Bilharzia-Studie
Schistosomiasis is a widespread helminthic infection. The World Health Organization (WHO) estimated that 249 million people in 78 countries require preventive antiparasitic therapy for schistosomiasis each year. Long lasting urogenital schistosomiasis related to continuous re-exposure as occurring in most endemic areas constitutes a risk factor for squamous bladder cancer (1, 2). In a study performed in Malawi the reproductive tract was affected, in more than 60% of women who excreted S. haematobium ova in urine (3). Transplacental transmission of schistosomiasis in humans has not been observed, but schistosomiasis of the pregnant uterus has been reported and placental schistosomiasis has been associated with stillbirth (4,5). Schistosomiasis has been associated to premature delivery and low birth weight [6-9]. Placental schistosomiasis has been reported only occasionally (5, 10, 11).
Migration to the European Union is numeralised with 1.7 million immigrants for 2012. The largest number with 592.200 was reported for Germany, followed by the United Kingdom, Italy, France and Spain. 709.100 citizens of non-EU countries acquired EU citizenship in 2012. These new citizens were predominantly from Africa and Asia (25 %, respectively), followed by Europe (outside of the EU, 20 %) and North and South America (15 %) (12). The major burden is imported by migrants coming from endemic countries. In that specific population schistosomiasis has an estimated prevalence of 10-20% (13-15). Schistosomiasis is sporadically reported in travelers from endemic areas.
The aim of the proposed research project is to study the impact of Schistosomiasis on adverse birth outcomes (ABO) in migrants to Europe from schistosoma endemic areas. Countries or areas defined by WHO as endemic areas for the following species are: Schistosoma mansoni: Africa, the Middle East, the Caribbean, Brazil, Venezuela and Suriname; Schistosoma japonicum: China, Indonesia, the Philippines; Schistosoma mekongi: Several districts of Cambodia and the Lao People’s Democratic Republic; Schistosoma guineensis and related S. intercalatum: Rain forest areas of central Africa; Schistosoma haematobium: Africa, the Middle East (16).
In order to determine the generally accepted clinical parameter intrauterine growth restriction; IUGR (17), birth weight for a given sex and gestational age of the newborn will be assessed. A prospective ascertained cross-sectional study using paired mother-child samples will be performed in pregnant migrants. Determination of schistosoma specific antibodies will define our positive and negative subgroup.
Referenzen:
- Richter J RA. Schistosomiasis oder Bilharziose. In: Löscher T. BGD, ed. Tropenmedizin in Klinik und Praxis. 4 ed. Stuttgart & New York2010:676-703.
- Mostafa MH BA, O’Connor PJ. Bladder cancer associated with schistosomiasis. Parasitology Today 1995;11:87-9.
- Kjetland EF, Poggensee G, Helling-Giese G, et al. Female genital schistosomiasis due to Schistosoma haematobium. Clinical and parasitological findings in women in rural Malawi. Acta Trop 1996;62:239-55.
- Youssef AF, Abdine FH. Bilharziasis of the pregnant uterus. The Journal of obstetrics and gynaecology of the British Empire 1958;65:991-3.
- Bittencourt AL, Cardoso de Almeida MA, Iunes MA, Casulari da Motta LD. Placental involvement in schistosomiasis mansoni. Report of four cases. The American journal of tropical medicine and hygiene 1980;29:571-5.
- Richter J RA. Schistosomiasis oder Bilharziose. In: Löscher T. BGD, ed. Tropenmedizin in Klinik und Praxis. 4 ed. Stuttgart & New York2010:676-703.
- Mostafa MH BA, O’Connor PJ. Bladder cancer associated with schistosomiasis. Parasitology Today 1995;11:87-9.
- Kjetland EF, Poggensee G, Helling-Giese G, et al. Female genital schistosomiasis due to Schistosoma haematobium. Clinical and parasitological findings in women in rural Malawi. Acta Trop 1996;62:239-55.
- Youssef AF, Abdine FH. Bilharziasis of the pregnant uterus. The Journal of obstetrics and gynaecology of the British Empire 1958;65:991-3.
- Bittencourt AL, Cardoso de Almeida MA, Iunes MA, Casulari da Motta LD. Placental involvement in schistosomiasis mansoni. Report of four cases. The American journal of tropical medicine and hygiene 1980;29:571-5.
- Friedman JF, Mital P, Kanzaria HK, Olds GR, Kurtis JD. Schistosomiasis and pregnancy. Trends in parasitology 2007;23:159-64.
- Olds GR. Administration of praziquantel to pregnant and lactating women. Acta Trop 2003;86:185-95.
- Siegrist D, Siegrist-Obimpeh P. Schistosoma haematobium infection in pregnancy. Acta Trop 1992;50:317-21.
- Siza JE. Risk factors associated with low birth weight of neonates among pregnant women attending a referral hospital in northern Tanzania. Tanzania journal of health research 2008;10:1-8.
- Renaud R, P. Brettes, C. Castanier, and R. Loubiere. Placental Bilharziasis. International Journal of Gynaecology and Obstetrics 1972:24-30.
- Schleenvoigt BT, Gajda M, Baier M, et al. Placental Schistosoma haematobium infection in a German returnee from Malawi. Infection 2014.
- Migration and migrant population statistics 2015. at http://ec.europa.eu/eurostat/statistics-explained/index.php/Migration_and_migrant_population_statistics.)
- Sadlier CM, Brown A, Lambert JS, Sheehan G, Mallon PW. Seroprevalence of Schistosomiasis and Strongyloides infection in HIV-infected patients from endemic areas attending a European infectious diseases clinic. AIDS research and therapy 2013;10:23.
- Ceccarelli G, d'Ettorre G, Riccardo F, et al. Urinary schistosomiasis in asylum seekers in Italy: an emergency currently undervalued. Journal of immigrant and minority health / Center for Minority Public Health 2013;15:846-50.
- Roca C, Balanzo X, Gascon J, et al. Comparative, clinico-epidemiologic study of Schistosoma mansoni infections in travellers and immigrants in Spain. European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology 2002;21:219-23.
- Schistosomiasis, Fact sheet N°115. WHO, 2013. at http://www.who.int/mediacentre/factsheets/fs115/en/.)
- Marsal K. Intrauterine growth restriction. Curr Opin Obstet Gynecol 2002;14:127-35.