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Imported schistosomiasis in Paris region of France: A multicenter study of prevalence and diagnostic methods
Claire Leblanc1, Sophie Brun2, Olivier Bouchaud3
1Department of Pediatrics, AP-HP University Paris 13, Jean Verdier Hospital, Bondy, France.
Insights
Imported schistosomiasis is prevalent in at-risk children in Paris, with a 24.3% detection rate. A serum immunochromatographic assay is recommended as an effective, low-cost screening tool.
Area of Science:
- Tropical medicine
- Pediatric infectious diseases
- Parasitology
Background:
- Limited data exists on imported schistosomiasis in pediatric populations.
- Children at risk, particularly recent migrants, may present with undiagnosed infections.
- The greater Paris region is a potential hub for imported parasitic diseases.
Purpose of the Study:
- To determine the prevalence of imported schistosomiasis in at-risk children in the Paris region.
- To evaluate and compare various diagnostic methods for schistosomiasis detection in children.
- To inform public health strategies for screening and management.
Main Methods:
- Prospective inclusion of children at risk consulting in Parisian hospitals.
- Screening of urine and stool samples using microscopy, circulating cathodic antigen (CCA), and real-time PCR.
- Analysis of serum samples with Western blot, ELISA, indirect hemagglutination, and immunochromatographic assays.
- Prevalence and test performance estimation using latent class analysis.
Main Results:
- 114 children were included, primarily recent migrants from sub-Saharan Africa.
- A prevalence of 24.3% was observed, with 10.5% confirmed and 11.4% suspected cases.
- Enzyme-linked immunosorbent assay (ELISA) and Western blot showed 83% sensitivity and 99% specificity; serum immunochromatographic assay demonstrated good performance.
Conclusions:
- High prevalence underscores the need for systematic schistosomiasis screening in at-risk children.
- Serum immunochromatographic assay is identified as a highly effective and cost-efficient screening method.
- Early detection and intervention are crucial for managing imported schistosomiasis in children.
Background:
There are few data on imported schistosomiasis - especially in children. The objectives of the present study were to estimate the prevalence of imported schistosomiasis in at-risk children in the greater Paris region of France and to compare diagnostic methods.
Method:
Children at risk of schistosomiasis who consulted or were hospitalized in four hospitals in the greater Paris region were prospectively included. Clinical and laboratory data were collected. Urine and feces samples were screened for Schistosoma spp. using microscopy, a point-of-care circulating cathodic antigen and a real-time polymerase chain reaction assay. Serum samples were screened using Western blot, ELISA, indirect hemagglutination, and immunochromatographic assays. The diagnosis was characterized as confirmed (positive microscopy analysis) and as suspected (positive ELISA and Western blot assays). The prevalence of schistosomiasis and the tests' performances were estimated using the latent class method.
Results:
A total of 114 children were included. Most of the children were newly arrived migrants from sub-Saharan Africa. The mean age was 13.2 years-old. There were 12 (10.5%) confirmed cases and 13 (11.4%) suspected cases. Half of the confirmed and suspected cases were asymptomatic. The prevalence was 24.3%. The ELISA and the Western blot assays presented the same sensitivity (83%) and specificity (99%). The serum immunochromatographic assay also showed good performance.
Conclusions:
The high prevalence of imported schistosomiasis among at-risk children in the greater Paris region confirms the need for systematic screening. A serum immunochromatographic assay appears to be one of the most effective screening methods for a low cost.
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