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Background: Mansonella perstans infection can be considered one of the most neglected tropical infectious diseases. Very few studies have reported on the clinical picture caused by infection with this nematode. Therefore, our study was aimed to describe the clinical patterns and treatment of imported M. perstans infection by migrants from Africa.
Methods: The present study evaluated a large cohort of migrants who have been diagnosed, examined and treated for imported M. perstans infection at a Spanish reference center (Hospital Carlos III Tropical Medicine Unit, Madrid, Spain) over a 19-year period. Most patients voluntarily attend the emergency unit or are referred from primary care or general hospitals in Madrid.
Categorical variable results were expressed as percentages and as the mean and standard deviation (SD) for continuous variables. Chi-square test was used to compare the association between the categorical variables. The measured outcomes were expressed as the odds ratio (OR) with a 95% CI. The continuous variables were compared by Student’s t-test or the Mann–Whitney test. The corresponding regression models were used for multivariate analysis.
Results: Five hundred three cases of migrants from tropical and subtropical areas with M. perstans infection were identified. Two hundred sixty-four patients were female (52.5%). The mean age (±SD) was 44.6±18.2 years (range, 16–93 years). The mean time (±SD) between the arrival in Spain and the first consultation was 8.6±18.0 months. The origin of the patients was Equatorial Guinea (97.6%). Regarding the clinical picture, 257 patients were asymptomatic (54.7%) and 228 were symptomatic (45.3%); 190 patients had pruritus (37.8%), 50 (9.9%) had arthralgia, 18 patients had Calabar-like swelling (3.6%), and 15 (3%) had abdominal pain. Four hundred forty-two (87.9%) migrants had hyper-IgE, and 340 (67.6%) had eosinophilia. One hundred ninety-five patients had coinfections with other filarial nematodes (38.8%), and 308 migrants had only M. perstans infection (61.2%). Four hundred thirty-seven cases (86.9%) had been treated with anti-filarial drugs: 292 cases were treated with one anti-filarial drug, and 145 cases were treated with combined anti-filarial therapy. Additionally, 20 (4%) cases received steroids and 38 (7.6%) cases received antihistamines.
Conclusions: A long series of M. perstans infections is presented in sub-Saharan immigrants whose data indicate that it should be included in the differential diagnosis in patients with pruritus or analytical alterations such as eosinophilia or hyper-IgE presentation, and they also have a high number of coinfections with other microorganisms whose treatment needs to be protocolized.
Keywords
Mansonellosis; Mansonella perstans; Clinical study; Immigrant; Imported diseases; Spain.
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CURRENT STATUS: Published
View the published article at Infectious Diseases of Poverty.
Version 3
Posted 10 Jul, 2020
No community comments so far
Editorial decision: Accept
On 15 Jul, 2020
Editor assigned
On 08 Jul, 2020
Submission checks complete
On 07 Jul, 2020
Editor invited
On 07 Jul, 2020
No comments provided
Editorial decision: Minor revision
On 03 Jul, 2020
Review #2 received
Received 19 Jun, 2020
Review #1 received
Received 19 Jun, 2020
Editor assigned
On 19 Jun, 2020
Reviewers invited
Invitations sent on 19 Jun, 2020
Reviewer #1 agreed
On 19 Jun, 2020
Reviewer #2 agreed
On 19 Jun, 2020
Submission checks complete
On 18 Jun, 2020
Editor invited
On 18 Jun, 2020
No comments provided
Editorial decision: Major revision
On 30 May, 2020
Review #2 received
Received 29 May, 2020
Reviewer #3 agreed
On 28 May, 2020
Reviewer #2 agreed
On 25 May, 2020
Review #1 received
Received 22 May, 2020
Reviewer #1 agreed
On 14 May, 2020
Editor assigned
On 13 May, 2020
Reviewers invited
Invitations sent on 13 May, 2020
Editor invited
On 12 May, 2020
Submission checks complete
On 08 May, 2020
First submitted
On 07 May, 2020
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Subject Areas
Infectious Diseases
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See the published version of this preprint at Infectious Diseases of Poverty.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at Infectious Diseases of Poverty.
Version 3
Posted 10 Jul, 2020
No community comments so far
Editorial decision: Accept
On 15 Jul, 2020
Editor assigned
On 08 Jul, 2020
Submission checks complete
On 07 Jul, 2020
Editor invited
On 07 Jul, 2020
No comments provided
Editorial decision: Minor revision
On 03 Jul, 2020
Review #2 received
Received 19 Jun, 2020
Review #1 received
Received 19 Jun, 2020
Editor assigned
On 19 Jun, 2020
Reviewers invited
Invitations sent on 19 Jun, 2020
Reviewer #1 agreed
On 19 Jun, 2020
Reviewer #2 agreed
On 19 Jun, 2020
Submission checks complete
On 18 Jun, 2020
Editor invited
On 18 Jun, 2020
No comments provided
Editorial decision: Major revision
On 30 May, 2020
Review #2 received
Received 29 May, 2020
Reviewer #3 agreed
On 28 May, 2020
Reviewer #2 agreed
On 25 May, 2020
Review #1 received
Received 22 May, 2020
Reviewer #1 agreed
On 14 May, 2020
Editor assigned
On 13 May, 2020
Reviewers invited
Invitations sent on 13 May, 2020
Editor invited
On 12 May, 2020
Submission checks complete
On 08 May, 2020
First submitted
On 07 May, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at Infectious Diseases of Poverty.
Background: Mansonella perstans infection can be considered one of the most neglected tropical infectious diseases. Very few studies have reported on the clinical picture caused by infection with this nematode. Therefore, our study was aimed to describe the clinical patterns and treatment of imported M. perstans infection by migrants from Africa.
Methods: The present study evaluated a large cohort of migrants who have been diagnosed, examined and treated for imported M. perstans infection at a Spanish reference center (Hospital Carlos III Tropical Medicine Unit, Madrid, Spain) over a 19-year period. Most patients voluntarily attend the emergency unit or are referred from primary care or general hospitals in Madrid.
Categorical variable results were expressed as percentages and as the mean and standard deviation (SD) for continuous variables. Chi-square test was used to compare the association between the categorical variables. The measured outcomes were expressed as the odds ratio (OR) with a 95% CI. The continuous variables were compared by Student’s t-test or the Mann–Whitney test. The corresponding regression models were used for multivariate analysis.
Results: Five hundred three cases of migrants from tropical and subtropical areas with M. perstans infection were identified. Two hundred sixty-four patients were female (52.5%). The mean age (±SD) was 44.6±18.2 years (range, 16–93 years). The mean time (±SD) between the arrival in Spain and the first consultation was 8.6±18.0 months. The origin of the patients was Equatorial Guinea (97.6%). Regarding the clinical picture, 257 patients were asymptomatic (54.7%) and 228 were symptomatic (45.3%); 190 patients had pruritus (37.8%), 50 (9.9%) had arthralgia, 18 patients had Calabar-like swelling (3.6%), and 15 (3%) had abdominal pain. Four hundred forty-two (87.9%) migrants had hyper-IgE, and 340 (67.6%) had eosinophilia. One hundred ninety-five patients had coinfections with other filarial nematodes (38.8%), and 308 migrants had only M. perstans infection (61.2%). Four hundred thirty-seven cases (86.9%) had been treated with anti-filarial drugs: 292 cases were treated with one anti-filarial drug, and 145 cases were treated with combined anti-filarial therapy. Additionally, 20 (4%) cases received steroids and 38 (7.6%) cases received antihistamines.
Conclusions: A long series of M. perstans infections is presented in sub-Saharan immigrants whose data indicate that it should be included in the differential diagnosis in patients with pruritus or analytical alterations such as eosinophilia or hyper-IgE presentation, and they also have a high number of coinfections with other microorganisms whose treatment needs to be protocolized.
Figure 1
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