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oai:recercat.cat:11351/85542026-04-04T03:09:31Zcom_2072_378070com_2072_378040col_2072_378092

urn:hdl:11351/8554 A large case series of travel-related Mansonella perstans (vector-borne filarial nematode): a TropNet study in Europe Rodari, Paola Bottieau, Emmanuel Soriano-Pérez, Manuel Jesús Treviño Maruri, Begoña Salas-Coronas, Joaquin Tamarozzi, Francesca Salvador Velez, Fernando M Nematodes Malalties parasitàries - Tractament Agents antiparasitaris - Ús terapèutic Malalties transmissibles DISEASES::Parasitic Diseases::Helminthiasis::Nematode Infections::Secernentea Infections::Spirurida Infections::Filariasis::Mansonelliasis Other subheadings::Other subheadings::Other subheadings::/drug therapy CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Antiparasitic Agents Other subheadings::Other subheadings::/therapeutic use DISEASES::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Travel-Related Illness ENFERMEDADES::enfermedades parasitarias::helmintiasis::infecciones por nematodos::infecciones por Secernentea::infecciones por Spirurida::filariasis::mansoneliasis Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::usos terapéuticos::antiinfecciosos::antiparasitarios Otros calificadores::Otros calificadores::/uso terapéutico ENFERMEDADES::afecciones patológicas, signos y síntomas::signos y síntomas::enfermedades relacionadas con los viajes Mansonella perstans; Travel; Treatment Mansonella perstans; Viaje; Tratamiento Mansonella perstans; Viatge; Tractament Background Infection with Mansonella perstans is a neglected filariasis, widely distributed in sub-Saharan Africa, characterized by an elusive clinical picture; treatment for mansonellosis is not standardized. This retrospective study aimed to describe the clinical features, treatment schemes and evolution, of a large cohort of imported cases of M. perstans infection seen in four European centres for tropical diseases. Methods Mansonella perstans infections, diagnosed by identification of blood microfilariae in migrants, expatriates and travellers, collected between 1994 and 2018, were retrospectively analysed. Data concerning demographics, clinical history and laboratory examinations at diagnosis and at follow-up time points were retrieved. Results A total of 392 patients were included in the study. Of the 281 patients for whom information on symptoms could be retrieved, 150 (53.4%) reported symptoms, abdominal pain and itching being the most frequent. Positive serology and eosinophilia were present in 84.4% and 66.1%, respectively, of those patients for whom these data were available. Concomitant parasitic infections were reported in 23.5% of patients. Treatment, administered to 325 patients (82.9%), was extremely heterogeneous between and within centres; the most commonly used regimen was mebendazole 100 mg twice a day for 1 month. A total of 256 (65.3%) patients attended a first follow-up, median 3 months (interquartile range 2–12) after the first visit; 83.1% of patients having received treatment based on mebendazole and/or doxycycline, targeting Wolbachia, became amicrofilaremic, 41.1–78.4% of whom within 12 months from single treatment. Conclusions Lack of specific symptoms, together with the inconstant positivity of parasitological and antibody-based assays in the infected population, makes the clinical suspicion and screening for mansonellosis particularly difficult. Prospective studies evaluating prevalence of infection in migrants from endemic areas, infection-specific morbidity, presence of Wolbachia endosymbionts in M. perstans populations from different geographical areas and efficacy of treatment regimens are absolutely needed to optimize the clinical management of infection. The publication of this study was funded by Italian Ministry of Health Fondi Ricerca Corrente–L2 to IRCCS Sacro Cuore Don Calabria Hospital. 2022-11-30T08:17:31Z 2022-11-30T08:17:31Z 2022-10 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Journal of Travel Medicine;29(7) https://doi.org/10.1093/jtm/taac048 Attribution-NonCommercial 4.0 International http://creativecommons.org/licenses/by-nc/4.0/ info:eu-repo/semantics/openAccess Oxford University Press Scientia