AI Article Synopsis
- Lower eosinophil counts during acute malaria may mask existing helminth infections, complicating diagnoses.
- A study of 259 sub-Saharan migrants with imported malaria found significant rates of helminth co-infections, primarily schistosomiasis, strongly affecting eosinophil levels post-treatment.
- The findings highlight the importance of screening for helminth infections in malaria patients, as eosinophilia might not be immediately present and could delay timely treatment.
Article Abstract
Background: Lower eosinophil counts observed during acute malaria episodes could hide helminth-related eosinophilia.
Method: Retrospective observational study with sub-Saharan migrants with imported malaria from May-2007 to May-2020. Absolute eosinophil count was determined upon diagnosis at hospital admission and at least once after clearance of parasitemia. Helminthic co-infections were investigated by searching for stool and urine parasites, serology for Strongyloides spp. and Schistosoma spp., and Knott and/or saponin tests for blood microfilariae.
Results: A total of 259 patients were included. Most of them were male (n = 237; 91.5%) and VFR travelers (n = 241; 93.1%). 131 patients (50.6%) were diagnosed with probable schistosomiasis, 15 (5.8%) with confirmed schistosomiasis, 16 (6.2%) with strongyloidiasis, 4 (1.6%) with soil-transmitted helminthiasis, and 4 (1.6%) with filariasis (Mansonella perstans). Prevalence of eosinophilia increased from 2.7% on admission to 32.5% during outpatient follow-up. Eosinophilia did not appear until several weeks after hospital discharge in up to 24% of the confirmed helminthic co-infections and in 61.1% of patients with probable schistosomiasis. Eosinophilia was associated with confirmed schistosomiasis and mansonellosis while 56.2% and 75% of cases with strongyloidiasis and soil-transmitted worms did not present eosinophilia at any time, respectively.
Conclusions: Regardless of the absence of eosinophilia, patients hospitalized because of acute imported malaria might benefit from the screening of the main parasitic diseases, allowing for earlier diagnosis and treatment.
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| http://dx.doi.org/10.1016/j.tmaid.2022.102415 | DOI Listing |
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