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Abstract：
BACKGROUND: Schistosomiasis remains a public health concern worldwide. It is responsible for more than 240 million cases in 78 countries, 40 million of whom are women of childbearing age. In the Senegal River basin, both Schistosoma haematobium and Schistosoma mansoni are very prevalent in school-age children. However, there is a lack of information on the burden of schistosomiasis in pregnant women, which can cause complications in the pregnancy outcome. This study aimed to determine the prevalence and associated factors of schistosomiasis in pregnant women.
METHODS: We conducted a prospective cross-sectional study of pregnant women attending antenatal clinics at the health center of the Senegalese Sugar Company and at the hospital of Richard Toll between August and December 2021. The urine and stool samples collected were examined using microscopy techniques and quantitative polymerase chain reaction (qPCR) to detect the presence of S. haematobium and S. mansoni. The urines were previously tested using urine reagent strips to detect hematuria and proteinuria. Socio-demographical, clinical, and diagnostically data were recorded by the midwife and the gynaecologist. The data were analyzed using a logistic regression model.
RESULTS: Among the 298 women examined for the infection by microscopic, 65 (21.81%) were infected with urogenital schistosomiasis, 10 (3.36%) with intestinal schistosomiasis, and 4 (1.34%) were co-infected with both types of schistosomiasis. Out of the 288 samples tested by qPCR, 146 (48.99%) were positive for S. haematobium, 49 (35.51%) for S. mansoni and 22 (15.94%) for both species (co-infection). Pregnant women having microscopic haematuria and proteinuria were significantly more infected (p < 0.05).
CONCLUSIONS: This study has revealed a high prevalence of schistosomiasis in pregnant women in Senegal. The qPCR allowed us to detect more cases compared to the microscopy. There is a need to conduct more studies to understand the real burden of the disease and to set up a surveillance system to prevent pregnancy-related complications.
METHODS: We conducted a prospective cross-sectional study of pregnant women attending antenatal clinics at the health center of the Senegalese Sugar Company and at the hospital of Richard Toll between August and December 2021. The urine and stool samples collected were examined using microscopy techniques and quantitative polymerase chain reaction (qPCR) to detect the presence of S. haematobium and S. mansoni. The urines were previously tested using urine reagent strips to detect hematuria and proteinuria. Socio-demographical, clinical, and diagnostically data were recorded by the midwife and the gynaecologist. The data were analyzed using a logistic regression model.
RESULTS: Among the 298 women examined for the infection by microscopic, 65 (21.81%) were infected with urogenital schistosomiasis, 10 (3.36%) with intestinal schistosomiasis, and 4 (1.34%) were co-infected with both types of schistosomiasis. Out of the 288 samples tested by qPCR, 146 (48.99%) were positive for S. haematobium, 49 (35.51%) for S. mansoni and 22 (15.94%) for both species (co-infection). Pregnant women having microscopic haematuria and proteinuria were significantly more infected (p < 0.05).
CONCLUSIONS: This study has revealed a high prevalence of schistosomiasis in pregnant women in Senegal. The qPCR allowed us to detect more cases compared to the microscopy. There is a need to conduct more studies to understand the real burden of the disease and to set up a surveillance system to prevent pregnancy-related complications.
摘要：
背景：血吸虫病仍然是世界范围内的公共卫生问题。它负责78个国家超过2.4亿例，其中4000万是育龄妇女。在塞内加尔河流域，血吸虫和曼氏血吸虫在学龄儿童中非常普遍。然而,缺乏有关孕妇血吸虫病负担的信息，这可能会导致妊娠结局的并发症。本研究旨在确定孕妇血吸虫病的患病率及其相关因素。
方法：我们对2021年8月至12月在塞内加尔糖业公司健康中心和理查德·托尔医院就诊的孕妇进行了前瞻性横断面研究。使用显微镜技术和定量聚合酶链反应（qPCR）检查收集的尿液和粪便样品，以检测是否存在。先前使用尿液试剂条检测尿液以检测血尿和蛋白尿。社会人口统计学，临床,诊断数据由助产士和妇科医生记录.使用逻辑回归模型分析数据。
结果：在通过显微镜检查感染的298名妇女中，65人(21.81%)感染泌尿生殖道血吸虫病,10例(3.36%)为肠血吸虫病,4例（1.34％）与两种类型的血吸虫病同时感染。在通过qPCR测试的288个样本中，146例(48.99%)血吸虫阳性,曼氏链球菌49例（35.51%），两种物种22例（15.94%）（共感染）。具有镜下血尿和蛋白尿的孕妇明显感染更多（p<0.05）。
结论：这项研究揭示了塞内加尔孕妇血吸虫病的高患病率。与显微镜相比，qPCR使我们能够检测到更多的病例。有必要进行更多的研究，以了解该疾病的真正负担，并建立监测系统以预防与妊娠有关的并发症。
方法：我们对2021年8月至12月在塞内加尔糖业公司健康中心和理查德·托尔医院就诊的孕妇进行了前瞻性横断面研究。使用显微镜技术和定量聚合酶链反应（qPCR）检查收集的尿液和粪便样品，以检测是否存在。先前使用尿液试剂条检测尿液以检测血尿和蛋白尿。社会人口统计学，临床,诊断数据由助产士和妇科医生记录.使用逻辑回归模型分析数据。
结果：在通过显微镜检查感染的298名妇女中，65人(21.81%)感染泌尿生殖道血吸虫病,10例(3.36%)为肠血吸虫病,4例（1.34％）与两种类型的血吸虫病同时感染。在通过qPCR测试的288个样本中，146例(48.99%)血吸虫阳性,曼氏链球菌49例（35.51%），两种物种22例（15.94%）（共感染）。具有镜下血尿和蛋白尿的孕妇明显感染更多（p<0.05）。
结论：这项研究揭示了塞内加尔孕妇血吸虫病的高患病率。与显微镜相比，qPCR使我们能够检测到更多的病例。有必要进行更多的研究，以了解该疾病的真正负担，并建立监测系统以预防与妊娠有关的并发症。
