Therapeutic response to an empirical praziquantel treatment in long-staying sub-Saharan African migrants with positive Schistosoma serology and chronic symptoms: A prospective cohort study in Spain

Abstract

Objectives: Sub-Saharan African migrants may be experiencing imported schistosomiasis, which can evolve into chronic schistosomiasis. Positive response to empiric treatment with praziquantel may indicate the presence of persistent infection.

Methods: We tested the response to praziquantel in a cohort of sub-Saharan African migrants with probable chronic schistosomiasis. The tests were administered at baseline and 6 and 12 months.

Results: Of the 187 eligible participants, 149 completed the follow-up. Of these, 119 (79.9%) were males and 65 (43.6%) were from Senegal. The median age was 43 years (interquartile ranges 35-51 years) and their duration of residence in Europe was 17 years (interquartile ranges 12-21 years). The most prevalent clinical symptom was chronic abdominal pain (N = 96, 64.4%), pelvic pain in males (N = 55, 46.6%), and dysmenorrhea (N = 21; 70.0%) in females. We observed a significant decrease (P <0.001) in the number of signs and symptoms at 12 months, and 70.3% showed a total resolution of the symptoms and significant decreases in transaminase levels, eosinophilia, and abnormal glomerular filtration rates. The rates of clearance in positive enzyme-linked immunosorbent assay and immunochromatography tests were 54.7% and 24.3%.

Conclusion: The positive response to praziquantel suggests that chronic schistosomiasis is a prevalent condition among long-staying African migrants. These results need to be confirmed in randomized clinical trials.

Keywords: Chronic schistosomiasis; Empiric treatment; Migrants; Praziquantel; Sub-Saharan Africa.