Emergence of Urogenital Schistosomiasis Cases in Southwest Libya: Evaluation and Management

Background: Schistosomiasis is an infection caused by a parasitic worm that lives in fresh water throughout Africa. In many tropical and subtropical regions, including Libya, urogenital schistosomiasis is regarded as one of the neglected tropical illnesses. In Libya, the first known instance of schistosomiasis was in 1925. Since 2003, the prevalence of focally endemic Schistosoma haematobium and Schistosoma mansoni in Libya has been estimated at 5%. Aim: The primary goal of this study is to explore the emergence of bilharzial cystitis cases in southwest Libya and to evaluate current diagnostic and management approaches. Material and methods: 28 patients with belharzial cystitis were diagnosed at the Al Rahma Poly Clinic in Sabha City, Libya between February 2020 and August 2024, and were analyzed. Patient demographics, clinical presentations, laboratory findings, and treatment outcomes were reviewed. Results: the ages of the 28 patients in this study ranged from 9 to 65 years old (mean: 18.96 ± 10.64 years). The majority were Libyan (82.14%), while 17.86% were non-Libyan (from Niger and Chad). Following treatment with a single dose of praziquantel (40 mg/kg), only one patient (3.5%) exhibited persistent hematuria, and two (7.1%) had dysuria at one-month follow-up. Additionally, 3.5% had persistent bilharzial eggs in urine, 39.2% had persistent RBCs, and 21.4% had pus cells. Urogenital schistosomiasis remains hypoendemic in several Libyan regions. Conclusion: our data showed that both surveillance and management programs are necessary to detect and handle these occurrences. This can easily be achieved by focusing on snail control, praziquantel chemotherapy, public health education, and access to clean water. Schistosomiasis should be considered as a differential diagnosis for hematuria in endemic regions.