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Abstract：
We provide an update on diagnostic methods for the detection of urogenital schistosomiasis (UGS) in men and highlight that satisfactory urine-antigen diagnostics for UGS lag much behind that for intestinal schistosomiasis, where application of a urine-based point-of-care strip assay, the circulating cathodic antigen (CCA) test, is now advocated. Making specific reference to male genital schistosomiasis (MGS), we place greater emphasis on parasitological detection methods and clinical assessment of internal genitalia with ultrasonography. Unlike the advances made in defining a clinical standard protocol for female genital schistosomiasis, MGS remains inadequately defined. Whilst urine filtration with microscopic examination for ova of Schistosoma haematobium is a convenient but error-prone proxy of MGS, we describe a novel low-cost sampling and direct visualization method for the enumeration of ova in semen. Using exemplar clinical cases of MGS from our longitudinal cohort study among fishermen along the shoreline of Lake Malawi, the portfolio of diagnostic needs is appraised including: the use of symptomatology questionnaires, urine analysis (egg count and CCA measurement), semen analysis (egg count, circulating anodic antigen measurement and real-time polymerase chain reaction analysis) alongside clinical assessment with portable ultrasonography.
摘要：
我们提供了有关男性泌尿生殖道血吸虫病（UGS）的诊断方法的更新，并强调UGS令人满意的尿液抗原诊断远远落后于肠道血吸虫病。在应用基于尿液的现场护理试条测定的情况下，循环阴极抗原（CCA）测试，现在提倡。特别提到男性生殖器血吸虫病（MGS），我们更加重视寄生虫学检测方法和超声检查对内生殖器的临床评估.与在定义女性生殖器血吸虫病临床标准方案方面取得的进展不同，MGS定义不充分。虽然尿液过滤和显微镜检查血吸虫卵是MGS的一种方便但容易出错的替代方法，我们描述了一种新的低成本采样和直接可视化方法，用于精液中卵子的计数。使用来自马拉维湖沿岸渔民的纵向队列研究中MGS的示例性临床病例，对诊断需求的组合进行评估，包括：使用症状学问卷，尿液分析（鸡蛋计数和CCA测量），精液分析(卵子计数，循环阳极抗原测量和实时聚合酶链反应分析）以及便携式超声检查的临床评估。
