Presentation and outcome of 1107 cases of schistosomiasis from Africa diagnosed in a non-endemic country

Schistosomiasis is found in a significant proportion of returning traveller s and immigrants to Britain. This study is a retrospective review of 1107 c onsecutive cases of schistosomiasis from Africa diagnosed by microscopy or serology presenting to the Hospital for Tropical Diseases, London, UK. 50(. )4% of cases were asymptomatic. The most common symptom which resolved on t reatment was tiredness. Serology was positive in 951 (86%), and ova seen in 45%. Urine dipstick testing was positive for blood in 21% and protein in 1 5%, with eosinophilia in 44%. In this population urine dipstick, full blood count and serology were all insufficient screening tools used alone. Among patients with full follow-up data 3 months or more after treatment with pr aziquantel, definite treatment failure occured in 4 of 271 (1(.)5%),restric ting the analysis to those with ova seen at diagnosis. There was no signifi cant difference in treatment failure between 1 and 3 days of treatment. Ant ibody level was the same or higher than at treatment in 55% of cases seen a fter about 3 months and 38% after 1 year, confirming it is probably of limi ted clinical use in detecting treatment failure.