Presentation and outcome of 1107 cases of schistosomiasis from Africa diagnosed in a non-endemic country.
Schistosomiasis is found in a significant proportion of returning travellers and immigrants to Britain. This study is a retrospective review of 1107 consecutive cases of schistosomiasis from Africa diagnosed by microscopy or serology presenting to the Hospital for Tropical Diseases, London, UK. 50.4% of cases were asymptomatic. The most common symptom which resolved on treatment was tiredness. Serology was positive in 951 (86%), and ova seen in 45%. Urine dipstick testing was positive for blood in 21% and protein in 15%, with eosinophilia in 44%. In this population urine dipstick, full blood count and serology were all insufficient screening tools used alone. Among patients with full follow-up data 3 months or more after treatment with praziquantel, definite treatment failure occured in 4 of 271 (1.5%), restricting the analysis to those with ova seen at diagnosis. There was no significant difference in treatment failure between 1 and 3 days of treatment. Antibody level was the same or higher than at treatment in 55% of cases seen after about 3 months and 38% after 1 year, confirming it is probably of limited clinical use in detecting treatment failure.
Whitty
C J
CJ
Hospital for Tropical Diseases, Mortimer Market, Off Tottenham Court Road, London WC1E 6AU, UK.
Mabey
D C
DC
Armstrong
M
M
Wright
S G
SG
Chiodini
P L
PL
D000328:Adult; D000349:Africa; D000368:Aged; D000369:Aged, 80 and over; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011934:Reagent Strips / Q000592:standards; D012189:Retrospective Studies; D012553:Schistosomiasis haematobia / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D012555:Schistosomiasis mansoni / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D012680:Sensitivity and Specificity; D014195:Travel; D017211:Treatment Failure
D011934:Reagent Strips