Urinary schistosomiasis in asylum seekers in Italy: an emergency currently undervalued

Despite schistosomiasis is one of the most prevalent tropical diseases in developing countries and and large flows of migrants come from countries where the disease is endemic, imported urinary schistosomiasis is still not easily recognized in non-endemic areas, especially if not subjected to specific investigations. Moreover schistosomiasis is currently not reportable in any European public health system. The data presented in this report were collected were collected between asylum seekers by a simple screening method based on a prior or actual history of a macroscopic hematauria. In case of a history of gross hematuria, the patient underwent to specific exams standardized for the diagnosis of urinary schistosomiasis. Our data show that the prevalence of the disease has been largely underestimated by European Surveillance Systems; in fact in a small population of young asylum seekers coming from endemic areas for schistosomiasis, we found a significant number of individuals with symptomatic disease. Given that the disease typically has an insidious course, it is highly probable that a screening procedure is able to identify early asymptomatic or mildly symptomatic subjects and avoid the serious complications that are present in advanced stages of disease. Given the limits and the costs of a late diagnosis and that an effective treatment is available, subjects from endemic areas should be actively screened for urinary schistosomiasis.