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. 2025 Jan 14;10(1):22.
doi: 10.3390/tropicalmed10010022.

Description of the Serological Response After Treatment of Chronic Imported Schistosomiasis

Marta González-Sanz  1   2 , Irene Martín-Rubio  1 , Oihane Martín  3   4 , Alfonso Muriel  2   5   6 , Sagrario de la Fuente-Hernanz  4 , Clara Crespillo-Andújar  1   3 , Sandra Chamorro-Tojeiro  1   3 , Begoña Monge-Maíllo  1   3 , Francesca F Norman  1   2   3 , José A Pérez-Molina  1   3
Affiliations

Description of the Serological Response After Treatment of Chronic Imported Schistosomiasis

Marta González-Sanz et al. Trop Med Infect Dis. .

Abstract

Background: Chronic schistosomiasis can lead to significant morbidity. Serology is highly sensitive; however, its role in assessing treatment response is controversial. This study aimed to analyze serological values following treatment of chronic imported schistosomiasis.

Methods: A retrospective observational study was performed including patients treated for chronic imported schistosomiasis from 2018 to 2022 who had at least one serological result at baseline and during follow-up. Demographic, clinical, and laboratory data were evaluated. Generalized estimating equation (GEE) models and Kaplan-Meier curves were used to analyze the evolution of serological values.

Results: Of the 83 patients included, 72 (86.7%) were male, and the median age was 26 years (IQR 22-83). Most patients, 76 (91.6%), were migrants from sub-Saharan Africa. While 24 cases (28.9%) presented with urinary symptoms, the majority (59; 71.1%) were asymptomatic. Schistosoma haematobium eggs were observed in five cases (6.2%). Eosinophilia was present in 34 participants (40.9%). All patients had an initial positive Schistosoma ELISA serology, median ODI 2.3 (IQR 1.5-4.4); the indirect hemagglutination (IHA) test was positive/indeterminate in 34 cases (43.1%). Following treatment with praziquantel, serology values significantly decreased: -0.04 (IC95% -0.073, -0.0021) and -5.73 (IC95% -9.92, -1.53) units per month for ELISA and IHA, respectively. A quarter of patients (25%) had negative ELISA results 63 weeks after treatment. All symptomatic cases were clinically cured.

Conclusions: Serial serological determinations could be helpful for monitoring chronic schistosomiasis in non-endemic regions. The ideal timing for these follow-up tests is yet to be determined. Further research is needed to determine the factors that influence a negative result during follow-up.

Keywords: diagnosis; migrant health; neglected tropical diseases; schistosomiasis; serology; travelers.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Evolution of ELISA serological values following treatment (in days).
Figure 2
Figure 2
Kaplan–Meier survival curves showing the decrease in serological values following treatment of chronic imported schistosomiasis. (A) Time (in weeks) to 50% decrease in ELISA values. (B) Time (in weeks) to negative ELISA results. (C) Time (in weeks) to negative hemagglutination.
See this image and copyright information in PMC

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