Awareness of European practitioners toward uncommon tropical diseases: are we prepared to deal with mass migration? Results of an international survey

  • Guglielmo ManticaEmail author
  • André Van der Merwe
  • Carlo Terrone
  • Fabio Gallo
  • Amir D. Zarrabi
  • Adriaan L. Vlok
  • Hilgard M. Ackermann
  • Angelo Territo
  • Francesco Esperto
  • Emiola O. Olapade-Olapa
  • Niccolò Riccardi
  • Marius Bongers
  • Gernot Bonkat
Original Article



The recent rise in migration from Africa through the Mediterranean basin into Europe has resulted in an increased incidence of uncommon diseases such as schistosomiasis and genito-urinary tuberculosis, which were previously largely unknown in this region. This study aimed to evaluate the insight of European urologists into diagnosing and managing these disease conditions and to determine whether they were adequately prepared to deal with the changing disease spectrum in their countries.


A survey including specific questions about the diagnosis and management of ‘tropical’ urological diseases was distributed among urologists working in Europe and Africa. Multivariate logistic regression models were performed to detect the continent (African or European) effect on knowledge of and insight into tropical urological diseases.


A total of 312 surveys were administered. African and European respondents accounted for 109 (36.09%) and 193 (63.91%) respondents, respectively. The multivariate logistic regression analysis demonstrated a significant deficiency in the knowledge of tropical urological diseases in the European cohort compared with the African cohort (p < 0.05). Moreover, in the European cohort, markedly superior knowledge of tropical urological diseases was observed for respondents who had previously worked in a developing country.


Though European urologists are not required to have the same insight as African urologists, they showed a very unsatisfactory knowledge of tropical urological diseases. The experience of working in a developing country could improve the knowledge of European urologists regarding tropical urological diseases.


Schistosomiasis Squamous bladder cancer HIV Tuberculosis Training 



We sincerely thank Dr Heidi van Deventer and the Writing Lab of the University of Stellenbosch for the editing of the manuscript.

Author contributions

GM—idea, study design, data collection, data analysis and manuscript writing. AM—study design, editing of the manuscript and critical review. CT—study design, editing of the manuscript and critical review. FG—data collection, data analysis and manuscript writing. ADZ—study design and data collection. ALV—study design and data collection. HMA—study design and data collection. AT—data collection. FE—data collection. EOO—data collection. NR—data collection. MB—data collection. GB—study design, editing of the manuscript and critical review.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Supplementary material

345_2019_2957_MOESM1_ESM.docx (19 kb)
Supplementary material 1 (DOCX 19 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Guglielmo Mantica
    • 1
    • 2
    Email author
  • André Van der Merwe
    • 1
  • Carlo Terrone
    • 2
  • Fabio Gallo
    • 3
  • Amir D. Zarrabi
    • 1
  • Adriaan L. Vlok
    • 1
  • Hilgard M. Ackermann
    • 1
  • Angelo Territo
    • 4
  • Francesco Esperto
    • 5
  • Emiola O. Olapade-Olapa
    • 6
  • Niccolò Riccardi
    • 7
  • Marius Bongers
    • 8
  • Gernot Bonkat
    • 9
  1. 1.Department of UrologyStellenbosch University and Tygerberg HospitalCape TownSouth Africa
  2. 2.Department of Urology, Policlinico San Martino HospitalUniversity of GenoaGenoaItaly
  3. 3.UO Biostatistics, Department of Health SciencesUniversity of GenoaGenoaItaly
  4. 4.Department of Urology, Fundaciò PuigvertAutonoma University of BarcelonaBarcelonaSpain
  5. 5.Department of UrologyHumanitas Gavazzeni HospitalBergamoItaly
  6. 6.Department of SurgeryUniversity of Ibadan and University College HospitalIbadanNigeria
  7. 7.Infectious Disease ClinicSan Raffaele Scientific InstituteMilanItaly
  8. 8.Department of UrologyThe Urology HospitalPretoriaSouth Africa
  9. 9.Alta Uro AG, Merian Iselin Klinik, Centre of Biomechanics and CalorimetryUniversity of BaselBaselSwitzerland

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