Diagnosis and treatment of two imported cases with schistosomiasis haematobia in Fujian Province / 中国血吸虫病防治杂志

Objective To analyze the diagnosis and treatment of two imported cases with schistosomiasis haematobia, so as to provide insights into improving the diagnosis and treatment and avoiding misdiagnosis and mistreatment of imported schistosomiasis haematobia. Methods The medical records and epidemiological data pertaining to the two cases were collected. The stool and urine samples were collected for identification of Schistosoma eggs using the Kato-Katz technique and direct smear method after centrifugal precipitation, and blood samples were collected for detection of anti-Schistosoma antibody. Following definitive diagnosis, the patients were given praziquantel therapy. Results The patient 1, a Malagasy, was infected in Madagascar and returned to China for delivery. The case presented intermittent painless terminal hematuria symptoms, and showed no remarkable improvements following multiple-round treatments in several hospitals. In January 2017, she was found to be positive for anti-Schistosoma antibody, negative for feces test, and positive for S. haematobium eggs in urine test, and miracidia were hatched from eggs. Then, the case was diagnosed as schistosomiasis haematobia. Patient 2 worked in Republic of Malawi for many years, and presented intermittent painless terminal hematuria since October 2018; however, no definite diagnosis or effective treatment was received after admission to multiple hospitals. In March 2019, pathological examinations showed a number of eggs in the interstitium of the bladder mass, accompanied by a large number of eosinophils, which was consistent with schistosomiasis cystitis. In April 2019, he was tested positive for serum anti-Schistosoma antibody, negative for the fecal test, and had S. haematobium eggs in urine samples, with miracidia hatched from eggs. Then, the case was diagnosed as schistosomiasis haematobia. Following treatment with praziquantel at a dose of 60 mg/kg, all symptoms disappeared. Conclusions Overseas imported schistosomiasis haematobia is likely to be misdiagnosed. The training pertaining to schistosomiasis control knowledge requires to be improved among clinical professionals, in order to avoid misdiagnosis and mistreatment.

Imported schistosomiasis haematobia in Suzhou City: a case report / 中国血吸虫病防治杂志

Objective To report the diagnosis and treatment of an imported case of schistosomiasis haematobia. Methods The patient’s medical records were collected, and the clinical features, laboratory diagnosis, epidemiological survey, diagnosis and treatment were analyzed. Results The patient had arrived to Sudan and Egypt for many times and had a history of contact with the infested water. After returning to China, the patient reported a gross hematuria with unknown causes. Cystoscopy showed neoplasms in the bladder, and pathologic examinations showed chronic granulomatous inflammation with infiltration of plenty of plasma cells, and parasite eggs. Serological test showed positive for the dipstick dye immunoassay, and the microscopic examination of urine sediment revealed Schistosoma haematobium eggs. Following praziquantel treatment for a month, S. haematobium eggs were still detected in the urine. The case was treated with praziquantel again and cured without adverse reactions. Conclusions Health education should be strengthened among China-aid-African workers to improve the awareness of self-protection. In addition, the diagnosis and treatment should be improved in medical professionals to achieve a timely definitive diagnosis.

Imported schistosomiasis haematobia in Suzhou City: a case report / 中国血吸虫病防治杂志

Objective To report the diagnosis and treatment of an imported case of schistosomiasis haematobia. Methods The patient’s medical records were collected, and the clinical features, laboratory diagnosis, epidemiological survey, diagnosis and treatment were analyzed. Results The patient had arrived to Sudan and Egypt for many times and had a history of contact with the infested water. After returning to China, the patient reported a gross hematuria with unknown causes. Cystoscopy showed neoplasms in the bladder, and pathologic examinations showed chronic granulomatous inflammation with infiltration of plenty of plasma cells, and parasite eggs. Serological test showed positive for the dipstick dye immunoassay, and the microscopic examination of urine sediment revealed Schistosoma haematobium eggs. Following praziquantel treatment for a month, S. haematobium eggs were still detected in the urine. The case was treated with praziquantel again and cured without adverse reactions. Conclusions Health education should be strengthened among China-aid-African workers to improve the awareness of self-protection. In addition, the diagnosis and treatment should be improved in medical professionals to achieve a timely definitive diagnosis.

Diagnosis and treatment of imported African schistosomiasis / 中国血吸虫病防治杂志

This paper summarizes the clinical diagnosis and treatment of imported African schistosomiasis,in order to make the therapeutic standards. Imported African schistosomiasis includes mainly schistosomiasis haematobia and schistosomiasis mansoni in China. In order to set up the operational standards,enhance diagnostic and cure rates,and reduce the complica?tions,we review the related literature combined with our experience over years,and summarize,in this paper,the pathogenic mechanism,and key points of clinical diagnosis and treatment of schistosomiasis haematobia and schistosomiasis mansoni,so as to provide the reference for clinical doctors.

Schistosomiasis haematobia misdiagnosed as urinary trace infection:one case report / 中国血吸虫病防治杂志

This paper reports one case of schistosomiasis haematobia that was misdiagnosed as urinary tract infection. It sug-gests that epidemiological data should be considered in the diagnosis and treatment of the patients with urinary tract infection symp-toms coming back from Africa to avoid misdiagnosis.

Epidemic situation of oversea imported schistosomiasis in China and thinking about its prevention and control / 中国血吸虫病防治杂志

The imported schistosomiasis cases in the Chinese literature and reports from the infectious disease monitoring in-formation system from 1979 to 2013 were collected and compiled. Totally 365 cases were reported to be infected with outside schis-tosomiasis, including 239 cases of schistosomiasis haematobia (74.0%) and 71 cases of schistosomiasis mansoni (22.0%), and 42 foreigners (11.5%) and 323 Chinese (88.5%). The infection areas involved 15 countries and regions in Africa. Totally 74.92%of pa-tients worked in the construction or geological prospecting in the wild field. According to the analysis of these cases, we found that the management system of prevention and control of imported schistosomiasis cases was not perfect including the high missing re-port rate, high misdiagnosis rate, and no standard diagnostic criteria. We suggest that all the levels of CDC or health administrative authorities should adopt the following relevant control measures to strengthen the imported schistosomiasis prevention and control in order to reduce the damage to the public health and the risk of the spread of African schistosomiasis in China:1. to establish and perfect the imported schistosomiasis monitoring and control system in China;2. to integrate the dynamic information platform of la-bor export and establish the comprehensive prevention and control management system of infectious diseases;3. to standardize the diagnosis and treatment of oversea imported schistosomiasis; 4. to strengthen the research on the transmission risk of imported schistosomiasis in the territory of China.

Effect of communal piped water supply on pattern of water use and transmission of schistosomiasis haematobia in an endemic area of Kenya

An attempt was made to examine the long-term impact of the introduction of communal piped water supply on pattern of water use and transmission of schistosomiasis haematobia in an endemic area of Kenya. In the study area, Mtsangatamu, a control program based on repeated selective mass-chemotherapy had been carried out for 6 years from 1987 to 1993. The pre-treatment overall prevalence and intensity of infection in 1987 were 59.2% and 10.9 eggs⁄10 ml of urine (Muhoho <I>et al</I>., 1997). During the control program, the prevalence was kept at a low range of 20 to 40% (Muhoho <I>et al</I>., 1994). At the end of the program, in 1994, gravity-fed water supply was provided to the village. Although the water facilities were damaged by flooding in 1998, new and further expanded gravity-fed water supply facilities consisting of 7 standpipes were introduced in 2000. The follow-up survey done in 1999 revealed reduced prevalence and intensity of infection, I.e. 23.0% and 1.2 eggs⁄ 10 ml of urine (unpublished data). The present study was carried out in 2006, 6 years after the last mass-chemotherapy. Urine examination showed that the prevalence and intensity of infection had return to 52.2% and 7.4 eggs⁄10 ml, nearly the same level as the pre-treatment level. The results of our study demonstrated that, over the long-term, the gravity-fed water supply facilities had little impact on the overall prevalence and intensity of infection in this village. However, analysis of the spatial pattern of infection, observation of human water contact at the river and a questionnaire on water use shed light on the possible impact of water supply on human water contact. The younger people (5-19 years old) with easy access to the standpipes showed a lower prevalence and intensity of infection, while the relationship was not clear in other age groups.<br>The result of the questionnaire indicated that the long distance from household to standpipe was the major factor limiting the use of the communal tap water. Most of the villagers who used piped water as the main source of water lived within 800 m of the nearest standpipe, and villagers who used river water exclusively lived beyond that distance. Observation of water-related activities at the communal water facilities also indicated that the residents who lived near standpipes used the piped water more frequently.<br>The frequency of total visits to river water sites did not differ between residents who lived near and far from the standpipe. However, water contact in the form of playing, the highest risk behavior, was observed exclusively among children who lived far (>250m) from standpipes, although the number of observations was small.<br>The present study demonstrated that the water facilities had little effect on the dispersed population but might have a beneficial effect on some villagers given easy access to standpipes.

Schistosomiasis haematobia: histopathological course determined by cystoscopy in a patient in whom praziquantel treatment failed / Esquistossomíase hematóbica: seguimento histopatológico determinado por cistoscopia em um paciente com falha terapêutica ao praziquantel

Schistosomiasis haematobia or urinary schistosomiasis is one of the main public health problems in Africa and the Middle East. A single dose of 40 mg praziquantel per kg body weight continues to be the treatment of choice for this infection. The aims of this follow-up were to study the post-treatment course of a patient infected with S. haematobium and not submitted to re-exposure, and to identify complications of the disease and/or therapeutic failure after praziquantel treatment by histopathological analysis. Treatments were repeated under medical supervision to ensure the correct use of the drug. In view of the suspicion of lesions in cystoscopy, the patient was submitted to bladder biopsy. The histopathological characteristics observed in biopsies obtained, after each treatment, indicated viability of parasite eggs and activity of granulomas.

A Esquistossomíase Hematóbica ou Esquistossomíase Urinária é um dos principais problemas de Saúde Pública na África e no Oriente Médio. Uma única dose de praziquantel 40 mg/kg de peso, continua sendo o tratamento de escolha para esta infecção. Os objetivos deste seguimento foram: avaliar o período pós-tratamento de um paciente infectado com Schistosoma haematobium e não submetido à re-exposição e, identificar as complicações da doença e/ou falha terapêutica, após o tratamento com praziquantel, por análise histopatológica de material obtido por biópsia vesical. O tratamento foi repetido sob supervisão médica para assegurar o uso correto do medicamento. Na presença de lesões suspeitas a cistoscopia, o paciente foi submetido a biópsia vesical. As características histopatológicas observadas nos materiais obtidos por biópsia, após cada tratamento, indicaram viabilidade de ovos e atividade dos granulomas.