.B.)
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (J.N.N.); (M.V.E.); (E.B.)
| | - Patrick Soentjens
- Center for Infectious Diseases, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (E.D.); (P.V.); (P.S.)
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (J.N.N.); (M.V.E.); (E.B.)
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Mulate ST, Nur AM, Tasamma AT, Annose RT, Dawud EM, Ekubazgi KW, Mekonnen HD, Mohammed HY, Hailemeskel MB, Yimer SA. Colonic schistosomiasis mimicking cancer, polyp, and inflammatory bowel disease: Five case reports and review of literature. World J Gastrointest Endosc 2024; 16:472-482. [PMID: 39155995 PMCID: PMC11325876 DOI: 10.4253/wjge.v16.i8.472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 06/16/2024] [Accepted: 06/26/2024] [Indexed: 08/01/2024] Open
Abstract
BACKGROUND Schistosomiasis, officially named as a neglected tropical disease by The World Health Organization, is a serious parasitic disease caused by trematode flukes of the genus Schistosoma. It is a common infectious disease, endemic in more than 78 countries. The disease can involve various organs and poses far-reaching public health challenges. CASE SUMMARY Here, we present a series of five patients with variable presentations: an asymptomatic patient who was diagnosed with colonic schistosomiasis upon screening colonoscopy; 2 patients with clinical suspicion of colonic cancer; and 2 patients with a clinical diagnosis of inflammatory bowel disease. All patients were subsequently confirmed to have colonic schistosomiasis after colonoscopy and histopathologic examination. The clinical manifestations, colonoscopy features and histologic findings of the patients are described. Most of the patients showed significant clinical improvement following administration of oral praziquantel. CONCLUSION Intestinal schistosomiasis can present with features mimicking other gastrointestinal conditions. This disease should be a diagnostic consideration in patients who live in or have traveled to endemic areas.
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Affiliation(s)
- Sebhatleab T Mulate
- Department of Internal Medicine, Addis Ababa University, College of Health Science, Addis Ababa 9086, Ethiopia
| | - Abdulsemed M Nur
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Addis Ababa University, College of Health Science, Addis Ababa 9086, Ethiopia
| | - Abel T Tasamma
- Department of Internal Medicine, Addis Ababa University, College of Health Science, Addis Ababa 9086, Ethiopia
| | - Rodas T Annose
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Addis Ababa University, College of Health Science, Addis Ababa 9086, Ethiopia
| | - Esmael M Dawud
- Department of Internal Medicine, St Paul’s Hospital Millennium Medical College, Addis Ababa 9086, Ethiopia
| | - Kinfe W Ekubazgi
- Department of Internal Medicine, Hawassa University, Hawassa PO Box 05, Ethiopia
| | - Hailemichael D Mekonnen
- Department of Internal Medicine, St Paul’s Hospital Millennium Medical College, Addis Ababa 1271, Ethiopia
| | - Hidaya Y Mohammed
- Department of Pathology, Addis Ababa University, College of Health Science, Addis Ababa 9086, Ethiopia
| | - Meron B Hailemeskel
- Department of Pathology, St Paul’s Hospital Millennium Medical College, Addis Ababa 1271, Ethiopia
| | - Shimelis A Yimer
- Department of Pathology, Ethio Tebib General Hospital, Addis Ababa 1111, Ethiopia
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Thawornkuno C, Srisuksai K, Simanon N, Adisakwattana P, Ampawong S, Boonyuen U, Limpanont Y, Chusongsang P, Chusongsang Y, Kiangkoo N, Reamtong O. A reanalysis and integration of transcriptomics and proteomics datasets unveil novel drug targets for Mekong schistosomiasis. Sci Rep 2024; 14:12969. [PMID: 38839835 PMCID: PMC11153569 DOI: 10.1038/s41598-024-63869-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 06/03/2024] [Indexed: 06/07/2024] Open
Abstract
Schistosomiasis, caused by Schistosoma trematodes, is a significant global health concern, particularly affecting millions in Africa and Southeast Asia. Despite efforts to combat it, the rise of praziquantel (PZQ) resistance underscores the need for new treatment options. Protein kinases (PKs) are vital in cellular signaling and offer potential as drug targets. This study focused on focal adhesion kinase (FAK) as a candidate for anti-schistosomal therapy. Transcriptomic and proteomic analyses of adult S. mekongi worms identified FAK as a promising target due to its upregulation and essential role in cellular processes. Molecular docking simulations assessed the binding energy of FAK inhibitors to Schistosoma FAK versus human FAK. FAK inhibitor 14 and PF-03814735 exhibited strong binding to Schistosoma FAK with minimal binding for human FAK. In vitro assays confirmed significant anti-parasitic activity against S. mekongi, S. mansoni, and S. japonicum, comparable to PZQ, with low toxicity in human cells, indicating potential safety. These findings highlight FAK as a promising target for novel anti-schistosomal therapies. However, further research, including in vivo studies, is necessary to validate efficacy and safety before clinical use. This study offers a hopeful strategy to combat schistosomiasis and reduce its global impact.
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Affiliation(s)
- Charin Thawornkuno
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Krittika Srisuksai
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Nattapon Simanon
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Poom Adisakwattana
- Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Sumate Ampawong
- Department of Tropical Pathology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Usa Boonyuen
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Yanin Limpanont
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Phiraphol Chusongsang
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Yupa Chusongsang
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Nuttapohn Kiangkoo
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Onrapak Reamtong
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
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Percheron L, Leblanc C, Ulinski T, Fila M, Malvy D, Bacchetta J, Guigonis V, Debuisson C, Launay E, Martinez E, Morand A, Decramer S, Schanstra JP, Berry A. Pediatric urogenital schistosomiasis diagnosed in France. Pediatr Nephrol 2024; 39:1893-1900. [PMID: 38212419 DOI: 10.1007/s00467-023-06260-x] [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: 07/07/2023] [Revised: 12/09/2023] [Accepted: 12/11/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND Schistosomiasis affects approximately 230 million people worldwide. There is an increased incidence of schistosomiasis cases in France acquired from outside the country. This increases the risk of schistosomiasis outbreaks as observed in Corsica. Clinicians from non-endemic regions are not accustomed to diagnosing and managing this pathology. The objective of this study is to provide a better description of the clinical and paraclinical characteristics and disease evolution of affected children. METHODS Through the French Pediatric Nephrology Society and the Pediatric Infectious Pathology Group, we contacted all French pediatric centers that may have treated children with urinary schistosomiasis between 2013 and 2019. Age, sex, comorbidities, and clinical, biological, and radiological data (at discovery and follow-up) were collected retrospectively. RESULTS A total of 122 patients from 10 different centers were included. The median age was 14 years and the sex ratio M/F was 4:1. Hematuria was present in 82% of the patients while urinary tract abnormality was found in 36% of them. Fourteen patients (11%) displayed complicated forms of urinary schistosomiasis including 10 patients with chronic kidney disease. A total of 110 patients received treatment with praziquantel, which was well-tolerated and led to clinical resolution of symptoms in 98% of cases. CONCLUSION Patients with schistosomiasis present frequent kidney, urinary, or genital involvement. Systematic screening of patients returning from endemic areas is therefore recommended, especially since treatment with antiparasitic drugs is effective and well-tolerated. Enhancing medical knowledge of this pathology among all practitioners is essential to improve care and outcomes.
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Affiliation(s)
- Lucas Percheron
- Service de néphrologie, médecine interne pédiatrique, Hôpital des enfants, CHU de Toulouse, Avenue de grande Bretagne, 31000, Toulouse, France.
- Service de pédiatrie, centre hospitalier du Val d'Ariège, Foix, France.
| | - Claire Leblanc
- Service de pédiatrie générale, maladies infectieuses et médecine interne Hôpital Robert Debré, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Tim Ulinski
- Service de néphrologie et de transplantation pédiatrique, Université pierre marie curie, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Marc Fila
- Service de néphrologie endocrinologie pédiatrique, Hôpital Arnaud de Villeneuve, Montpellier, France
| | - Denis Malvy
- Service des maladies infectieuses et tropicales, Centre hospitalier universitaire, Bordeaux, France
| | - Justine Bacchetta
- Service de néphrologie rhumatologie pédiatrique, Centre hospitalier universitaire, Lyon, France
| | - Vincent Guigonis
- Service de pédiatrie générale, centre hospitalier universitaire, Limoges, France
| | - Cecile Debuisson
- Service de pédiatrie générale et de maladie infectieuse pédiatrique, Hôpital Purpan, Toulouse, France
| | - Elise Launay
- Service de pédiatrie générale et infectiologie pédiatrique, Centre hospitalier universitaire, Nantes, France
| | - Edouard Martinez
- Service de pédiatrie, Centre hospitalier universitaire, Rouen, France
| | - Aurelie Morand
- Pédiatrie spécialisée et médecine infantile, Hôpital de la Timone, AP-HM, Marseille, France
| | - Stéphane Decramer
- Service de néphrologie, médecine interne pédiatrique, Hôpital des enfants, CHU de Toulouse, Avenue de grande Bretagne, 31000, Toulouse, France
| | - Joost-Peter Schanstra
- Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Institute of Cardiovascular and Metabolic Disease, Toulouse, France
- Université Toulouse III Paul-Sabatier, Toulouse, France
| | - Antoine Berry
- Service de parasitologie-mycologie, Centre hospitalier universitaire de Toulouse, Toulouse, France
- Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université Toulouse, CNRS UMR5051, INSERM UMR1291, UPS, Toulouse, France
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Liu C, Fisher D, Pronyuk K, Musabaev E, Thu Hien NT, Dang Y, Zhao L. Therapeutic potential of natural products in schistosomiasis-associated liver fibrosis. Front Pharmacol 2024; 15:1332027. [PMID: 38770001 PMCID: PMC11102961 DOI: 10.3389/fphar.2024.1332027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 04/10/2024] [Indexed: 05/22/2024] Open
Abstract
Schistosomiasis is a parasitic disease that endangers human health and social development. The granulomatous reaction of Schistosoma eggs in the liver is the main cause of hepatosplenomegaly and fibrotic lesions. Anti liver fibrosis therapy is crucial for patients with chronic schistosomiasis. Although Praziquantel is the only clinical drug used, it is limited in insecticide treatment and has a long-term large-scale use, which is forcing the search for cost-effective alternatives. Previous research has demonstrated that plant metabolites and extracts have effective therapeutic effects on liver fibrosis associated with schistosomiasis. This paper summarizes the mechanisms of action of metabolites and some plant extracts in alleviating schistosomiasis-associated liver fibrosis. The analysis was conducted using databases such as PubMed, Google Scholar, and China National Knowledge Infrastructure (CNKI) databases. Some plant metabolites and extracts ameliorate liver fibrosis by targeting multiple signaling pathways, including reducing inflammatory infiltration, oxidative stress, inhibiting alternate macrophage activation, suppressing hepatic stellate cell activation, and reducing worm egg load. Natural products improve liver fibrosis associated with schistosomiasis, but further research is needed to elucidate the effectiveness of natural products in treating liver fibrosis caused by schistosomiasis, as there is no reported data from clinical trials in the literature.
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Affiliation(s)
- Cuiling Liu
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - David Fisher
- Department of Medical Biosciences, Faculty of Natural Sciences, University of the Western Cape, Bellville, South Africa
| | - Khrystyna Pronyuk
- Infectious Diseases Department, O.Bogomolets National Medical University, Kyiv, Ukraine
| | - Erkin Musabaev
- The Research Institute of Virology, Ministry of Health, Tashkent, Uzbekistan
| | | | - Yiping Dang
- Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lei Zhao
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Zrieq R, Alzain MA, Ali RM, Alazzeh AY, Tirawi AO, Attili R, Acar T, Haouas N. Epidemiological Profile of Urinary and Intestinal Schistosomiasis in the Kingdom of Saudi Arabia: A Seven-Year Retrospective Study. Trop Med Infect Dis 2023; 9:11. [PMID: 38251208 PMCID: PMC10820950 DOI: 10.3390/tropicalmed9010011] [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: 11/07/2023] [Revised: 12/20/2023] [Accepted: 12/27/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Despite the marked decline of schistosomiasis in Saudi Arabia in recent years, it is still reported in several regions. This study investigates the epidemiology of schistosomiasis in Saudi Arabia over seven years (2014-2020). METHODOLOGY A retrospective study was retrieved from the annual reports of the Ministry of Health. A Geographic Information System GIS, Chi-square, and logistic regression were used to analyze the data. RESULTS Out of the 4,371,481 tested, 680 cases were positive for schistosomiasis, with a cumulative incidence rate of 2.155/100,000 population. This number showed significant variation over the study period (p value < 0.001). The highest number of cases detected in 2015 was almost 2-fold (OR = 1.93; 95%CI: 1.36-2.74) higher than in 2020. Both clinical forms (urinary and intestinal schistosomiasis) exist in Saudi Arabia (79.6% and 20.4% of all schistosomiasis cases, respectively). Schistosomiasis was reported in seven out of thirteen regions. Among them, Mecca has a relatively high number of cases (OR = 5.57; 95%CI: 2.49-12.47). Conversely, the Eastern Province has a low number of cases (OR = 0.09; 95%CI: 0.02-0.39) when compared to the Najran region (p value > 0.001). Regarding the distribution of schistosomiasis cases by gender and nationality, we noticed that most of the positive cases were found among males (70.6%) and expatriates (83.6%). CONCLUSIONS The persistence of schistosomiasis and the disparity in the demographic factors underscores the imperative for intensified and integrative One Health interventions to combat this disease in Saudi Arabia.
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Affiliation(s)
- Rafat Zrieq
- Department of Public Health, College of Public Health and Health Informatics, University of Ha'il, Ha'il 2440, Saudi Arabia
- Applied Science, Research Center, Applied Science Private University, Amman 11931, Jordan
| | - Mohamed Ali Alzain
- Department of Public Health, College of Public Health and Health Informatics, University of Ha'il, Ha'il 2440, Saudi Arabia
| | - Reem M Ali
- Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, University of Ha'il, Ha'il 2440, Saudi Arabia
| | - Awfa Y Alazzeh
- Department of Clinical Nutrition, College of Applied Medical Sciences, University of Ha'il, Ha'il 2440, Saudi Arabia
| | - Anas O Tirawi
- Faculty of Medicine, Yarmouk University, Irbid 21163, Jordan
| | - Rozan Attili
- Department of Medical Laboratory Science, Faculty of Pharmacy and Medical Sciences, Hebron University, Hebron P.O. Box 40, Palestine
| | - Tolgahan Acar
- Department of Physical Therapy, College of Applied Medical Sciences, University of Ha'il, Ha'il 2440, Saudi Arabia
| | - Najoua Haouas
- Laboratory of Medical and Molecular Parasitology-Mycology LP3M (Code LR12ES08), Department of Clinical Biology B, Faculty of Pharmacy, University of Monastir, Street 1, Avicenne, Monastir 5000, Tunisia
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Manciulli T, Marangoni D, Salas-Coronas J, Bocanegra C, Richter J, Gobbi F, Motta L, Minervini A, Bartoloni A, Zammarchi L. Diagnosis and management of complicated urogenital schistosomiasis: a systematic review of the literature. Infection 2023; 51:1185-1221. [PMID: 37466786 PMCID: PMC10545601 DOI: 10.1007/s15010-023-02060-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/31/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Currently, there are no standardized guidelines for the diagnosis or management of the complications of urogenital schistosomiasis (UGS). This systematic review of the literature aims to investigate the state of the art in reference to diagnostic approaches and the clinical management of this condition. METHODS A systematic review of literature published between January 1990 and January 2021 was conducted in the MEDLINE database, scoping for articles regarding diagnostic means or therapeutic options for the complications of UGS, namely obstructive uropathy, bladder cancer, abortion, ectopic pregnancy, infertility, kidney failure, urolithiasis and the need for invasive procedures. Relevant data were then extracted from the articles deemed eligible according to the inclusion criteria. MAIN RESULTS In total, 3052 articles were identified by the research query, of which 167 articles fulfilling inclusion criteria after title/abstract screening and full-text evaluation were included, 35% on both diagnostic and therapeutic aspects, and 51% on diagnosis and 14% on therapy. Ultrasound was the most frequently tool employed for the diagnosis of UGS complications showing a good performance. Concerning the management of hydronephrosis, the majority of available evidences came from community-based studies where universal treatment with praziquantel was used leading to decrease of prevalence of obstructive uropathy. Concerning studies on surgical procedures, laser endoureterotomy followed by stenting was mostly employed in adult patients leading to a crude cure rate of 60% (43 of 71 patients). In the case of severe hydronephrosis, surgery consisting of ureteral re-implantation showed excellent results with a crude cure rate of 98% (157 cured patients of 160 treated). Concerning bladder cancer, data on 93 patients with a clear diagnosis of UGS-related bladder were available reporting a variable and sometime combined approach based on disease stage. Available data on diagnosis and management of abortion, ectopic pregnancy, infertility, kidney failure, urolithiasis and the need for invasive procedures due to UGS are also presented. CONCLUSIONS The review produced a complete picture of the diagnostic and therapeutic options currently available for complicated UGS. These results can be useful both for guiding clinicians towards correct management and for tracing the direction of future research.
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Affiliation(s)
- Tommaso Manciulli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Davide Marangoni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | - Cristina Bocanegra
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Joachim Richter
- Institute of Tropical Medicine and International Health, Charité Universitätsmedizin, Corporate Member of Free University and Humboldt University Berlin and Berlin Health Institute, Berlin, Germany
| | - Federico Gobbi
- Infectious-Tropical Diseases and Microbiology Department, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Verona, Italy
| | - Leonardo Motta
- Infectious-Tropical Diseases and Microbiology Department, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Verona, Italy
| | - Andrea Minervini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Department of Infectious and Tropical Diseases, Azienda Ospedaliero Universitaria Careggi, Largo Giovanni Alessandro Brambilla, 3, 50134, Florence, Italy
| | - Lorenzo Zammarchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
- Department of Infectious and Tropical Diseases, Azienda Ospedaliero Universitaria Careggi, Largo Giovanni Alessandro Brambilla, 3, 50134, Florence, Italy.
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Mustafa S, Matarneh AS, Mohamed A, Fadul A, Musa M, Mohamed RI, Abdallah E, Mohamed TG. Cerebral Neuroschistosomiasis Presenting as a Brain Mass. Cureus 2023; 15:e45418. [PMID: 37854757 PMCID: PMC10581503 DOI: 10.7759/cureus.45418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2023] [Indexed: 10/20/2023] Open
Abstract
Neuroschistosomiasis is a rare manifestation of schistosomal infections presenting with cerebral and spinal cord involvement. We reported a case of a 31-year-old woman who presented with a history of headache, dizziness, and nausea. Brain MRI with contrast showed features suggestive of brain lesion with edema, and a serology test for Schistosoma was positive. She was diagnosed with neuroschistosomiasis and treated with intravenous steroids followed by praziquantel resulting in a significant regression of the brain mass. Cerebral neuroschistosomiasis is a rare complication of Schistosoma infection, and clinicians should consider it among the differential diagnosis of unexplained brain lesions.
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Affiliation(s)
- Salma Mustafa
- Internal Medicine, Hamad Medical Corporation, Doha, QAT
| | | | | | - Abdalla Fadul
- Internal Medicine, Hamad Medical Corporation, Doha, QAT
| | - Muzamil Musa
- Internal Medicine, Hamad Medical Corporation, Doha, QAT
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Abaasa A, Egesa M, Driciru E, Koopman JPR, Kiyemba R, Sanya RE, Nassuuna J, Ssali A, Kimbugwe G, Wajja A, van Dam GJ, Corstjens PLAM, Cose S, Seeley J, Kamuya D, Webb EL, Yazdanbakhsh M, Kaleebu P, Siddiqui AA, Kabatereine N, Tukahebwa E, Roestenberg M, Elliott AM. Establishing a single-sex controlled human Schistosoma mansoni infection model for Uganda: protocol for safety and dose-finding trial. IMMUNOTHERAPY ADVANCES 2023; 3:ltad010. [PMID: 37538934 PMCID: PMC10396375 DOI: 10.1093/immadv/ltad010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 07/13/2023] [Indexed: 08/05/2023] Open
Abstract
Control of schistosomiasis depends on a single drug, praziquantel, with variable cure rates, high reinfection rates, and risk of drug resistance. A vaccine could transform schistosomiasis control. Preclinical data show that vaccine development is possible, but conventional vaccine efficacy trials require high incidence, long-term follow-up, and large sample size. Controlled human infection studies (CHI) can provide early efficacy data, allowing the selection of optimal candidates for further trials. A Schistosoma CHI has been established in the Netherlands but responses to infection and vaccines differ in target populations in endemic countries. We aim to develop a CHI for Schistosoma mansoni in Uganda to test candidate vaccines in an endemic setting. This is an open-label, dose-escalation trial in two populations: minimal, or intense, prior Schistosoma exposure. In each population, participants will be enrolled in sequential dose-escalating groups. Initially, three volunteers will be exposed to 10 cercariae. If all show infection, seven more will be exposed to the same dose. If not, three volunteers in subsequent groups will be exposed to higher doses (20 or 30 cercariae) following the same algorithm, until all 10 volunteers receiving a particular dose become infected, at which point the study will be stopped for that population. Volunteers will be followed weekly after infection until CAA positivity or to 12 weeks. Once positive, they will be treated with praziquantel and followed for one year. The trial registry number is ISRCTN14033813 and all approvals have been obtained. The trial will be subjected to monitoring, inspection, and/or audits.
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Affiliation(s)
- Andrew Abaasa
- MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene & Tropical Medicine, London, UK
| | - Moses Egesa
- MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene & Tropical Medicine, London, UK
| | | | | | | | - Richard E Sanya
- MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
- African Population and Health Research Center, Nairobi, Kenya
| | | | - Agnes Ssali
- MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene & Tropical Medicine, London, UK
| | | | - Anne Wajja
- MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
| | | | | | - Stephen Cose
- MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene & Tropical Medicine, London, UK
| | - Janet Seeley
- MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene & Tropical Medicine, London, UK
| | - Dorcas Kamuya
- Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
| | - Emily L Webb
- London School of Hygiene & Tropical Medicine, London, UK
| | | | - Pontiano Kaleebu
- MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene & Tropical Medicine, London, UK
| | | | | | | | | | - Alison M Elliott
- MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene & Tropical Medicine, London, UK
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10
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Iriarte C, Marks DH. Cutaneous schistosomiasis: epidemiological and clinical characteristics in returning travelers. Int J Dermatol 2023; 62:376-386. [PMID: 36096120 DOI: 10.1111/ijd.16389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 06/15/2022] [Accepted: 07/28/2022] [Indexed: 11/29/2022]
Abstract
The clinical manifestations of parasitic diseases are well-covered in the infectious disease literature; however, cutaneous manifestations often receive limited attention. There is a need to update existing knowledge and improve reporting of disease characteristics. Given continued increases in travel and transportation, more individuals are acquiring cutaneous infections while traveling abroad. Schistosomiasis is the second most important tropical disease among returning travelers and affects more than 200 million individuals worldwide. The literature classically describes three forms of skin disease in those infected with Schistosoma: the immediate pruritic eruption of cercarial dermatitis, the urticarial response of Katayama syndrome, and the granulomatous lesions of late cutaneous schistosomiasis. Over the last two decades, more atypical presentations have been described. Travelers returning from Africa, South America, and Asia are at highest risk given these are the continents in which the parasite is endemic. This review highlights the cutaneous manifestations of schistosomiasis, with a focus on international travelers with atypical presentations. Additionally, genital schistosomiasis will be reviewed given its significant morbidity. The aim of this review is to update the current body of literature. Dermatologists and other physicians evaluating the skin should be aware of the following principles regarding schistosomal infections: (i) the importance of an early skin biopsy in making the diagnosis; (ii) the necessity of adding schistosomiasis to the differential diagnosis for zosteriform lesions; (iii) the resemblance of chronic cutaneous schistosomiasis of the genitals to sexually transmitted infections; and (iv) the need to revise definitions for early and late infection, specifically for cutaneous disease.
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Affiliation(s)
- Christopher Iriarte
- Harvard Medical School, Boston, MA, USA.,Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA
| | - Dustin H Marks
- Department of Dermatology, Stanford University, Palo Alto, CA, USA
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11
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Zammarchi L, Botta A, Tilli M, Gobbi F, Bartoloni A, Boccalini S. Presumptive treatment or serological screening for schistosomiasis in migrants from Sub-Saharan Africa could save both lives and money for the Italian National Health System: results of an economic evaluation. J Travel Med 2023; 30:6845442. [PMID: 36420915 DOI: 10.1093/jtm/taac140] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/20/2022] [Accepted: 11/20/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Schistosomiasis can lead to severe irreversible complications and death if left untreated. Italian and European guidelines recommend serological screening for this infection in migrants from Sub-Saharan Africa (SSA). However, studies on clinical and economic impact of this strategy in the Italian and European settings are lacking. This study aims to compare benefits and costs of different strategies to manage schistosomiasis in migrants from SSA to Italy. METHODS A decision tree and a Markov model were developed to assess the health and economic impacts of three interventions: (i) passive diagnosis for symptomatic patients (current practice in Italy); (ii) serological screening of all migrants and treating those found positive and (iii) presumptive treatment for all migrants with praziquantel in a single dose. The time horizon of analysis was one year to determine the exact expenses, and 28 years to consider possible sequelae, in the Italian health-care perspective. Data input was derived from available literature; costs were taken from the price list of Careggi University Hospital, Florence, and from National Hospitals Records. RESULTS Assuming a population of 100 000 migrants with schistosomiasis prevalence of 21·2%, the presumptive treatment has a greater clinical impact with 86.3% of the affected being cured (75.2% in screening programme and 44.9% in a passive diagnosis strategy). In the first year, the presumptive treatment and the screening strategy compared with passive diagnosis prove cost-effective (299 and 595 cost/QALY, respectively). In the 28-year horizon, the two strategies (screening and presumptive treatment) compared with passive diagnosis become dominant (less expensive with more QALYs) and cost-saving. CONCLUSION The results of the model suggest that presumptive treatment and screening strategies are more favourable than the current passive diagnosis in the public health management of schistosomiasis in SSA migrants, especially in a longer period analysis.
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Affiliation(s)
- Lorenzo Zammarchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Referral Centre for Tropical Diseases of Tuscany, Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Annarita Botta
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Marta Tilli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Federico Gobbi
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Referral Centre for Tropical Diseases of Tuscany, Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Sara Boccalini
- Department of Health Sciences, University of Florence, Florence, Italy
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12
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Liu Z, Zhang L, Liang Y, Lu L. Pathology and molecular mechanisms of Schistosoma japonicum-associated liver fibrosis. Front Cell Infect Microbiol 2022; 12:1035765. [PMID: 36389166 PMCID: PMC9650140 DOI: 10.3389/fcimb.2022.1035765] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 10/13/2022] [Indexed: 11/23/2022] Open
Abstract
Schistosomiasis has been widely disseminated around the world, and poses a significant threat to human health. Schistosoma eggs and soluble egg antigen (SEA) mediated inflammatory responses promote the formation of egg granulomas and liver fibrosis. With continuous liver injuries and inflammatory stimulation, liver fibrosis can develop into liver cirrhosis and liver cancer. Therefore, anti-fibrotic therapy is crucial to increase the survival rate of patients. However, current research on antifibrotic treatments for schistosomiasis requires further exploration. In the complicated microenvironment of schistosome infections, it is important to understand the mechanism and pathology of schistosomiasis-associated liver fibrosis(SSLF). In this review, we discuss the role of SEA in inhibiting liver fibrosis, describe its mechanism, and comprehensively explore the role of host-derived and schistosome-derived microRNAs (miRNAs) in SSLF. Inflammasomes and cytokines are significant factors in promoting SSLF, and we discuss the mechanisms of some critical inflammatory signals and pro-fibrotic cytokines. Natural killer(NK) cells and Natural killer T(NKT) cells can inhibit SSLF but are rarely described, therefore, we highlight their significance. This summarizes and provides insights into the mechanisms of key molecules involved in SSLF development.
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Affiliation(s)
- Zhilong Liu
- Laboratory of Genetic Regulators in the Immune System, Henan Collaborative Innovation Center of Molecular Diagnosis and Laboratory Medicine, School of Laboratory Medicine, Xinxiang Medical University, Xinxiang, China
- Henan Key Laboratory of Immunology and Targeted Therapy, Xinxiang Medical University, Xinxiang, China
| | - Lichen Zhang
- Laboratory of Genetic Regulators in the Immune System, Henan Collaborative Innovation Center of Molecular Diagnosis and Laboratory Medicine, School of Laboratory Medicine, Xinxiang Medical University, Xinxiang, China
- Henan Key Laboratory of Immunology and Targeted Therapy, Xinxiang Medical University, Xinxiang, China
| | - Yinming Liang
- Laboratory of Genetic Regulators in the Immune System, Henan Collaborative Innovation Center of Molecular Diagnosis and Laboratory Medicine, School of Laboratory Medicine, Xinxiang Medical University, Xinxiang, China
- Henan Key Laboratory of Immunology and Targeted Therapy, Xinxiang Medical University, Xinxiang, China
- Institute of Psychiatry and Neuroscience, Xinxiang Medical University, Xinxiang, China
- *Correspondence: Yinming Liang, ; Liaoxun Lu,
| | - Liaoxun Lu
- Laboratory of Genetic Regulators in the Immune System, Henan Collaborative Innovation Center of Molecular Diagnosis and Laboratory Medicine, School of Laboratory Medicine, Xinxiang Medical University, Xinxiang, China
- Henan Key Laboratory of Immunology and Targeted Therapy, Xinxiang Medical University, Xinxiang, China
- Institute of Psychiatry and Neuroscience, Xinxiang Medical University, Xinxiang, China
- *Correspondence: Yinming Liang, ; Liaoxun Lu,
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13
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Chienwichai P, Nogrado K, Tipthara P, Tarning J, Limpanont Y, Chusongsang P, Chusongsang Y, Tanasarnprasert K, Adisakwattana P, Reamtong O. Untargeted serum metabolomic profiling for early detection of Schistosoma mekongi infection in mouse model. Front Cell Infect Microbiol 2022; 12:910177. [PMID: 36061860 PMCID: PMC9433908 DOI: 10.3389/fcimb.2022.910177] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 07/29/2022] [Indexed: 11/13/2022] Open
Abstract
Mekong schistosomiasis is a parasitic disease caused by blood flukes in the Lao People’s Democratic Republic and in Cambodia. The standard method for diagnosis of schistosomiasis is detection of parasite eggs from patient samples. However, this method is not sufficient to detect asymptomatic patients, low egg numbers, or early infection. Therefore, diagnostic methods with higher sensitivity at the early stage of the disease are needed to fill this gap. The aim of this study was to identify potential biomarkers of early schistosomiasis using an untargeted metabolomics approach. Serum of uninfected and S. mekongi-infected mice was collected at 2, 4, and 8 weeks post-infection. Samples were extracted for metabolites and analyzed with a liquid chromatography-tandem mass spectrometer. Metabolites were annotated with the MS-DIAL platform and analyzed with Metaboanalyst bioinformatic tools. Multivariate analysis distinguished between metabolites from the different experimental conditions. Biomarker screening was performed using three methods: correlation coefficient analysis; feature important detection with a random forest algorithm; and receiver operating characteristic (ROC) curve analysis. Three compounds were identified as potential biomarkers at the early stage of the disease: heptadecanoyl ethanolamide; picrotin; and theophylline. The levels of these three compounds changed significantly during early-stage infection, and therefore these molecules may be promising schistosomiasis markers. These findings may help to improve early diagnosis of schistosomiasis, thus reducing the burden on patients and limiting spread of the disease in endemic areas.
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Affiliation(s)
- Peerut Chienwichai
- Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Kathyleen Nogrado
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Phornpimon Tipthara
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Joel Tarning
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Yanin Limpanont
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Phiraphol Chusongsang
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Yupa Chusongsang
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Kanthi Tanasarnprasert
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Poom Adisakwattana
- Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Onrapak Reamtong
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- *Correspondence: Onrapak Reamtong,
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14
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Giboda M, Bergquist R, Utzinger J. Schistosomiasis at the Crossroad to Elimination: Review of Eclipsed Research with Emphasis on the Post-Transmission Agenda. Trop Med Infect Dis 2022; 7:55. [PMID: 35448830 PMCID: PMC9029828 DOI: 10.3390/tropicalmed7040055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/18/2022] [Accepted: 03/24/2022] [Indexed: 02/06/2023] Open
Abstract
While chronic schistosomiasis is pathologically well defined, the acute form of the disease is less well understood. It is generally agreed that early lesions, such as lung nodules and bladder polyps, are reversible, which impedes identification of the time elapsed since exposure. The intermediate stage between the acute and the chronic forms of schistosomiasis requires further investigation, as does the clinical stage due to lesions remaining after treatment. With current schistosomiasis control efforts gradually progressing to elimination, there is a need to focus on post-transmission schistosomiasis, which not only refers to remaining lesions from previous infections, but also accounts for the potential presence of surviving worms after treatment. This issue is particularly salient for migrants from endemic to non-endemic countries and should be kept in mind for returning expatriates from schistosomiasis-endemic countries. Negative stool examination or urine filtration are generally taken as indicative of cure since rectoscopy for Schistosoma mansoni infection, or cystoscopy for S. haematobium infection, are rarely performed. However, pathology of affected organs may persist indefinitely, while potentially remaining live worms could produce additional pathology. Hence, post-transmission schistosomiasis can prevail for years after elimination of the disease, and thus, warrant further attention.
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Affiliation(s)
- Michal Giboda
- Institute of Parasitology, Czech Academy of Science, CZ 370 01 České Budějovice, Czech Republic
| | | | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, CH-4123 Allschwil, Switzerland;
- University of Basel, CH-4003 Basel, Switzerland
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15
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Mekonnen GG, Tedla BA, Pearson MS, Becker L, Field M, Amoah AS, van Dam G, Corstjens PLAM, Mduluza T, Mutapi F, Loukas A, Sotillo J. Characterisation of tetraspanins from Schistosoma haematobium and evaluation of their potential as novel diagnostic markers. PLoS Negl Trop Dis 2022; 16:e0010151. [PMID: 35073344 PMCID: PMC8812969 DOI: 10.1371/journal.pntd.0010151] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 02/03/2022] [Accepted: 01/06/2022] [Indexed: 01/01/2023] Open
Abstract
Schistosoma haematobium is the leading cause of urogenital schistosomiasis and it is recognised as a class 1 carcinogen due to the robust association of infection with bladder cancer. In schistosomes, tetraspanins (TSPs) are abundantly present in different parasite proteomes and could be potential diagnostic candidates due to their accessibility to the host immune system. The large extracellular loops of six TSPs from the secretome (including the soluble excretory/secretory products, tegument and extracellular vesicles) of S. haematobium (Sh-TSP-2, Sh-TSP-4, Sh-TSP-5, Sh-TSP-6, Sh-TSP-18 and Sh-TSP-23) were expressed in a bacterial expression system and polyclonal antibodies were raised to the recombinant proteins to confirm the anatomical sites of expression within the parasite. Sh-TSP-2, and Sh-TSP-18 were identified on the tegument, whereas Sh-TSP-4, Sh-TSP-5, Sh-TSP-6 and Sh-TSP-23 were identified both on the tegument and internal tissues of adult parasites. The mRNAs encoding these TSPs were differentially expressed throughout all schistosome developmental stages tested. The potential diagnostic value of three of these Sh-TSPs was assessed using the urine of individuals (stratified by infection intensity) from an endemic area of Zimbabwe. The three Sh-TSPs were the targets of urine IgG responses in all cohorts, including individuals with very low levels of infection (those positive for circulating anodic antigen but negative for eggs by microscopy). This study provides new antigen candidates to immunologically diagnose S. haematobium infection, and the work presented here provides compelling evidence for the use of a biomarker signature to enhance the diagnostic capability of these tetraspanins. Schistosoma haematobium, the leading cause of urogenital schistosomiasis, affects millions of people worldwide. Infection with this parasite is associated with different clinical complications such as squamous cell carcinoma and genital malignancy in women. Despite its importance, there is a lack of sensitive and specific diagnostics that support control and elimination initiatives against this devastating disease. Herein, we have characterised six molecules belonging to the tetraspanin family of membrane proteins, providing details about their relative expression during parasite’s development and their localization in adult forms of S. haematobium. Furthermore, we have characterised the antibody responses against three of these molecules in urine from infected human subjects from an endemic area, providing compelling evidence for the use of these molecules to diagnose urogenital schistosomiasis.
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Affiliation(s)
- Gebeyaw G. Mekonnen
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australia
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bemnet A. Tedla
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australia
| | - Mark S. Pearson
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australia
- * E-mail: (MSP); (AL); (JS)
| | - Luke Becker
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australia
| | - Matt Field
- Australian Institute of Tropical Health & Medicine and Centre for Tropical Bioinformatics and Molecular Biology, James Cook University, Cairns, Australia
- Immunogenomics Lab, Garvan Institute of Medical Research, Darlinghurst, Australia
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Abena S. Amoah
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Malawi Epidemiology and Intervention Research Unit, Chilumba, Malawi
| | - Govert van Dam
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Paul L. A. M. Corstjens
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, The Netherlands
| | - Takafira Mduluza
- Biochemistry Department, University of Zimbabwe, P.O. Box MP167, Mount Pleasant, Harare, Zimbabwe
- Tackling Infections to Benefit Africa Partnership, NIHR Global Health Research Unit, University of Zimbabwe, Mount Pleasant, Harare, Zimbabwe
| | - Francisca Mutapi
- Tackling Infections to Benefit Africa Partnership, NIHR Global Health Research Unit, University of Zimbabwe, Mount Pleasant, Harare, Zimbabwe
- Institute of Immunology & Infection Research, Ashworth Laboratories, University of Edinburgh, King’s Buildings, Edinburgh, United Kingdom
| | - Alex Loukas
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australia
- * E-mail: (MSP); (AL); (JS)
| | - Javier Sotillo
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australia
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
- * E-mail: (MSP); (AL); (JS)
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16
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The returned traveler with neurologic manifestations: could my patient have a parasite? Curr Opin Infect Dis 2021; 34:245-254. [PMID: 33769967 DOI: 10.1097/qco.0000000000000732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE OF REVIEW The present review focuses on parasitic infections of the central nervous system (CNS) that can affect the international traveler. RECENT FINDINGS The epidemiology of imported parasitic infections is changing and clinicians are treating increasing numbers of returned travelers with parasitic infections in the CNS with which they are not familiar. SUMMARY The epidemiology, life cycle, clinical manifestations, diagnosis, and treatment of parasites that affect the CNS will be discussed.
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17
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Hoekstra PT, van Dam GJ, van Lieshout L. Context-Specific Procedures for the Diagnosis of Human Schistosomiasis – A Mini Review. FRONTIERS IN TROPICAL DISEASES 2021. [DOI: 10.3389/fitd.2021.722438] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Schistosomiasis is a parasitic disease caused by trematode blood flukes of the genus Schistosoma, affecting over 250 million people mainly in the tropics. Clinically, the disease can present itself with acute symptoms, a stage which is relatively more common in naive travellers originating from non-endemic regions. It can also develop into chronic disease, with the outcome depending on the Schistosoma species involved, the duration and intensity of infection and several host-related factors. A range of diagnostic tests is available to determine Schistosoma infection, including microscopy, antibody detection, antigen detection using the Point-Of-Care Circulating Cathodic Antigen (POC-CCA) test and the Up-Converting Particle Lateral Flow Circulating Anodic Antigen (UCP-LF CAA) test, as well as Nucleic Acid Amplification Tests (NAATs) such as real-time PCR. In this mini review, we discuss these different diagnostic procedures and explore their most appropriate use in context-specific settings. With regard to endemic settings, diagnostic approaches are described based on their suitability for individual diagnosis, monitoring control programs, determining elimination as a public health problem and eventual interruption of transmission. For non-endemic settings, we summarize the most suitable diagnostic approaches for imported cases, either acute or chronic. Additionally, diagnostic options for disease-specific clinical presentations such as genital schistosomiasis and neuro-schistosomiasis are included. Finally, the specific role of diagnostic tests within research settings is described, including a controlled human schistosomiasis infection model and several clinical studies. In conclusion, context-specific settings have different requirements for a diagnostic test, stressing the importance of a well-considered decision of the most suitable diagnostic procedure.
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18
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Cavalcanti MG, Engel DC, de Araujo Cunha AF, Peralta JM. Case Report: Diagnosis and Assessment of Cure Approaches for Acute Schistosomiasis in Pre-School Children. Front Immunol 2021; 12:624736. [PMID: 34054799 PMCID: PMC8149760 DOI: 10.3389/fimmu.2021.624736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 04/27/2021] [Indexed: 02/02/2023] Open
Abstract
Acute schistosomiasis (AS) manifests with a broad spectrum of clinical features in pediatric populations. Diagnosis may be difficult in the absence of detectable numbers of eggs. As a result, new approaches may be required to achieve an accurate diagnosis. Optimal praziquantel (PZQ) treatment regimen for young children is debatable. Also, the post-treatment response is still poorly evaluated due to the lack of reliable markers. A group of 6 children (a toddler and 5 pre-school children) and one pre-adolescent were investigated for AS clinical manifestations and followed-up for two years after treatment. Ova detection was performed by Kato-Katz (KK) and presence of Schistosoma mansoni DNA was assessed by real-time PCR (rt-PCR) in stool samples. IgG and IgE anti-Schistosoma levels and urinary antigen were detected by ELISA and point-of-care circulating cathodic antigen (POC-CCA) testing in serum and urine, respectively. AS clinical symptoms were present in 5/7 (71.4%) of the infected children, and hypereosinophilia was detected in all of them. Ova detection and serology were positive in only 3/7 (44.9%) and 4/7 (57.1%), respectively. However, real-time PCR (rt-PCR) showed the presence of Schistosoma DNA in 6/7 (85.7%) of the cases, and urinary antigen was detected in all infected children. The long-term follow-up after treatment with three doses of PZQ (80mg/kg/dose), showed high cure rates (CR) as demonstrated by the DNA-based assay as well as reduced levels of side effects. CR based on urinary antigen detection ranged from 28.6 to 100%, being the highest CR due to double testing the 2-year post-treatment samples. The results suggest that high dose and repeated treatment with PZQ might be effective for AS in young children. Also, new laboratory markers should be considered to diagnosis and monitor the drug response.
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Affiliation(s)
- Marta G Cavalcanti
- Serviço de Doenças Infecciosas e Parasitárias, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.,Departmento de Imunologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Délia Celser Engel
- Serviço de Doenças Infecciosas e Parasitárias, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Aline Fernandes de Araujo Cunha
- Departmento de Imunologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - José Mauro Peralta
- Departmento de Imunologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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19
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Gleeson SE, Zhang X, Azar MM. Recurrent Hematochezia in a Returning Traveler. JAMA 2021; 325:1558-1559. [PMID: 33666646 DOI: 10.1001/jama.2021.0368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Shana E Gleeson
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Xuchen Zhang
- Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
| | - Marwan M Azar
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
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20
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Makhani L, Kopalakrishnan S, Bhasker S, Boggild AK. Five key points about intestinal schistosomiasis for the migrant health practitioner. Travel Med Infect Dis 2021; 40:101971. [PMID: 33444785 DOI: 10.1016/j.tmaid.2021.101971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 01/06/2021] [Indexed: 12/21/2022]
Affiliation(s)
- Leila Makhani
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada; Tropical Disease Unit, Toronto General Hospital, Toronto, Canada
| | | | - Shveta Bhasker
- Department of Psychology, University of Toronto, Toronto, Canada
| | - Andrea K Boggild
- Tropical Disease Unit, Toronto General Hospital, Toronto, Canada; Public Health Ontario Laboratory, Public Health Ontario, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada.
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Singer MA, Chen A, Shetty A, Hodges S. Hematuria in a 13-year-old Boy. Pediatr Rev 2021; 42:S32-S34. [PMID: 33386357 DOI: 10.1542/pir.2019-0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
| | | | | | - Steve Hodges
- Department of Urology, Wake Forest University Medical Center, Winston-Salem, NC
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22
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Matarneh AS, Abdullah W, Khan AA, Sadiq A, Farooqui K. A Case of Neuroschistosomiasis Presenting as Transverse Myelitis: The Importance of History Taking. Cureus 2020; 12:e11445. [PMID: 33324527 PMCID: PMC7732780 DOI: 10.7759/cureus.11445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2020] [Indexed: 11/19/2022] Open
Abstract
Neuroschistosomiasis is a rare manifestation of Schistosoma infection and can either manifest as cerebritis or with spinal cord involvement. We present a case of low back pain and lower limb weakness, which was initially managed as idiopathic transverse myelitis and later on found to have neuroschistosomiasis. A 23-year-old Sudanese gentleman presented with a one-week history of low back pain, lower limb weakness, and urinary retention. An urgent MRI of the spine with contrast showed features suggestive of transverse myelitis. The patient was treated with intravenous methylprednisolone for five days, which showed significant improvement in his symptoms. One week later, the patient developed the same symptoms again. An urgent MRI spine showed an interval progression of MRI findings. Repeat history taking revealed a history of swimming many times in the river Nile. Serology was sent for Schistosoma and came positive with titer 1:1280. He was treated as neuroschistosomiasis with intravenous steroids for three days, followed by praziquantel for five days along with the steroids, after which he showed significant improvement in his lower limb weakness. Spinal neuroschistosomiasis is one of the very rare complications of Schistosoma infection that should be kept in mind when dealing with unexplained myelopathy with a history of travel or origin from an endemic area. If not treated promptly, it can result in severe irreversible complications.
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Affiliation(s)
| | - Wafa Abdullah
- Internal Medicine, Hamad Medical Corporation, Doha, QAT
| | - Adeel A Khan
- Internal Medicine, Hamad Medical Corporation, Doha, QAT
| | - Amna Sadiq
- Radiology, Hamad Medical Corporation, Doha, QAT
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Casacuberta-Partal M, Janse JJ, van Schuijlenburg R, de Vries JJC, Erkens MAA, Suijk K, van Aalst M, Maas JJ, Grobusch MP, van Genderen PJJ, de Dood C, Corstjens PLAM, van Dam GJ, van Lieshout L, Roestenberg M. Antigen-based diagnosis of Schistosoma infection in travellers: a prospective study. J Travel Med 2020; 27:5822102. [PMID: 32307517 PMCID: PMC7359925 DOI: 10.1093/jtm/taaa055] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 04/09/2020] [Accepted: 04/10/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND Travellers infected with Schistosoma spp. might be pauci- or even asymptomatic on first presentation. Therefore, schistosomiasis may remain undiagnosed in this population. Active infection, as evidenced by the presence of the tissue-dwelling worm, can be demonstrated via the detection of adult worm-derived circulating anodic antigen (CAA) utilising a robust well-described lateral flow-(LF) based test applying background-free up-converting reporter particles (UCP). In this prospective study, we assessed the diagnostic value of serum and urine UCP-LF CAA test in comparison with two Schistosoma-specific serological assays detecting antibodies against adult worm antigen-immuno fluorescence assay (AWA-IFA) and against soluble egg antigen-enzyme-linked immunosorbent assay (SEA-ELISA) antigens in travellers. METHODS Samples were collected from 106 Dutch travellers who reported freshwater contact in sub-Saharan Africa and who were recruited up to 2 years after return. Subjects were asked to complete a detailed questionnaire on travel history, water contact, signs and symptoms compatible with schistosomiasis. RESULTS Two travellers were positive by serum CAA and an additional one by urine CAA. A total of 22/106 (21%) samples were antibody positive by AWA-IFA and 9/106 (9%) by SEA-ELISA. At follow-up 6 weeks and 6 months after praziquantel treatment, all seropositives remained antibody positive whereas CAA was cleared. Seropositivity could not be predicted by the type of fresh water-related activity, country visited or symptoms reported. CONCLUSION The low number of UCP-LF CAA positives suggests that in travellers, active infections often do not establish or have very low worm burden. Based on our high seroconversion rates, we conclude that the AWA-IFA assay is the most sensitive test to detect schistosome exposure. Given the lack of predictive symptoms or risk factors, we recommend schistosomiasis screening at least by serology in all travellers with reported freshwater contact in high-endemic areas.
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Affiliation(s)
- Miriam Casacuberta-Partal
- Department of Parasitology, Leiden University Medical Centre, L4-Q, PO Box 9600, 2333 ZA Leiden, The Netherlands
| | - Jacqueline J Janse
- Department of Parasitology, Leiden University Medical Centre, L4-Q, PO Box 9600, 2333 ZA Leiden, The Netherlands
| | - Roos van Schuijlenburg
- Department of Parasitology, Leiden University Medical Centre, L4-Q, PO Box 9600, 2333 ZA Leiden, The Netherlands
| | - Jutte J C de Vries
- Department of Medical Microbiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Marianne A A Erkens
- Department of Medical Microbiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Kitty Suijk
- Department of Infectious Diseases, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Mariëlle van Aalst
- Centre of Tropical Medicine and Travel Medicine, Amsterdam University Medical Centres, AMC, University of Amsterdam, 1100 DD Amsterdam, The Netherlands
| | - Jaap J Maas
- Occupational Health and Safety Service, Amsterdam University Medical Centres, AMC, University of Amsterdam, 1100 DD Amsterdam, The Netherlands
| | - Martin P Grobusch
- Centre of Tropical Medicine and Travel Medicine, Amsterdam University Medical Centres, AMC, University of Amsterdam, 1100 DD Amsterdam, The Netherlands
| | - Perry J J van Genderen
- Institute for Tropical Diseases, Erasmus University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands
| | - Claudia de Dood
- Department of Cell and Chemical Biology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Paul L A M Corstjens
- Department of Cell and Chemical Biology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Govert J van Dam
- Department of Parasitology, Leiden University Medical Centre, L4-Q, PO Box 9600, 2333 ZA Leiden, The Netherlands
| | - Lisette van Lieshout
- Department of Parasitology, Leiden University Medical Centre, L4-Q, PO Box 9600, 2333 ZA Leiden, The Netherlands.,Department of Medical Microbiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Meta Roestenberg
- Department of Parasitology, Leiden University Medical Centre, L4-Q, PO Box 9600, 2333 ZA Leiden, The Netherlands.,Department of Infectious Diseases, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
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Norman FF, Chamorro S, Comeche B, Pérez-Molina JA, López-Vélez R. Update on the major imported helminth infections in travelers and migrants. Future Microbiol 2020; 15:437-444. [PMID: 32250168 DOI: 10.2217/fmb-2019-0273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Helminth infections cause considerable morbidity worldwide and may be frequently underdiagnosed especially in areas of lower endemicity. Patients may harbor latent infections that may become symptomatic years or decades after the initial exposure and timely diagnosis may be critical to prevent complications and improve outcomes. In this context, disease in special populations, such as immunosuppressed patients, may be of particular concern. Heightened awareness and recent diagnostic developments may contribute to the correct management of helminth infections in nonendemic regions. A review of the main helminth infections in travelers and migrants (strongyloidiasis, taeniasis-neurocysticercosis and schistosomiasis) is presented, focusing on epidemiology, developments in diagnosis, treatment and prevention.
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Affiliation(s)
- F F Norman
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Ctra Colmenar, Km 9100, 28034 Madrid, Spain
| | - S Chamorro
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Ctra Colmenar, Km 9100, 28034 Madrid, Spain
| | - B Comeche
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Ctra Colmenar, Km 9100, 28034 Madrid, Spain
| | - J A Pérez-Molina
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Ctra Colmenar, Km 9100, 28034 Madrid, Spain
| | - R López-Vélez
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Ctra Colmenar, Km 9100, 28034 Madrid, Spain
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Epidemiology of schistosomiasis in China (2004-2016). Travel Med Infect Dis 2020; 36:101598. [PMID: 32084591 DOI: 10.1016/j.tmaid.2020.101598] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 11/11/2019] [Accepted: 02/17/2020] [Indexed: 11/20/2022]
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Zhang LJ, Mwanakasale V, Xu J, Sun LP, Yin XM, Zhang JF, Hu MC, Si WM, Zhou XN. Diagnostic performance of two specific schistosoma japonicum immunological tests for screening schistosoma haematobium in school children in Zambia. Acta Trop 2020; 202:105285. [PMID: 31786108 DOI: 10.1016/j.actatropica.2019.105285] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 11/22/2019] [Accepted: 11/27/2019] [Indexed: 12/27/2022]
Abstract
Dipstick Dye Immunoassay (DDIA) and Indirect Haemagglutination Assay (IHA), are two commercially available kits which have been widely used for screening Schistosoma japonicum in P.R. China. Whether they can be used for screening of Schistosoma haematobium are not clear. In order to evaluate the diagnostic efficiency of DDIA and IHA for screening Schistosoma haematobium, serum samples were collected from pupils in endemic areas in Zambia, Southern Africa, and tested by DDIA and IHA by single-blind manner. Meanwhile, the pupils were microscopically examined by infection with Schistosoma and soil-transmitted helminths, visually observed for parasite eggs. Of the enrolled 148 pupils, 61% tested positive for S. haematobium infection, while 31% and 36% of pupils were infected with hookworm and Ascaris respectively. Regarding the parasitological tests as reference standard, for the diagnosis of S. haematobium infection, IHA performed higher sensitivity (74%, 95% CI: 65%-83%) than that of DDIA (60%, 95%CI: 49%-70%). The sensitivities of IHA and DDIA are significant higher in 10-14 years old students than those of 7-9 years old group. The specificity of DDIA and IHA were 61% (95%CI: 49%-74%) and 72% (95%CI: 60%-84%), respectively. The co-infection with STHs decreased the specificity of DDIA but had no impact on that of IHA. Our study indicated that IHA has more potential as an alternative diagnostic tool for identifying schistosomiasis haematobium but need further improvement.
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Affiliation(s)
- Li-Juan Zhang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, PR China; WHO Collaborating Center for Tropical Diseases, Shanghai, PR China; National Center for International Research on Tropical Diseases, Shanghai, PR China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, PR China
| | | | - Jing Xu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, PR China; WHO Collaborating Center for Tropical Diseases, Shanghai, PR China; National Center for International Research on Tropical Diseases, Shanghai, PR China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, PR China.
| | - Le-Ping Sun
- Institute for Schistosomiasis Control, Wuxi, Jiangsu, PR China
| | - Xiao-Mei Yin
- Institute for Schistosomiasis Control, Hefei, Anhui, PR China
| | - Jian-Feng Zhang
- Institute for Schistosomiasis Control, Wuxi, Jiangsu, PR China
| | - Ming-Chuang Hu
- Institute for Schistosomiasis Control, Hefei, Anhui, PR China
| | - Wu-Min Si
- Institute for Schistosomiasis Control, Hefei, Anhui, PR China
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, PR China; WHO Collaborating Center for Tropical Diseases, Shanghai, PR China; National Center for International Research on Tropical Diseases, Shanghai, PR China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, PR China.
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Reamtong O, Simanon N, Thiangtrongjit T, Limpanont Y, Chusongsang P, Chusongsang Y, Anuntakarun S, Payungporn S, Phuphisut O, Adisakwattana P. Proteomic analysis of adult Schistosoma mekongi somatic and excretory-secretory proteins. Acta Trop 2020; 202:105247. [PMID: 31672487 DOI: 10.1016/j.actatropica.2019.105247] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 07/30/2019] [Accepted: 10/25/2019] [Indexed: 12/19/2022]
Abstract
Schistosoma mekongi is a causative agent of human schistosomiasis. There is limited knowledge of the molecular biology of S. mekongi and very few studies have examined drug targets, vaccine candidates and diagnostic biomarkers for S. mekongi. To explore the biology of S. mekongi, computational as well as experimental approaches were performed on S. mekongi males and females to identify excretory-secretory (ES) proteins and proteins that are differentially expressed between genders. According to bioinformatic prediction, the S. mekongi ES product was approximately 4.7% of total annotated transcriptome sequences. The classical secretory pathway was the main process to secrete proteins. Mass spectrometry-based quantification of male and female adult S. mekongi proteins was performed. We identified 174 and 156 differential expression of proteins in male and female worms, respectively. The dominant male-biased proteins were involved in actin filament-based processes, microtubule-based processes, biosynthetic processes and homeostatic processes. The major female-biased proteins were related to biosynthetic processes, organelle organization and signal transduction. An experimental approach identified 88 proteins in the S. mekongi secretome. The S. mekongi ES proteins mainly contributed to nutrient uptake, essential substance supply and host immune evasion. This research identifies proteins in the S. mekongi secretome and provides information on ES proteins that are differentially expressed between S. mekongi genders. These findings will contribute to S. mekongi drug and vaccine development. In addition, the study enhances our understanding of basic S. mekongi biology.
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Paran Y, Ben-Ami R, Orlev B, Halutz O, Elalouf O, Wasserman A, Zimmerman O, Nahmani I, Rabinowich L, Finn T. Chronic schistosomiasis in African immigrants in Israel: Lessons for the non-endemic setting. Medicine (Baltimore) 2019; 98:e18481. [PMID: 31876734 PMCID: PMC6946286 DOI: 10.1097/md.0000000000018481] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
To study the clinical presentation of Chronic Schistosomiasis (CS) in immigrants from East Africa to Israel and the tests that were useful in confirming the diagnosis.A retrospective study of all medical notes pertaining to hospitalized patients who were immigrants from East Africa with a pathological or microscopic confirmation of CS. Literature review was also conducted focusing on diagnosis of schistosomiasis among immigrants from endemic countries.We identified 32 suspected and 11 confirmed cases of CS. Most of the patients (82%) presented with gastrointestinal symptoms. Sensitivity of stool smear, serology and tissue diagnosis (by histopathology or microscopy) were 14%, 100%, 89%, respectively. Patients have undergone extensive diagnostic evaluation with long hospitalization stays (median 10 days, range 4 to 33 days).CS has multiple presentations and is seen in Israel among refugees from Eritrea and Sudan. Most of the manifestations are gastrointestinal, suggestive of infection with Schistosoma mansoni (S. mansoni). Standard diagnostic techniques used in endemic countries, such as microscopy for ova and parasites were unhelpful, necessitating more advanced procedures like colonoscopic or liver biopsy. We propose a diagnostic algorithm for CS in this patient population in order to make an accurate diagnosis and avoid unnecessary invasive procedures.
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Affiliation(s)
- Yael Paran
- Infectious Diseases Unit
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv
| | - Ronen Ben-Ami
- Infectious Diseases Unit
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv
| | | | | | | | - Asaf Wasserman
- Infectious Diseases Unit
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv
| | - Ofer Zimmerman
- Infectious Diseases Unit
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv
| | - Ido Nahmani
- Department of Surgery
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv
| | | | - Talya Finn
- Sanz Medical Centre, Laniado Hospital, Netanya
- Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel
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Affiliation(s)
- Felicia A Scaggs Huang
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
| | - Elizabeth Schlaudecker
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Pretravel Considerations for Non-vaccine-Preventable Travel Infections. TRAVEL MEDICINE 2019. [PMCID: PMC7152013 DOI: 10.1016/b978-0-323-54696-6.00007-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Pretravel advice should be tailored to the individual following a thorough review of his or her itinerary, planned activities, and host characteristics. In addition to vaccinations and malaria chemoprophylaxis, a pretravel consultation should include advice on regionally endemic or emerging non–vaccine-preventable infections that can cause severe illness or chronic morbidity. These include mosquito-borne infections such as dengue, chikungunya, and Zika, and regionally endemic severe respiratory infections such as Middle East respiratory syndrome (MERS) and some strains of avian influenza. Zika virus is notable given its capacity for sexual transmission and association with congenital birth defects. Preventive advice for other potentially relevant infections associated with specific exposures or activities (e.g., schistosomiasis and leptospirosis from freshwater exposure) should be provided where relevant. Understanding the epidemiology and prevention of these infections is crucial to providing a comprehensive pretravel consultation.
Pretravel advice should be tailored to the individual following a thorough review of his or her itinerary, planned activities, and host characteristics. The pretravel consultation should include preventive advice for regionally endemic non–vaccine-preventable infections that can cause severe illness or chronic morbidity. Special consideration should be given to common or emerging arboviral infections (including dengue, chikungunya, and Zika) and regionally endemic severe respiratory infections such as Middle East respiratory syndrome (MERS) and certain strains of avian influenza. Preventive advice for other infections associated with specific exposures or activities should be provided where relevant. Understanding the epidemiology and prevention of these infections is crucial to providing a comprehensive pretravel consultation.
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Al-Abdulwahhab AH, Al-Sharydah AM, Al-Suhibani SS, Al-Jubran SA, Al-Haidey AK, Al-Hifzi AI, Al-Issawi W. Neuroschistosomiasis mimicking lower back pain: case report of a rare differential diagnosis in a pediatric patient. Patient Saf Surg 2018; 12:28. [PMID: 30323860 PMCID: PMC6173919 DOI: 10.1186/s13037-018-0175-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 09/30/2018] [Indexed: 11/10/2022] Open
Abstract
Background Spinal myelitis is an infrequent manifestation of spinal cord infection. It is caused by the Schistosoma species, which are endemic in South America, part of the Middle East, and Africa. Case presentation We report the case of a 13-year-old male adolescent complaining of progressive lower back pain and weakness of the lower extremities for 3 days. Initial magnetic resonance imaging revealed typical transverse myelitis. Subsequently, parasite serology showed a markedly elevated level of Schistosoma antibody titers, and cerebrospinal fluid analysis yielded normal results. Because of our presumptive diagnosis of neuroschistosomiasis, the patient was prescribed an empirical regimen of an anti-parasitic agent, after which his neurological deficit promptly subsided. The patient was followed for 1 year and showed a complete long-term resolution of symptoms. Conclusions This case highlights the increasing prevalence of neuroschistosomiasis in recent years, particularly in patients with a history of travel to endemic regions. Moreover, the study reports the clinicoradiological features of this enigmatic disorder. This rare occurrence potentiates further studies to address unanswered questions about neuroschistosomiasis.
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Affiliation(s)
- Abdulrahman Hamad Al-Abdulwahhab
- Radiology Department, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, P.O. box: 4398, Khobar City, Eastern Province 31952 Saudi Arabia
| | - Abdulaziz Mohammad Al-Sharydah
- Radiology Department, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, P.O. box: 4398, Khobar City, Eastern Province 31952 Saudi Arabia
| | - Sari Saleh Al-Suhibani
- Radiology Department, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, P.O. box: 4398, Khobar City, Eastern Province 31952 Saudi Arabia
| | - Saeed Ahmad Al-Jubran
- Radiology Department, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, P.O. box: 4398, Khobar City, Eastern Province 31952 Saudi Arabia
| | - Ali Khalaf Al-Haidey
- 2Radiology Department, Prince Sultan Military Medical City, Riyadh, Al-Riyadh Province Saudi Arabia
| | | | - Wissam Al-Issawi
- Neurosurgery Department, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Khobar City, Eastern Province 31952 Saudi Arabia
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Phuphisut O, Ajawatanawong P, Limpanont Y, Reamtong O, Nuamtanong S, Ampawong S, Chaimon S, Dekumyoy P, Watthanakulpanich D, Swierczewski BE, Adisakwattana P. Transcriptomic analysis of male and female Schistosoma mekongi adult worms. Parasit Vectors 2018; 11:504. [PMID: 30201055 PMCID: PMC6131826 DOI: 10.1186/s13071-018-3086-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 08/29/2018] [Indexed: 12/23/2022] Open
Abstract
Background Schistosoma mekongi is one of five major causative agents of human schistosomiasis and is endemic to communities along the Mekong River in southern Lao People’s Democratic Republic (Laos) and northern Cambodia. Sporadic cases of schistosomiasis have been reported in travelers and immigrants who have visited endemic areas. Schistosoma mekongi biology and molecular biology is poorly understood, and few S. mekongi gene and transcript sequences are available in public databases. Results Transcriptome sequencing (RNA-Seq) of male and female S. mekongi adult worms (a total of three biological replicates for each sex) were analyzed and the results demonstrated that approximately 304.9 and 363.3 million high-quality clean reads with quality Q30 (> 90%) were obtained from male and female adult worms, respectively. A total of 119,604 contigs were assembled with an average length of 1273 nt and an N50 of 2017 nt. From the contigs, 20,798 annotated protein sequences and 48,256 annotated transcript sequences were obtained using BLASTP and BLASTX searches against the UniProt Trematoda database. A total of 4658 and 3509 transcripts were predominantly expressed in male and female worms, respectively. Male-biased transcripts were mostly involved in structural organization while female-biased transcripts were typically involved in cell differentiation and egg production. Interestingly, pathway enrichment analysis suggested that genes involved in the phosphatidylinositol signaling pathway may play important roles in the cellular processes and reproductive systems of S. mekongi worms. Conclusions We present comparative transcriptomic analyses of male and female S. mekongi adult worms, which provide a global view of the S. mekongi transcriptome as well as insights into differentially-expressed genes associated with each sex. This work provides valuable information and sequence resources for future studies of gene function and for ongoing whole genome sequencing efforts in S. mekongi. Electronic supplementary material The online version of this article (10.1186/s13071-018-3086-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Orawan Phuphisut
- Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Pravech Ajawatanawong
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Yanin Limpanont
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Onrapak Reamtong
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Supaporn Nuamtanong
- Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Sumate Ampawong
- Department of Tropical Pathology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Salisa Chaimon
- Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Paron Dekumyoy
- Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Dorn Watthanakulpanich
- Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Brett E Swierczewski
- Department of Enteric Diseases, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Poom Adisakwattana
- Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
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Drayer SM, Shank JJ. Infectious diseases mimicking ovarian carcinomatosis. Gynecol Oncol Rep 2018; 26:29-31. [PMID: 30211290 PMCID: PMC6129668 DOI: 10.1016/j.gore.2018.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 08/14/2018] [Accepted: 08/27/2018] [Indexed: 11/24/2022] Open
Abstract
Infectious diseases can present similar to ovarian cancer and occur concomitantly with ovarian pathology. With increased worldwide travel and migration of populations, infections endemic to developing countries can emerge in the United States. We present 2 cases of infectious diseases mimicking ovarian carcinomatosis. Two Filipino women presented with abdominal distension and had evaluations suggestive of advanced gynecologic malignancy. The first patient underwent surgery and was found to have peritoneal tuberculosis. Intra-operative pathology from the second case revealed ovarian carcinoma with schistosomal granulomas of the intestines. Tuberculosis and schistosomiasis should be considered when treating women with gynecologic malignancies, especially those from abroad or who have spent time overseas. Correct identification of infectious etiologies allows for pharmacological intervention and can minimize unnecessary surgical procedures.
Sporadic cases of tuberculosis and schistosomiasis have appeared in non-endemic regions due to global migration. Infectious diseases, such as pelvic tuberculosis, can have imaging findings suggestive of gynecologic malignancy. Recognition of infectious diseases allows for pharmacologic intervention and can minimize unnecessary surgical procedures.
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Affiliation(s)
- Sara M Drayer
- Department of Obstetrics and Gynecology, Naval Medical Center San Diego, San Diego, CA, United States
| | - Jessica J Shank
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Naval Medical Center San Diego, San Diego, CA, United States
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Abstract
Schistosomiasis (bilharzia) is a neglected tropical disease caused by parasitic flatworms (blood flukes) of the genus Schistosoma, with considerable morbidity in parts of the Middle East, South America, Southeast Asia and, particularly, in sub-Saharan Africa. Infective larvae grow in an intermediate host (fresh-water snails) before penetrating the skin of the definitive human host. Mature adult worms reside in the mesenteric (Schistosoma mansoni and Schistosoma japonicum) or pelvic (Schistosoma haematobium) veins, where female worms lay eggs, which are secreted in stool or urine. Eggs trapped in the surrounding tissues and organs, such as the liver and bladder, cause inflammatory immune responses (including granulomas) that result in intestinal, hepato-splenic or urogenital disease. Diagnosis requires the detection of eggs in excreta or worm antigens in the serum, and sensitive, rapid, point-of-care tests for populations living in endemic areas are needed. The anti-schistosomal drug praziquantel is safe and efficacious against adult worms of all the six Schistosoma spp. infecting humans; however, it does not prevent reinfection and the emergence of drug resistance is a concern. Schistosomiasis elimination will require a multifaceted approach, including: treatment; snail control; information, education and communication; improved water, sanitation and hygiene; accurate diagnostics; and surveillance-response systems that are readily tailored to social-ecological settings.
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Affiliation(s)
- Donald P McManus
- Immunology Department, QIMR Berghofer Medical Research Institute, Herston, Brisbane, Queensland, Australia.
| | - David W Dunne
- Department of Pathology, University of Cambridge, Cambridge, UK
| | - Moussa Sacko
- Department of Diagnostic and Biomedical Research, Institut National de Recherche en Santé Publique, Bamako, Mali
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Birgitte J Vennervald
- Department of Veterinary and Animal Science, University of Copenhagen, Copenhagen, Denmark
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Shanghai, People's Republic of China
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35
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van Grootveld R, van Dam GJ, de Dood C, de Vries JJC, Visser LG, Corstjens PLAM, van Lieshout L. Improved diagnosis of active Schistosoma infection in travellers and migrants using the ultra-sensitive in-house lateral flow test for detection of circulating anodic antigen (CAA) in serum. Eur J Clin Microbiol Infect Dis 2018; 37:1709-1716. [PMID: 29974279 PMCID: PMC6133035 DOI: 10.1007/s10096-018-3303-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 06/11/2018] [Indexed: 01/10/2023]
Abstract
Schistosomiasis is a parasitic disease affecting over 250 million people in the tropics. In non-endemic regions, imported Schistosoma infections are commonly diagnosed by serology, but based on antibody detection an active infection cannot be distinguished from a cured infection and it may take more than 8 weeks after exposure before seroconversion occurs. In endemic populations, excellent results have been described in diagnosing low-grade active Schistosoma infections by the detection of the adult worm-derived circulating anodic antigen (CAA) utilising robust lateral flow (LF) assays combined with up-converting phosphor (UCP) reporter technology. The purpose of this study is to explore the diagnostic value of the UCP-LF CAA assay in a non-endemic setting. CAA concentrations were determined in 111 serum samples originating from 81 serology-positive individuals. In nine individuals, serum could be collected before travel and an additional five provided samples before and after seroconversion occurred. Based on detectable CAA levels, an active infection was seen in 56/81 (69%) of the exposed individuals, while the 10 controls and the 9 sera collected before travel were tested negative for CAA. Positive CAA levels were observed starting 4 weeks after exposure and in four cases CAA was detected even before Schistosoma-specific antibodies became positive. Higher serum CAA levels were seen in migrants than in travellers and CAA concentrations dropped sharply when testing follow-up samples after treatment. This explorative study indicates the UCP-LF CAA serum assay to be a highly accurate test for detecting active low-grade Schistosoma infections in a non-endemic routine diagnostic setting.
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Affiliation(s)
- Rebecca van Grootveld
- Department of Parasitology, Leiden University Medical Center, L4-Q, PO Box 9600, 2300 RC, Leiden, The Netherlands.,Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Govert J van Dam
- Department of Parasitology, Leiden University Medical Center, L4-Q, PO Box 9600, 2300 RC, Leiden, The Netherlands
| | - Claudia de Dood
- Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jutte J C de Vries
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Leo G Visser
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Paul L A M Corstjens
- Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, The Netherlands
| | - Lisette van Lieshout
- Department of Parasitology, Leiden University Medical Center, L4-Q, PO Box 9600, 2300 RC, Leiden, The Netherlands. .,Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands.
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36
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Abstract
PURPOSE OF REVIEW International travel, adventure travel, and eco-tourism are increasing over the past few decades. This review aims to summarize the spectrum of infections associated with recreational freshwater activities and international travel. RECENT FINDINGS Recreational water activities can be associated with a wide range of infections. Acute febrile illnesses due to leptospirosis and schistosomiasis are not uncommon in travelers following extensive freshwater exposure. Aeromonas and other water-associated pathogens are important to consider in a traveler presenting with a skin and soft tissue infection. Recreational water activities are often associated with diarrheal illnesses, especially in children, and the range of enteric pathogens includes bacterial pathogens such as Escherichia coli O157:H7 and Shigella species and the protozoan parasites Cryptosporidium and Giardia duodenalis. Infections due to free-living amebas though rare can lead to fulminant central nervous system infections. A diverse range of infections may be associated with freshwater exposure, and it is important that these entities are considered in a returning traveler presenting with an acute illness.
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37
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Heggie TW. Lake tourism fatalities: a 46-year history of death at Lake Powell. J Travel Med 2018; 25:5025907. [PMID: 29860445 DOI: 10.1093/jtm/tay037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 05/08/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND This study investigates tourist mortality at Lake Powell over a 46-year period. To date no comprehensive long-term investigation examining the relationship between the lake environment and tourist mortality exists. METHODS A retrospective study was conducted of all tourist fatalities between 1959 and 2005. RESULTS There were 351 fatal incidents resulting in 386 deaths between 1959 and 2005. Over the 46-year period, the average number of fatalities was 8.4 (±5.26) per year. Out of all fatalities, 282 were classified as accidental, 80 were classified as natural deaths, 13 were suicides and 5 were classified as homicides. Males accounted for 80% of fatalities and tourists aged 20-29 years and 10-19 years accounted for 36% of all fatalities. The highest number of fatalities was recorded in July (74), May (64), August (63) and June (59). Out of all accidental deaths, boating (29%) and swimming (22%) were the most common pre-death activities. High winds capsizing boats and carbon monoxide poisoning from boat engines were common factors contributing to 31 boating fatalities. Fatigue and exhaustion contributed to 22 swimming deaths. CONCLUSIONS Recreational boating and swimming account for over half of all accidental deaths. Tourists visiting Lake Powell for recreational purposes should be informed of the risks associated with the lake environment.
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Affiliation(s)
- Travis W Heggie
- Bowling Green State University, School of Human Movement, Sport and Leisure Studies, Bowling Green, OH 43403, USA
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38
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Loridant S, Mouahid G, Cornu M, Allienne JF, Leroy J, Maurage CA, Fréalle E, Assaker R, Zairi F, Dutoit E, Moné H, Sendid B. Case Report: Hemianopia: From Suspected Glioblastoma to the Diagnosis of Ectopic Schistosomiasis Haematobium Infection in a Traveler Returning from the Republic of the Congo. Am J Trop Med Hyg 2018; 99:94-96. [PMID: 29714164 DOI: 10.4269/ajtmh.18-0028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Schistosomiasis due to Schistosoma haematobium is a widespread disease usually affecting the urinary tract associated with hematuria and kidney disorders. Neurological damage is rarely reported and symptoms are nonspecific and may suggest brain tumors such as glioma. We describe the first double ectopic haematobium schistosomiasis case involving the brain and intestine.
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Affiliation(s)
- Séverine Loridant
- Laboratoire de Parasitologie Mycologie, Institut de Microbiologie, Lille University hospital, Lille Inflammation Research International center- Unité Mixte de Recherche 995, Institut National de la Santé et de la Recherche Médicale/Université Lille, Lille, France
| | - Gabriel Mouahid
- Centre National de la Recherche Scientifique, Laboratoire Interactions Hôtes-Pathogènes-Environnement, University Perpignan Via Domitia, Institut Français de Recherche pour l'Exploitation de la Mer, University Montpellier, Perpignan, France
| | - Marjorie Cornu
- Laboratoire de Parasitologie Mycologie, Institut de Microbiologie, Lille University hospital, Lille Inflammation Research International center- Unité Mixte de Recherche 995, Institut National de la Santé et de la Recherche Médicale/Université Lille, Lille, France
| | - Jean-François Allienne
- Centre National de la Recherche Scientifique, Laboratoire Interactions Hôtes-Pathogènes-Environnement, University Perpignan Via Domitia, Institut Français de Recherche pour l'Exploitation de la Mer, University Montpellier, Perpignan, France
| | - Jordan Leroy
- Laboratoire de Parasitologie Mycologie, Institut de Microbiologie, Lille University hospital, Lille Inflammation Research International center- Unité Mixte de Recherche 995, Institut National de la Santé et de la Recherche Médicale/Université Lille, Lille, France
| | - Claude-Alain Maurage
- Laboratoire d'Anatomopathologie, Centre de Biologie Pathologie Génétique, Lille University hospital, Lille, France
| | - Emilie Fréalle
- Laboratoire de Parasitologie Mycologie, Institut de Microbiologie, Lille University hospital, Lille Inflammation Research International center- Unité Mixte de Recherche 995, Institut National de la Santé et de la Recherche Médicale/Université Lille, Lille, France
| | - Richard Assaker
- Service de Neurochirurgie, Lille University hospital, Hôpital Roger Salengro, Lille, France
| | - Fahed Zairi
- Service de Neurochirurgie, Lille University hospital, Hôpital Roger Salengro, Lille, France
| | - Emmanuel Dutoit
- Laboratoire de Parasitologie Mycologie, Institut de Microbiologie, Lille University hospital, Lille Inflammation Research International center- Unité Mixte de Recherche 995, Institut National de la Santé et de la Recherche Médicale/Université Lille, Lille, France
| | - Hélène Moné
- Centre National de la Recherche Scientifique, Laboratoire Interactions Hôtes-Pathogènes-Environnement, University Perpignan Via Domitia, Institut Français de Recherche pour l'Exploitation de la Mer, University Montpellier, Perpignan, France
| | - Boualem Sendid
- Laboratoire de Parasitologie Mycologie, Institut de Microbiologie, Lille University hospital, Lille Inflammation Research International center- Unité Mixte de Recherche 995, Institut National de la Santé et de la Recherche Médicale/Université Lille, Lille, France
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39
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Krog AD, Axelsson JM, Bondgaard ALR, Kurtzhals JA. Schistosomiasis Presenting as Recurring Sigmoid Volvulus in a Danish Man With an Inconspicuous Travel History-A Case Report. Open Forum Infect Dis 2018; 5:ofy057. [PMID: 29644249 PMCID: PMC5888620 DOI: 10.1093/ofid/ofy057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 03/16/2018] [Indexed: 11/14/2022] Open
Abstract
A healthy 72-year-old Danish male presenting with recurring sigmoid volvulus was found to be infested with Schistosoma mansoni. No other explanation for recurring volvulus was found. A travel history 12 years ago, which included bathing in the Botswana Okavango delta for 10 minutes, revealed the likely time and place of infection. To our knowledge, this is the first reported case of recurrent sigmoid volvulus and chronic intestinal schistosomiasis in a patient from a nonendemic area.
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Affiliation(s)
- Asger D Krog
- Department of Surgical Gastroenterology, Bispebjerg Hospital, Copenhagen, Denmark
| | - Johanna M Axelsson
- Department of Infectious Diseases, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | | | - Jørgen A Kurtzhals
- Centre for Medical Parasitology, Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
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40
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Shuja A, Guan J, Harris C, Alkhasawneh A, Malespin M, De Melo S. Intestinal Schistosomiasis: A Rare Cause of Abdominal Pain and Weight loss. Cureus 2018; 10:e2086. [PMID: 29560299 PMCID: PMC5856413 DOI: 10.7759/cureus.2086] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Abdominal pain is one of the most common reasons for outpatient visits. Although intestinal schistosomiasis is extremely rare in US, it should be considered in the differential diagnosis for those patients with risk factors such as international traveling history. This case report illustrates a unique case of intestinal schistosomiasis, which presented with an eight-week history of nonspecific abdominal pain and weight loss. Her colonoscopy revealed a 10 mm polyp in the colon. Endoscopic mucosal resection confirmed the diagnosis of schistosomiasis. Treatment with Praziquantel resulted in significant improvement of her symptoms.
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Affiliation(s)
- Asim Shuja
- Division of Gastroenterology, University of Florida College of Medicine-Jacksonville
| | - Jian Guan
- Internal Medicine, Florida Hospital-Orlando
| | - Ciel Harris
- Internal Medicine, University of Florida College of Medicine-Jacksonville
| | | | - Miguel Malespin
- Division of Gastroenterology, University of Florida College of Medicine-Jacksonville
| | - Silvio De Melo
- Division of Gastroenterology, University of Florida College of Medicine-Jacksonville
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41
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Imported Schistosomiasis in Children: Clinical, Diagnostic Aspects And Outcome in 5 Tertiary Hospitals in France. Pediatr Infect Dis J 2017; 36:e349-e351. [PMID: 28767615 DOI: 10.1097/inf.0000000000001679] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The objective of this retrospective study is to describe imported schistosomiasis in children in the Paris region between 2010 and 2015. Forty children with a diagnosis of schistosomiasis were included. Thirty-seven (93%) had a chronic urinary form with hematuria. The lost-to-follow up rate for the second consultation was 25%. The diagnosis and management of imported schistosomiasis must be improved-notably by raising awareness among clinicians and providing families with more information.
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42
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Infurnari L, Galli L, Bigoloni A, Carbone A, Chiappetta S, Sala A, Ceserani N, Lazzarin A, Castagna A, Gaiera/ G. The use of circulating cathodic antigen rapid test and serology for diagnosis of active Schistosoma mansoni infection in migrants in Italy, a non-endemic country: a cross sectional study. Mem Inst Oswaldo Cruz 2017; 112:452-455. [PMID: 28591406 PMCID: PMC5446235 DOI: 10.1590/0074-02760160355] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Accepted: 03/04/2017] [Indexed: 12/23/2022] Open
Abstract
Diagnosis of schistosomiasis in migrants coming from endemic areas can be difficult, especially in asymptomatic subjects. Light-intensity disease, in fact, may be missed due to the low sensitivity of the stool microscopy and serologic testing cannot distinguish between a resolved infection and an active infection in patients who have been infected and treated in the past, because specific antibodies can persist despite cure. We describe a cross-sectional study conducted on 82 migrants tested for Schistosoma mansoni on single blood (anti-schistosome antibodies, total IgE) and urine [point-of-care (POC) circulating-cathodic-antigen (CCA) test] samples. A positive POC-CCA test (active infection) resulted in two untreated patients with a positive serology while all patients (n = 66) with a past infection showed a negative POC-CCA test. POC-CCA urine test in combination with serology may be helpful in rapidly differentiate active from past S. mansoni infection in migrants coming from endemic areas.
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Affiliation(s)
- Laura Infurnari
- San Raffaele Scientific Institute, Laboratory of Microbiology and Virology, Milan, Italy
| | - Laura Galli
- San Raffaele Scientific Institute, Infectious Diseases Department, Milan, Italy
| | - Alba Bigoloni
- San Raffaele Scientific Institute, Infectious Diseases Department, Milan, Italy
| | - Alessia Carbone
- San Raffaele Scientific Institute, Infectious Diseases Department, Milan, Italy
| | - Stefania Chiappetta
- San Raffaele Scientific Institute, Infectious Diseases Department, Milan, Italy
| | - Angelo Sala
- Saint Michel Centre, Society of Priests of the Sacred Heart of Betharram, Health Pastoral Diocese of Bouar, Bouar, Central African Republic
| | - Norberto Ceserani
- San Raffaele Scientific Institute, Infectious Diseases Department, Milan, Italy
| | - Adriano Lazzarin
- San Raffaele Scientific Institute, Infectious Diseases Department, Milan, Italy.,Università Vita-Salute San Raffaele, Milan, Italy
| | - Antonella Castagna
- San Raffaele Scientific Institute, Infectious Diseases Department, Milan, Italy.,Università Vita-Salute San Raffaele, Milan, Italy
| | - Giovanni Gaiera/
- San Raffaele Scientific Institute, Infectious Diseases Department, Milan, Italy
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43
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Lingscheid T, Kurth F, Clerinx J, Marocco S, Trevino B, Schunk M, Muñoz J, Gjørup IE, Jelinek T, Develoux M, Fry G, Jänisch T, Schmid ML, Bouchaud O, Puente S, Zammarchi L, Mørch K, Björkman A, Siikamäki H, Neumayr A, Nielsen H, Hellgren U, Paul M, Calleri G, Kosina P, Myrvang B, Ramos JM, Just-Nübling G, Beltrame A, Saraiva da Cunha J, Kern P, Rochat L, Stich A, Pongratz P, Grobusch MP, Suttorp N, Witzenrath M, Hatz C, Zoller T, TropNet Schistosomiasis Investigator Group. Schistosomiasis in European Travelers and Migrants: Analysis of 14 Years TropNet Surveillance Data. Am J Trop Med Hyg 2017; 97:567-574. [PMID: 28722637 PMCID: PMC5544096 DOI: 10.4269/ajtmh.17-0034] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 03/30/2017] [Indexed: 02/05/2023] Open
Abstract
Schistosomiasis remains one of the most prevalent parasitic diseases worldwide and the infection is frequently found in travelers and migrants. The European Network for Tropical Medicine and Travel Health conducted a sentinel surveillance study on imported schistosomiasis between 1997 and 2010. This report summarizes epidemiological and clinical data from 1,465 cases of imported schistosomiasis. Direct pathogen detection and serology were the main diagnostic tools applied. Of these, 486 (33%) cases were identified among European travelers, 231 (16%) among long-term expatriates, and 748 (51%) among non-European immigrants. Overall, only 18.6% of travelers had received pretravel advice; 95% of infections were acquired in the African region. On species level, Schistosoma mansoni was identified in 570 (39%) and Schistosoma haematobium in 318 (22%) cases; 57.5% of patients were symptomatic. Acute symptoms were reported in 27% of patients leading to earlier presentation within 3 months. Praziquantel was used in all patients to treat schistosomiasis. Many infections were detected in asymptomatic patients. In 47.4% of asymptomatic patients infection was detected by microscopy and in 39% by serology or antigen testing. Schistosomiasis remains a frequent infection in travelers and migrants to Europe. Travelers should be made aware of the risk of schistosomiasis infection when traveling to sub-Saharan Africa. Posttravel consultations particularly for returning expatriates are useful given the high potential for detecting asymptomatic infections.
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Affiliation(s)
- Tilman Lingscheid
- Medizinische Klinik mit Schwerpunkt Infektiologie und Pneumologie, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Florian Kurth
- Medizinische Klinik mit Schwerpunkt Infektiologie und Pneumologie, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Jan Clerinx
- Institute of Tropical Medicine, Antwerp, Belgium
| | - Stefania Marocco
- Centro per le Malattie Tropicali, Ospedale S. Cuore, Negrar, Verona, Italy
| | - Begoña Trevino
- Tropical Medicine and International Health Unit, Hospital Vall d’Hebron Drassanes, PROSICS Barcelona, Barcelona, Spain
| | - Mirjam Schunk
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the Ludwig-Maximilians-University (LMU), Munich, Germany
| | - José Muñoz
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Ida E. Gjørup
- Infectious Diseases Unit, Herlev University Hospital, Copenhagen, Denmark
| | - Tomas Jelinek
- Berlin Centre for Travel and Tropical Medicine, Berlin, Germany
| | - Michel Develoux
- Service de Parasitologie, Hôpital Saint-Antoine, Paris, France
| | - Graham Fry
- Tropical Medical Bureau, Dublin, Ireland
| | - Thomas Jänisch
- Department of Infectious Diseases, University Hospital Heideberg, Heidelberg, Germany
| | - Matthias L. Schmid
- Department of Infection and Tropical Medicine, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
| | - Olivier Bouchaud
- Consultation de médecine tropicale, Hôpital Avicenne, Bobigny, France
| | | | - Lorenzo Zammarchi
- Infectious Diseases Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Kristine Mørch
- Department of Medicine, National Centre for Tropical Infectious Diseases, Haukeland University Hospital, Bergen, Norway
| | - Anders Björkman
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Heli Siikamäki
- Inflammation Centre, Clinic of Infectious Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Andreas Neumayr
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Henrik Nielsen
- Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
| | - Urban Hellgren
- Unit of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Malgorzata Paul
- Department and Clinic of Tropical and Parasitic Diseases, Karol Marcinkowski University of Medical Sciences, Poznan, Poland
| | - Guido Calleri
- Travel Medicine Unit, Department of Infectious Diseases, Amedeo di Savoia Hospital-ASLTO2, Turin, Italy
| | - Pavel Kosina
- Department of Infectious Diseases, University Hospital, Hradec Králové, Czech Republic
| | | | - José M. Ramos
- Infectious Diseases Unit, Hospital General Universitario de Elche, Alicante, Spain
| | - Gudrun Just-Nübling
- Department of Internal Medicine II, Section Infectious Diseases and Tropical Medicine, University Hospital Frankfurt, Main, Germany
| | - Anna Beltrame
- Centro per le Malattie Tropicali, Ospedale S. Cuore, Negrar, Verona, Italy
- Clinic of Infectious Diseases, University of Udine, Udine, Italy
| | | | - Peter Kern
- Department of Internal Medicine III, Comprehensive Infectious Diseases Center, Ulm University Hospital, Ulm, Germany
| | - Laurence Rochat
- Department of Ambulatory Care and Community Medicine, Travel Clinic, University Hospital, Lausanne, Switzerland
| | - August Stich
- Abteilung Tropenmedizin, Missionsärztliche Klinik, Würzburg, Germany
| | - Peter Pongratz
- Division of Tropical Medicine and Infectious Diseases, Rostock University Medical Center, Germany
| | - Martin P. Grobusch
- Center of Tropical Medicine and Travel Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Norbert Suttorp
- Medizinische Klinik mit Schwerpunkt Infektiologie und Pneumologie, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Martin Witzenrath
- Medizinische Klinik mit Schwerpunkt Infektiologie und Pneumologie, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Christoph Hatz
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Thomas Zoller
- Medizinische Klinik mit Schwerpunkt Infektiologie und Pneumologie, Charité Universitätsmedizin Berlin, Berlin, Germany
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - TropNet Schistosomiasis Investigator Group
- Medizinische Klinik mit Schwerpunkt Infektiologie und Pneumologie, Charité Universitätsmedizin Berlin, Berlin, Germany
- Institute of Tropical Medicine, Antwerp, Belgium
- Centro per le Malattie Tropicali, Ospedale S. Cuore, Negrar, Verona, Italy
- Tropical Medicine and International Health Unit, Hospital Vall d’Hebron Drassanes, PROSICS Barcelona, Barcelona, Spain
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the Ludwig-Maximilians-University (LMU), Munich, Germany
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- Infectious Diseases Unit, Herlev University Hospital, Copenhagen, Denmark
- Berlin Centre for Travel and Tropical Medicine, Berlin, Germany
- Service de Parasitologie, Hôpital Saint-Antoine, Paris, France
- Tropical Medical Bureau, Dublin, Ireland
- Department of Infectious Diseases, University Hospital Heideberg, Heidelberg, Germany
- Department of Infection and Tropical Medicine, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
- Consultation de médecine tropicale, Hôpital Avicenne, Bobigny, France
- Hospital Carlos III, Madrid, Spain
- Infectious Diseases Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Department of Medicine, National Centre for Tropical Infectious Diseases, Haukeland University Hospital, Bergen, Norway
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
- Inflammation Centre, Clinic of Infectious Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
- Unit of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
- Department and Clinic of Tropical and Parasitic Diseases, Karol Marcinkowski University of Medical Sciences, Poznan, Poland
- Travel Medicine Unit, Department of Infectious Diseases, Amedeo di Savoia Hospital-ASLTO2, Turin, Italy
- Department of Infectious Diseases, University Hospital, Hradec Králové, Czech Republic
- Oslo University Hospital, Ullevål, Norway
- Infectious Diseases Unit, Hospital General Universitario de Elche, Alicante, Spain
- Department of Internal Medicine II, Section Infectious Diseases and Tropical Medicine, University Hospital Frankfurt, Main, Germany
- Clinic of Infectious Diseases, University of Udine, Udine, Italy
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Department of Internal Medicine III, Comprehensive Infectious Diseases Center, Ulm University Hospital, Ulm, Germany
- Department of Ambulatory Care and Community Medicine, Travel Clinic, University Hospital, Lausanne, Switzerland
- Abteilung Tropenmedizin, Missionsärztliche Klinik, Würzburg, Germany
- Division of Tropical Medicine and Infectious Diseases, Rostock University Medical Center, Germany
- Center of Tropical Medicine and Travel Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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Duplessis CA, Gutierrez RL, Porter CK. Review: chronic and persistent diarrhea with a focus in the returning traveler. TROPICAL DISEASES TRAVEL MEDICINE AND VACCINES 2017; 3:9. [PMID: 28883979 PMCID: PMC5531020 DOI: 10.1186/s40794-017-0052-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Accepted: 04/18/2017] [Indexed: 02/08/2023]
Abstract
Background Travelers’ diarrhea is a common malady afflicting up to 50% of travelers after a 2-week travel period. An appreciable percentage of these cases will become persistent or chronic. We summarized the published literature reporting persistent/chronic diarrhea in travelers elucidating current understanding of disease incidence, etiology and regional variability. Methods We searched electronic databases (Medline, Embase, and Cochrane database of clinical trials) from 1990 to 2015 using the following terms: “chronic or persistent diarrh* and (returning) travel* or enteropathogen, GeoSentinel, and travel-associated infection. Included studies published in the English language on adult returning travelers (duration < 3-months) reporting denominator data. Point estimates and standard 95% confidence intervals were calculated for incidence using a random-effects model. Study incidence heterogeneity rates were assessed using x2 heterogeneity statistics, graphically represented with Forest plots. Results We identified 19 studies meeting the inclusion criteria (all published after 1999). 18 studies reported upon the incidence of persistent/chronic diarrhea as a syndromic diagnosis in returning travelers; one study reported adequate denominator data from which to assess pathogen specific etiology. Giardiasis comprise an appreicaible percentage of infectious mediated persistent/chronic diarrhea in returning travelers. The overall estimate of persistent/chronic diarrhea incidence was 6% (0.05–0.07) in 321,454, travelers; with significant heterogeniety observed across regions. The total number of regional travelers, and point estimates for incidence (95% CI) for Latin American, African, and Asian travelers were [15816 (0.09 [0.07–0.11]), 42290 (0.06 [0.05–0.07]), and 27433 (0.07 [0.06–0.09])] respectively. We identified lower published rates of chronic diarrhea from Sub-Saharan Africa relative to [North Africa, South Central Asia, and Central America]. Persistent/chronic diarrhea ranked fourth as a syndromic diagnosis in all regions. Conclusions Persistent/Chronic diarrhea is a leading syndromic diagnosis in returning travelers across all regions. The 6% incidence [proportionate morbidity (PM) of 60] observed in over >300,000 global travelers is comparable to prior estimates. We identified lower published rates of chronic diarrhea from Sub-Saharan Africa relative to [North Africa, South Central Asia, and Central America]. Giardiasis comprises an appreciabile percentatge of travel-associated infectious mediated persistent/chronic diarrhea. There’s a dearth of published data characterizing the incidence of specific enteropathogenic etiologies for persistent/chronic diarrhea in returning travelers.
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Affiliation(s)
- Christopher A Duplessis
- Enteric Disease Department, Infectious Disease Directorate, Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD 20910 USA
| | - Ramiro L Gutierrez
- Enteric Disease Department, Infectious Disease Directorate, Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD 20910 USA
| | - Chad K Porter
- Enteric Disease Department, Infectious Disease Directorate, Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD 20910 USA
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Note S, Vanbrabant P, Soentjens P. Perianal lesions after return from Togo: An isolated cutaneous manifestation of schistosomiasis. Acta Clin Belg 2016; 71:431-434. [PMID: 27075797 DOI: 10.1080/17843286.2016.1138591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Isolated perianal lesions in a returned traveller from Togo were observed. Eosinophilia was the lead to schistosomiasis, although no systemic symptoms were reported. This case report of cutaneous schistosomiasis demonstrates the importance of a travel history, especially geographic and exposure features, and treats the differential diagnosis of eosinophilia in a returned traveller with skin lesions.
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Soentjens P, Cnops L, Huyse T, Yansouni C, De Vos D, Bottieau E, Clerinx J, Van Esbroeck M. Diagnosis and Clinical Management of Schistosoma haematobium-Schistosoma bovis Hybrid Infection in a Cluster of Travelers Returning From Mali. Clin Infect Dis 2016; 63:1626-1629. [PMID: 27941144 DOI: 10.1093/cid/ciw493] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 07/13/2016] [Indexed: 11/12/2022] Open
Abstract
Ten Belgian travelers returned from Mali with a Schistosoma haematobium-Schistosoma bovis hybrid infection, confirmed by DNA sequencing from eggs. Clinical symptoms and laboratory findings resembled those of classic acute schistosomiasis, but the detected eggs were morphologically unusual.
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Affiliation(s)
- Patrick Soentjens
- Department of Clinical Sciences, Institute for Tropical Medicine, Antwerp.,Centre for Infectious Diseases, Polyclinic Department
| | - Lieselotte Cnops
- Department of Clinical Sciences, Institute for Tropical Medicine, Antwerp
| | - Tine Huyse
- Department of Biomedical Sciences, Institute for Tropical Medicine, Antwerp.,Laboratory of Biodiversity and Evolutionary Genomics, University of Leuven, Belgium
| | - Cedric Yansouni
- J.D. MacLean Centre for Tropical Diseases.,Divisions of Infectious Diseases and Medical Microbiology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Daniel De Vos
- Laboratory for Molecular and Cellular Technology, Queen Astrid, Military Hospital, Brussels
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute for Tropical Medicine, Antwerp
| | - Jan Clerinx
- Department of Clinical Sciences, Institute for Tropical Medicine, Antwerp
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Mu A, Fernandes I, Phillips D. A 57-Year-Old Woman With a Cecal Mass. Clin Infect Dis 2016; 63:703-5. [PMID: 27521443 DOI: 10.1093/cid/ciw413] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Anandit Mu
- Fresno Medical Education Program, University of California, San Francisco
| | - Ingrid Fernandes
- Fresno Medical Education Program, University of California, San Francisco
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Infectious Diseases in Refugee Children: To Screen or Not to Screen. CURRENT PEDIATRICS REPORTS 2016. [DOI: 10.1007/s40124-016-0103-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gautret P, Mockenhaupt FP, von Sonnenburg F, Rothe C, Libman M, Van De Winkel K, Bottieau E, Grobusch MP, Hamer DH, Esposito DH, Parola P, Schlagenhauf P. Schistosomiasis Screening of Travelers to Corsica, France. Emerg Infect Dis 2016; 22:160-1. [PMID: 26691533 PMCID: PMC4696722 DOI: 10.3201/eid2201.151606] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Xu J, Bergquist R, Qian YJ, Wang Q, Yu Q, Peeling R, Croft S, Guo JG, Zhou XN. China-Africa and China-Asia Collaboration on Schistosomiasis Control: A SWOT Analysis. ADVANCES IN PARASITOLOGY 2016; 92:435-66. [PMID: 27137455 DOI: 10.1016/bs.apar.2016.02.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Schistosomiasis, a disease caused by a trematode, parasitic worm, is a worldwide public health problem. In spite of great progress with regard to morbidity control, even elimination of this infection in recent decades, there are still challenges to overcome in sub-Saharan Africa and endemic areas in Southeast Asia. Regarded as one of the most successful countries with respect to schistosomiasis control, The People's Republic of China has accumulated considerable experience and learnt important lessons in various local settings that could benefit schistosomiasis control in other endemic countries. Based on an analysis of conceived strengths, weaknesses, opportunities and threats (SWOT) of potential collaborative activities with regard to schistosomiasis in Africa and Asia, this article addresses the importance of collaborative efforts and explores the priorities that would be expected to facilitate the transfer of Chinese experience to low- and middle-income countries in Africa and Asia.
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Affiliation(s)
- J Xu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, The People's Republic of China; Key Laboratory of Parasite & Vector Biology, Ministry of Public Health, Shanghai, The People's Republic of China; WHO Collaborating Center for Tropical Diseases, Shanghai, The People's Republic of China
| | - R Bergquist
- Geospatial Health, University of Naples Federico II, Naples, Italy
| | - Y-J Qian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, The People's Republic of China; Key Laboratory of Parasite & Vector Biology, Ministry of Public Health, Shanghai, The People's Republic of China; WHO Collaborating Center for Tropical Diseases, Shanghai, The People's Republic of China
| | - Q Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, The People's Republic of China; Key Laboratory of Parasite & Vector Biology, Ministry of Public Health, Shanghai, The People's Republic of China; WHO Collaborating Center for Tropical Diseases, Shanghai, The People's Republic of China
| | - Q Yu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, The People's Republic of China; Key Laboratory of Parasite & Vector Biology, Ministry of Public Health, Shanghai, The People's Republic of China; WHO Collaborating Center for Tropical Diseases, Shanghai, The People's Republic of China
| | - R Peeling
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - S Croft
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - J-G Guo
- World Health Organization, Geneva, Switzerland
| | - X-N Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, The People's Republic of China; Key Laboratory of Parasite & Vector Biology, Ministry of Public Health, Shanghai, The People's Republic of China; WHO Collaborating Center for Tropical Diseases, Shanghai, The People's Republic of China
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