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.