Schistosomiasis in migrant children and adolescents in a paediatric tropical referral unit in Spain: diagnosis and long-term management challenges.

Autor: Rodríguez-Molino P; General Paediatrics, Infectious and Tropical Diseases Department, Hospital La Paz, Madrid, Spain.; La Paz Hospital Research Institute (IdiPAZ), Madrid, Spain.; Autonomous University of Madrid (UAM), Madrid, Spain.; Centro de Investigacion en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain., González Martínez S; Health Centre Alameda de Osuna, Madrid, Spain., Bustamante Amador J; La Paz Hospital Research Institute (IdiPAZ), Madrid, Spain.; Hospital Paediatrics Department, Childhood Infections, El Escorial Hospital, Madrid, Spain.; Health Centre Guzmán el Bueno, SERMAS, Madrid, Spain., Mellado-Sola I; General Paediatrics, Infectious and Tropical Diseases Department, Hospital La Paz, Madrid, Spain.; La Paz Hospital Research Institute (IdiPAZ), Madrid, Spain.; Autonomous University of Madrid (UAM), Madrid, Spain., Montes Martín L; Sanitas la Moraleja University Hospital, Madrid, Spain., Falces-Romero I; La Paz Hospital Research Institute (IdiPAZ), Madrid, Spain.; Centro de Investigacion en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain.; Department of Microbiology and Parasitology, La Paz University Hospital, Madrid, Spain., García López-Hortelano M; General Paediatrics, Infectious and Tropical Diseases Department, Hospital La Paz, Madrid, Spain.; La Paz Hospital Research Institute (IdiPAZ), Madrid, Spain.; Centro de Investigacion en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain.; Translational Research Network in Paediatric Infectious Diseases (RITIP), Madrid, Spain., Hurtado-Gallego J; La Paz Hospital Research Institute (IdiPAZ), Madrid, Spain.; Centro de Investigacion en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain., Mellado MJ; General Paediatrics, Infectious and Tropical Diseases Department, Hospital La Paz, Madrid, Spain.; La Paz Hospital Research Institute (IdiPAZ), Madrid, Spain.; Autonomous University of Madrid (UAM), Madrid, Spain.; Centro de Investigacion en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain.; Translational Research Network in Paediatric Infectious Diseases (RITIP), Madrid, Spain., Grasa C; General Paediatrics, Infectious and Tropical Diseases Department, Hospital La Paz, Madrid, Spain.; La Paz Hospital Research Institute (IdiPAZ), Madrid, Spain.; Autonomous University of Madrid (UAM), Madrid, Spain.; Centro de Investigacion en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain., Sainz T; General Paediatrics, Infectious and Tropical Diseases Department, Hospital La Paz, Madrid, Spain. talia.sainz@uam.es.; La Paz Hospital Research Institute (IdiPAZ), Madrid, Spain. talia.sainz@uam.es.; Autonomous University of Madrid (UAM), Madrid, Spain. talia.sainz@uam.es.; Centro de Investigacion en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain. talia.sainz@uam.es.; Translational Research Network in Paediatric Infectious Diseases (RITIP), Madrid, Spain. talia.sainz@uam.es.
Jazyk: angličtina
Zdroj: European journal of pediatrics [Eur J Pediatr] 2024 Oct; Vol. 183 (10), pp. 4457-4465. Date of Electronic Publication: 2024 Aug 15.
DOI: 10.1007/s00431-024-05623-2
Abstrakt: Globalisation and population movement have led to an increasing number of migrant children residing in areas non-endemic for schistosomiasis. However, diagnosing and managing schistosomiasis in children remain controversial. This study aims to investigate the prevalence of schistosomiasis in migrant children and to describe the diagnostic approach and management strategies, including long-term follow-up, to explore the potential role of serological tests in evaluating treatment response. We conducted a retrospective descriptive study spanning from January 2014-July 2021 at a referral unit for Paediatric Tropical Diseases in Madrid (Spain). The study included patients under 18 years diagnosed with schistosomiasis. Of 679 children screened for schistosomiasis, 73 (10.8%) tested positive. The median age was 16.3 years [IQR 9-17.6], 74% male. The majority originated from Sub-Saharan Africa (47%) and Asia (47%). Only 40% presented with symptoms, with gastrointestinal (18%) and cutaneous (17%) manifestations being the most common. Eosinophilia was observed in 43% (median [IQR]: 1103/mm3 [671-1536]), and ova were visualised in the urine of 2/50 (4.0%). Praziquantel treatment was administered to 92%, and 5 patients required retreatment. Follow-up data were available for 58 (80%) over a median period of 9 months [IQR 6-19.8], revealing a progressive decline in eosinophil count, IgE titres, and ELISA optical density.    Conclusion: In this series, the prevalence of schistosomiasis among migrant children was significant (10%), highlighting the importance of including serological tests in migrant health screening. The disease is largely asymptomatic, eosinophilia is often absent, and visualisation of ova in urine is exceedingly rare. Eosinophil count, IgE titres, and ELISA optical density could prove valuable as an initial approach for monitoring inflammation during follow-up assessments. What is Known: • The burden of disease related to schistosomiasis is significant, particulary in children, and it is advisable to screen this vulnerable population. What is New: • Eosinophilia may not be present in parasitic infections, so serological tests are crucial for screening migrant children. • Serological monitoring facilitates long-term management of migrant children with schistosomiasis.
(© 2024. The Author(s).)
Databáze: MEDLINE
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