Infectious Diseases of Poverty (Mar 2024)

Male genitourinary schistosomiasis-related symptoms among long-term Western African migrants in Spain: a prospective population-based screening study

  • Sílvia Roure,
  • Xavier Vallès,
  • Olga Pérez-Quílez,
  • Israel López-Muñoz,
  • Anna Chamorro,
  • Elena Abad,
  • Lluís Valerio,
  • Laura Soldevila,
  • Sergio España,
  • Alaa H. A. Hegazy,
  • Gema Fernández-Rivas,
  • Ester Gorriz,
  • Dolores Herena,
  • Mário Oliveira,
  • Maria Carme Miralles,
  • Carmen Conde,
  • Juan José Montero-Alia,
  • Elia Fernández-Pedregal,
  • Jose Miranda-Sánchez,
  • Josep M. Llibre,
  • Mar Isnard,
  • Josep Maria Bonet,
  • Oriol Estrada,
  • Núria Prat,
  • Bonaventura Clotet,
  • The Schisto-Stop study group

DOI
https://doi.org/10.1186/s40249-024-01190-8
Journal volume & issue
Vol. 13, no. 1
pp. 1 – 10

Abstract

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Abstract Background Schistosomiasis is highly endemic in sub-Saharan Africa and frequently imported to Europe. Male urogenital manifestations are often neglected. We aimed to ascertain the prevalence of genitourinary clinical signs and symptoms among long-term African migrants in a non-endemic European country using a serology test. Methods We carried out a prospective, community-based cross-sectional study of adult male migrants from sub-Saharan Africa living in Spain. Schistosoma serology tests and microscopic urine examinations were carried out, and clinical data were obtained from an electronic medical record search and a structured questionnaire. Results We included 388 adult males, mean age 43.5 years [Standard Deviation (SD) = 12.0, range: 18–76]. The median time since migration to the European Union was 17 [Interquartile range (IQR): 11–21] years. The most frequent country of origin was Senegal (N = 179, 46.1%). Of the 338, 147 (37.6%) tested positive for Schistosoma. Parasite eggs were present in the urine of only 1.3%. Nine genitourinary clinical items were significantly associated with positive Schistosoma serology results: pelvic pain (45.2%; OR = 1.57, 95% CI: 1.0–2.4), pain on ejaculation (14.5%; OR = 1.85, 95% CI: 1.0–3.5), dyspareunia (12.4%; OR = 2.45, 95% CI: 1.2–5.2), erectile dysfunction (9.5%; OR = 3.10, 95% CI: 1.3–7.6), self-reported episodes of infertility (32.1%; OR = 1.69, 95% CI: 1.0–2.8), haematuria (55.2%; OR = 2.37, 95% CI: 1.5–3.6), dysuria (52.1%; OR = 2.01, 95% CI: 1.3–3.1), undiagnosed syndromic STIs (5.4%), and orchitis (20.7%; OR = 1.81, 95% CI: 1.0–3.1). Clinical signs tended to cluster. Conclusions Urogenital clinical signs and symptoms are prevalent among male African long-term migrants with a positive Schistosoma serology results. Genital involvement can be frequent even among those with long periods of non-residence in their sub-Saharan African countries of origin. Further research is needed to develop diagnostic tools and validate therapeutic approaches to chronic schistosomiasis. Graphical Abstract

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