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

Background: Sub-Saharan African migrants may be suffering from 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 response to praziquantel in a cohort of sub-Saharan African migrants with probable chronic schistosomiasis. Tests were administered at baseline and 6 and 12 months.

Results: Among 187 were eligible participants 149 completed follow-up. Of these 119 (79.9%) were males and 65 (43.6%) from Senegal. Median age was 43 years (IQR 35–51) and duration of residence in Europe was 17 years (IQR 12–21). The most prevalent clinical symptom was chronic abdominal pain (N=96, 64.4%), pelvic pain among males (N=55, 46.6%), and dysmenorrhea (N=21; 70.0%) among 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 ELISA and ICT tests were 54.7% and 24.3%.

Conclusions: 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.