Schistosoma haematobium urinary tract complications in African migrants attending primary care facilities in Paris, France: A retrospective cohort study (2004–2018) - 01/09/23
, Nicolas Vignier b, c, d, Gauthier Raynal e, Nicolas Boo f, Anne Collignon g, Christophe Hennequin hHighlights |
• | Ultra-sonography of the urinary tract was performed in 100 migrants with S. haematobium eggs detected in urine microscopy. Prevalence of UGS-related abnormalities was 33.7%, with major abnormalities in 6.3%. |
• | Contrary to endemic areas, no single factor was found to be associated with these complications. |
• | Ultrasonography is the gold standard for detection of UGS complications in primary care settings. |
• | Up until now, urine microscopy has remained the single means of detection of UGS complications outside endemic regions; that is why it should be used during the first step-diagnosis. |
Abstract |
Objectives |
Little is known about the burden of urogenital schistosomiasis (UGS) outside endemic areas. This study was aimed at describing urinary complications of UGS detected among African migrants in French primary care facilities.
Patients and methods |
A retrospective cohort study included patients with UGS diagnosed from 2004 to 2018 in 5 primary health centers in Paris. Cases were defined by the presence of typical Schistosoma haematobium eggs at urine microscopy. Demographic, clinical, biological and imaging data were collected. Ultrasonography (U-S) findings were classified in accordance with the WHO guidelines.
Results |
U-S was prescribed for all patients and performed in 100/118. Sex ratio (F/M) was 2/98, and mean age 24.4 years. Patients were from West Africa (73% from Mali) and consulted 8 months (median) after their arrival. Among the 95 patients with interpretable findings, 32 (33.7%) had abnormalities related to UGS, considered as major in 6 cases (6.3%), and mostly localized at the bladder (31/32) without detection of cancer. No sociodemographic, clinical, or biological factors were found to be associated with U-S abnormalities. All 100 patients were treated by praziquantel (PZQ). Among those with abnormalities, 20/32 received two to four doses at various time intervals. Post-cure imaging control performed in 19/32 showed persistent abnormalities in 6 patients, on average 5 months after the last PZQ uptake.
Conclusion |
Urinary tract abnormalities associated with UGS were common and predominated at the bladder. U-S should be prescribed to any patient with positive urine microscopy. Schedules for PZQ uptake and U-S monitoring for patients with complications remain to be determined.
Le texte complet de cet article est disponible en PDF.Keywords : France, Transient and Migrants, Ultrasonography, Urinary tract complications, Urogenital schistosomiasis
Plan
Vol 53 - N° 6
Article 104715- septembre 2023 Retour au numéro
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