Urogenital schistosomiasis detected in sub-Saharan African migrants attending primary healthcare consultations in Paris, France: a 14-year retrospective cohort study (2004–2017)

Urogenital schistosomiasis (UGS) remains common in sub-Saharan African migrants. The aim of the study was to describe UGS cases detected among patients attending primary healthcare consultations in free outpatient clinics in Paris. This retrospective cohort study included all cases of active UGS from 2004 to 2017. Cases were defined by the presence of Schistosoma haematobium typical ova at urine microscopy. Primary care physicians prescribed it on the basis of epidemiological or clinical criteria. Demographic, clinical, biological, and imaging data were retrieved. Active UGS was diagnosed in 105 cases. The sex ratio (F/M) was 3/102 with a median age of 25. Most cases came from West Africa and recently arrived in Europe (median delay, 1 year). Patients under 18 (23%) were more frequent after 2011. Compatible symptoms were reported in 63/104 patients (60%), hematuria being the most frequent (43/104). Urine dipstick detected micro-hematuria in 42/60 patients screened (70%). In 73 cases, urine microscopy was performed from either one, two, or three micturitions on separate days. The rate of positive urine microscopy increased from one (69.2%) to two micturitions (95.4%). All patients except three received praziquantel. Among those who underwent ultrasonography, 30/86 (35%) had abnormalities, 28/30 at the bladder. A step-by-step clinical assessment led to the detection of active UGS: questions on age, location in childhood and hematuria, physical examination, and urine dipstick. A prospective study in primary care is needed for protocol-based management of active UGS to be part of a socio-medical program for migrants.