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. 2021 Jun 24;15(6):e0009478.
doi: 10.1371/journal.pntd.0009478. eCollection 2021 Jun.

Schistosomal appendicitis: Case series and systematic literature review

Mateus Zacarias  1 , Damiano Pizzol  2 , Helder de Miranda  1 , Anna Claudia Colangelo  3 , Nicola Veronese  4 , Lee Smith  5
Affiliations

Schistosomal appendicitis: Case series and systematic literature review

Mateus Zacarias et al. PLoS Negl Trop Dis. .

Abstract

Background: Globally, schistosomiasis affects at least 240 million people each year with a high proportion of cases in sub-Saharan Africa. The infection presents a wide range of symptoms mainly at the gastrointestinal and urogenital level. Cases of schistosomiasis-related appendicitis are seldom reported. The aim of the present study is to identify the prevalence of schistosomiasis-related appendicitis in Beira, Mozambique and compare to global prevalence.

Methods: We retrospectively reviewed all cases of appendicitis recorded from January 2017 to March 2020 at a single pathology department located in Beira in order to assess the prevalence of schistosomiasis. Moreover, we performed a systematic review on the prevalence of schistosomiasis-related appendicitis in all countries.

Findings: A total of 145 appendicitis cases in Beira showed a 13.1% prevalence of schistosomal-related appendicitis. The mean age of patients was 29.1 years, and 14 (73.7%) were male. The systematic review identified 20 studies with 34,790 inpatients with schistosomiasis-related appendicitis with a global prevalence of 1.31% (95% confidence interval (CI): 0.72 to 2.06); a high heterogeneity (I2 = 96.0%) was observed. Studies carried out in Africa reported a significantly higher prevalence of schistosomiasis-related appendicitis (2.75%; 95% CI: 1.28 to 4.68) than those in Middle East (0.49%; 95% CI: 0.18 to 0.95) (p for interaction < 0.0001).

Conclusions: Schistosomiasis infection should be considered as possible cause of appendicitis not only in endemic areas but also in developed countries. Considering that prevention is the best way to control the infection, more efforts should be put in place in order to increase the prevention coverage and avoid the cascading implications for health. This is even more so important in this Coronavirus Disease 2019 (COVID-19) era where the majority of attention and funds are used to fight the pandemic.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flowchart.
Fig 2
Fig 2. Prevalence of schistosomiasis in appendicitis.
CI, confidence interval; ES, Effect Size.
See this image and copyright information in PMC

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References

    1. WHO Intestinal worms. https://www.who.int/intestinal_worms/epidemiology/en/ [cited March 2021].
    1. Colley DG, Bustinduy AL, Secor WE, King CH. Human schistosomiasis. Lancet. 2014;383:2253–64. doi: 10.1016/S0140-6736(13)61949-2 - DOI - PMC - PubMed
    1. Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al.. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2012;380:2163–96. doi: 10.1016/S0140-6736(12)61729-2 - DOI - PMC - PubMed
    1. King CH, Dickman K, Tisch DJ. Reassessment of the cost of chronic helmintic infection: a meta-analysis of disability-related outcomes in endemic schistosomiasis. Lancet. 2005;365:1561. doi: 10.1016/S0140-6736(05)66457-4 - DOI - PubMed
    1. Schistosomiasis: number of people treated worldwide in 2014. https://www.who.int/wer/2016/wer9105.pdf. Weekly epidemiological record, WHO, 2016. - PubMed

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