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

Mar 07, 2024

Experts: 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,

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.
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.
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.
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.

© 2024. The Author(s).

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ABOUT THE EXPERTS

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,

Sílvia Roure

International Health Program (PROSICS), Barcelona North Metropolitan Territorial Directorate for Infectious Diseases, Catalan Institute for Health, CAP La Salut, Passatge dels Encants S/N, 08916, Badalona, Spain. sroure@lluita.org.

Fundació Lluita contra les Infeccions, c/ Can Ruti s/n, 08916, Badalona, Spain. sroure@lluita.org.

Infectious Diseases Department, Hospital Universitari Germans Trias i Pujol, c/ Can Ruti s/n, 08916, Badalona, Spain. sroure@lluita.org.

Xavier Vallès

International Health Program (PROSICS), Barcelona North Metropolitan Territorial Directorate for Infectious Diseases, Catalan Institute for Health, CAP La Salut, Passatge dels Encants S/N, 08916, Badalona, Spain.

Fundació Lluita contra les Infeccions, c/ Can Ruti s/n, 08916, Badalona, Spain.

Germans Trias i Pujol Research Institute, c/ Can Ruti s/n, 08916, Badalona, Spain.

Olga Pérez-Quílez

International Health Program (PROSICS), Barcelona North Metropolitan Territorial Directorate for Infectious Diseases, Catalan Institute for Health, CAP La Salut, Passatge dels Encants S/N, 08916, Badalona, Spain.

Israel López-Muñoz

International Health Program (PROSICS), Barcelona North Metropolitan Territorial Directorate for Infectious Diseases, Catalan Institute for Health, CAP La Salut, Passatge dels Encants S/N, 08916, Badalona, Spain.

Anna Chamorro

Fundació Lluita contra les Infeccions, c/ Can Ruti s/n, 08916, Badalona, Spain.

Elena Abad

Fundació Lluita contra les Infeccions, c/ Can Ruti s/n, 08916, Badalona, Spain.

Lluís Valerio

International Health Program (PROSICS), Barcelona North Metropolitan Territorial Directorate for Infectious Diseases, Catalan Institute for Health, CAP La Salut, Passatge dels Encants S/N, 08916, Badalona, Spain.

Fundació Lluita contra les Infeccions, c/ Can Ruti s/n, 08916, Badalona, Spain.

Laura Soldevila

International Health Program (PROSICS), Barcelona North Metropolitan Territorial Directorate for Infectious Diseases, Catalan Institute for Health, CAP La Salut, Passatge dels Encants S/N, 08916, Badalona, Spain.

Fundació Lluita contra les Infeccions, c/ Can Ruti s/n, 08916, Badalona, Spain.

Infectious Diseases Department, Hospital Universitari Germans Trias i Pujol, c/ Can Ruti s/n, 08916, Badalona, Spain.

Sergio España

International Health Program (PROSICS), Barcelona North Metropolitan Territorial Directorate for Infectious Diseases, Catalan Institute for Health, CAP La Salut, Passatge dels Encants S/N, 08916, Badalona, Spain.

Fundació Lluita contra les Infeccions, c/ Can Ruti s/n, 08916, Badalona, Spain.

Infectious Diseases Department, Hospital Universitari Germans Trias i Pujol, c/ Can Ruti s/n, 08916, Badalona, Spain.

Alaa H A Hegazy

Microbiology Department, Germans Trias i Pujol University Hospital, c/ Can Ruti s/n, 08916, Badalona, Spain.

Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, c/ Can Ruti s/n, 08916, Badalona, Spain.

Faculty of Medicine, University of Asyut, El Fateh, Assiut Governorate, 71515, Egypt.

Gema Fernández-Rivas

Microbiology Department, Germans Trias i Pujol University Hospital, c/ Can Ruti s/n, 08916, Badalona, Spain.

Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, c/ Can Ruti s/n, 08916, Badalona, Spain.

Ester Gorriz

International Health Program (PROSICS), Barcelona North Metropolitan Territorial Directorate for Infectious Diseases, Catalan Institute for Health, CAP La Salut, Passatge dels Encants S/N, 08916, Badalona, Spain.

Dolores Herena

International Health Program (PROSICS), Barcelona North Metropolitan Territorial Directorate for Infectious Diseases, Catalan Institute for Health, CAP La Salut, Passatge dels Encants S/N, 08916, Badalona, Spain.

Mário Oliveira

Department of Urology, Germans Trias i Pujol University Hospital, c/ Can Ruti s/n, 08916, Badalona, Spain.

Maria Carme Miralles

Canovelles Primary Health Care Unit, Barcelona North Metropolitan Health Directorate, Catalan Institute for Health, C/ Indústria 23, 08420, Canovelles, Spain.

Carmen Conde

Canovelles Primary Health Care Unit, Barcelona North Metropolitan Health Directorate, Catalan Institute for Health, C/ Indústria 23, 08420, Canovelles, Spain.

Juan José Montero-Alia

Primary Health Care Unit Mataró-3 (Rocafonda-Palau), Barcelona North Metropolitan Health Directorate, Catalan Institute for Health, Camí Ral el Ravalet 208, Mataró, 08302, Barcelona, Spain.

Elia Fernández-Pedregal

International Health Program (PROSICS), Barcelona North Metropolitan Territorial Directorate for Infectious Diseases, Catalan Institute for Health, CAP La Salut, Passatge dels Encants S/N, 08916, Badalona, Spain.

Fundació Lluita contra les Infeccions, c/ Can Ruti s/n, 08916, Badalona, Spain.

Infectious Diseases Department, Hospital Universitari Germans Trias i Pujol, c/ Can Ruti s/n, 08916, Badalona, Spain.

Jose Miranda-Sánchez

Barcelona North Metropolitan Primary Care Directorate, Catalan Institute for Health, Ctra. de Barcelona 473, Sabadell, 08204, Barcelona, Spain.

Josep M Llibre

Fundació Lluita contra les Infeccions, c/ Can Ruti s/n, 08916, Badalona, Spain.

Infectious Diseases Department, Hospital Universitari Germans Trias i Pujol, c/ Can Ruti s/n, 08916, Badalona, Spain.

Mar Isnard

Barcelona North Metropolitan Primary Care Directorate, Catalan Institute for Health, Ctra. de Barcelona 473, Sabadell, 08204, Barcelona, Spain.

Josep Maria Bonet

Barcelona North Metropolitan Primary Care Directorate, Catalan Institute for Health, Ctra. de Barcelona 473, Sabadell, 08204, Barcelona, Spain.

Oriol Estrada

Directorate for Innovation and Interdisciplinary Cooperation, Barcelona North Metropolitan Health Directorate, Catalan Institute for Health, C/ Can Ruti S/N, 08916, Badalona, Spain.

Núria Prat

Barcelona North Metropolitan Primary Care Directorate, Catalan Institute for Health, Ctra. de Barcelona 473, Sabadell, 08204, Barcelona, Spain.

Bonaventura Clotet

Fundació Lluita contra les Infeccions, c/ Can Ruti s/n, 08916, Badalona, Spain.

IrsiCaixa-AIDS Research Institute, Hospital Universitari Germans Trias i Pujol University Hospital, c/ Can Ruti s/n, 08916, Badalona, Spain.

Infectious Diseases Directorate, Barcelona North Metropolitan Health Directorate, Catalan Institute for Health, C/ Can Ruti S/N, 08916, Badalona, Spain.