International Journal of Environmental Research and Public Health
Volume 16, Issue 1, 2019

Effectiveness of screening and treatment approaches for schistosomiasis and strongyloidiasis in newly-arrived migrants from endemic countries in the EU/EEA: A systematic review (Review) (Open Access)

Agbata E.N.* , Morton R.L. , Bisoffi Z. , Bottieau E. , Greenaway C. , Biggs B. , Montero N. , Tran A. , Rowbotham N. , Arevalo-Rodriguez I. , Myran D.T. , Noori T. , Alonso-Coello P. , Pottie K. , Requena-Méndez A.
  • a Faculty of Health Science, University of Roehampton London, London, SW15 5PU, United Kingdom, Department of Paediatrics, Obstetrics, Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, 08193, Spain
  • b NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW 2050, Australia
  • c Centre for Tropical Diseases (CTD), IRCCS Sacro Cuore Don Calabria Negrar, Negrar, Verona 37024, Italy, Department of Diagnostics and Public Health, University of Verona, Verona, 37134, Italy
  • d Department of Clinical Sciences, Institute of Tropical Medicine, 155 Nationalestraat, Antwerp, 2000, Belgium
  • e Division of Infectious Diseases and Clinical Epidemiology, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, QC H3A 0G4, Canada
  • f Department of Medicine at the Doherty Institute, University of Melbourne, ParkvilleVIC 3010, Australia, Victorian Infectious Diseases Service, The Royal Melbourne Hospital RMH, ParkvilleVIC 3050, Australia
  • g Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad Tecnológica Equinoccial, Quito, 170509, Ecuador
  • h NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW 2050, Australia
  • i NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW 2050, Australia
  • j Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad Tecnológica Equinoccial, Quito, 170509, Ecuador, Clinical Biostatistics Unit, Hospital Universitario Ramon y Cajal (IRYCIS), CIBER Epidemiology and Public Health (CIBERESP), Madrid, 28034, Spain
  • k Bruyere Research Institute, University of Ottawa, Ottawa, ON K1N 6N5, Canada
  • l European Centre for Disease Prevention and Control, Gustav III: s Boulevard 40, Solna, 169 73, Sweden
  • m Iberoamerican Cochrane Center, Biomedical Research Institute Sant Pau (IIB Sant Pau-CIBERESP), Barcelona, 08025, Spain
  • n Centre for Global Health Institute of Population Health, University of Ottawa, Ottawa, ON K1N 6N5, Canada
  • o ISGlobal, Barcelona Institute for Global Health (ISGlobal-CRESIB, Hospital Clínic-University of Barcelona), Barcelona, E-08036, Spain

Abstract

We aimed to evaluate the evidence on screening and treatment for two parasitic infections—schistosomiasis and strongyloidiasis—among migrants from endemic countries arriving in the European Union and European Economic Area (EU/EEA). We conducted a systematic search of multiple databases to identify systematic reviews and meta-analyses published between 1 January 1993 and 30 May 2016 presenting evidence on diagnostic and treatment efficacy and cost-effectiveness. We conducted additional systematic search for individual studies published between 2010 and 2017. We assessed the methodological quality of reviews and studies using the AMSTAR, Newcastle–Ottawa Scale and QUADAS-II tools. Study synthesis and assessment of the certainty of the evidence was performed using GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. We included 28 systematic reviews and individual studies in this review. The GRADE certainty of evidence was low for the effectiveness of screening techniques and moderate to high for treatment efficacy. Antibody-detecting serological tests are the most effective screening tests for detection of both schistosomiasis and strongyloidiasis in low-endemicity settings, because they have higher sensitivity than conventional parasitological methods. Short courses of praziquantel and ivermectin were safe and highly effective and cost-effective in treating schistosomiasis and strongyloidiasis, respectively. Economic modelling suggests presumptive single-dose treatment of strongyloidiasis with ivermectin for all migrants is likely cost-effective, but feasibility of this strategy has yet to be demonstrated in clinical studies. The evidence supports screening and treatment for schistosomiasis and strongyloidiasis in migrants from endemic countries, to reduce morbidity and mortality. © 2018 by the authors. Licensee MDPI, Basel, Switzerland.

Author Keywords

Strongyloidiasis/strongyloides Grade Screening/diagnosis Migrant populations Schistosomiasis/schistosoma Public health Treatment

Index Keywords

Strongyloidiasis Schistosoma japonicum Cost benefit analysis mass screening economics Serologic Tests human diagnostic accuracy ivermectin screening test drug efficacy screening health care cost Humans migrant antibody detection Schistosoma mansoni Review European Union diagnostic approach route Schistosoma haematobium organization and management infection control schistosomiasis migration serology drug safety endemic disease praziquantel Endemic Diseases single drug dose Economic Model Transients and Migrants systematic review cost-benefit analysis clinical effectiveness cost effectiveness analysis
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85058916900&doi=10.3390%2fijerph16010011&partnerID=40&md5=a2dcbcbb59063f836c6344c842bc6ad2
DOI: 10.3390/ijerph16010011
ISSN: 16617827
Cited by: 3
Original Language: English