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PLoS Neglected Tropical Diseases Feb 2022Strongyloidiasis and Chagas disease are endemic in northern Argentina. In this study we evaluate the association between S. stercoralis and T. cruzi infections in...
BACKGROUND
Strongyloidiasis and Chagas disease are endemic in northern Argentina. In this study we evaluate the association between S. stercoralis and T. cruzi infections in villages with diverse prevalence levels for these parasites. Further understanding in the relationship between these Neglected Tropical Diseases of South America is relevant for the design of integrated control measures as well as exploring potential biologic interactions.
METHODOLOGY
Community based cross-sectional studies were carried in different villages of the Chaco and Yungas regions in Argentina. Individuals were diagnosed by serology for S. stercoralis and T. cruzi. The association between S. stercoralis and T. cruzi, and between anemia and the two parasites was evaluated using two approaches: marginal (Ma) and multilevel regression (Mu).
RESULTS
A total of 706 individuals from six villages of northern Argentina were included. A total of 37% were positive for S. stercoralis, 14% were positive for T. cruzi and 5% were positive for both. No association was found between infection with S. stercoralis and T. cruzi in any of the models, but we found a negative correlation between the prevalence of these species in the different villages (r = -0.91). Adults (> 15 years) presented association with S. stercoralis (Ma OR = 2.72; Mu OR = 2.84) and T. cruzi (Ma OR = 5.12; Mu OR = 5.48). Also, 12% and 2% of the variance of infection with S. stercoralis and T. cruzi, respectively, could be explained by differences among villages. On the other hand, anemia was associated with infection with S. stercoralis (Ma OR = 1.73; Mu OR = 1.78) and was more prevalent in adults (Ma OR = 2.59; Mu OR = 2.69).
CONCLUSION
We found that coinfection between S. stercoralis and T. cruzi is not more frequent than chance in endemic areas. However, the high prevalence for both parasites, raises the need for an integrated strategy for the control of STH and Chagas disease.
Topics: Adolescent; Adult; Animals; Argentina; Chagas Disease; Child; Child, Preschool; Coinfection; Cross-Sectional Studies; Emigrants and Immigrants; Endemic Diseases; Feces; Female; Humans; Male; Middle Aged; Prevalence; Strongyloides stercoralis; Strongyloidiasis; Trypanosoma cruzi; Young Adult
PubMed: 35120117
DOI: 10.1371/journal.pntd.0010179 -
Infection Dec 2015Strongyloides stercoralis may lead to overwhelming infestation [Strongyloides hyperinfection syndrome (SHS)]. We aimed at describing a case series of patients admitted... (Review)
Review
BACKGROUND
Strongyloides stercoralis may lead to overwhelming infestation [Strongyloides hyperinfection syndrome (SHS)]. We aimed at describing a case series of patients admitted in intensive care unit (ICU) with SHS and report a literature review of such cases.
PATIENTS AND METHODS
Retrospective multicenter study of 11 patients admitted to the ICU of tertiary hospitals with SHS between 2000 and 2013. Literature review with Pubmed retrieved 122 cases. Logistic regression analysis was performed to identify predictive factors of ICU mortality and shock occurrence.
RESULTS
133 patients [median age 53 (39, 64), 72.2 % males] were included. Underlying immunosuppression was present in 127 patients, mostly long-term corticosteroid treatment in 111 (83.5 %) patients. Fever (80.8 %), respiratory (88.6 %), and gastrointestinal (71.2 %) symptoms were common clinical manifestations. Shock occurred in 75 (57.3 %) patients and mechanical ventilation was required in 89 (67.9 %) patients. Hypereosinophilia and a concomitant bacterial infection were observed in 34 (34.3 %) and 51 (38.4 %) patients, respectively. The in-ICU mortality rate was 60.3 %. Predictive factors of ICU mortality were shock occurrence [Odds ratio (OR) 18.1, 95 % confidence interval (95 % CI) 3.03-107.6, p < 0.01] and mechanical ventilation (OR 28.1, 95 % CI 3.6-217, p < 0.01). Hypereosinophilia (OR 0.21, 95 % CI 0.06-0.7, p = 0.01) and a concomitant bacterial infection (OR 4.68, 95 % CI 1.3-16.8, p = 0.02) were independent predictors of shock occurrence.
CONCLUSION
SHS remains associated with a poor outcome, especially when associated with shock and mechanical ventilation. Deterioration to shock is often related to concomitant bacterial infection. The poor outcome of established SHS pleads for a large application of antiparasitic primary prophylaxis in at-risk patients.
Topics: Adult; Animals; Female; Humans; Male; Middle Aged; Retrospective Studies; Risk Factors; Shock, Septic; Strongyloides stercoralis; Strongyloidiasis; Survival Analysis
PubMed: 26008854
DOI: 10.1007/s15010-015-0799-1 -
International Journal For Parasitology Dec 2021Strongyloidiasis represents a major medical and veterinary helminthic disease. Human infection is caused by Strongyloides stercoralis, Strongyloides fuelleborni... (Review)
Review
Strongyloidiasis represents a major medical and veterinary helminthic disease. Human infection is caused by Strongyloides stercoralis, Strongyloides fuelleborni fuelleborni and Strongyloides fuelleborni kellyi, with S.stercoralis accounting for the majority of cases. Strongyloides f. fuelleborni likely represents a zoonosis acquired from non-human primates (NHPs), while no animal reservoir for S. f. kellyi infection has been found. Whether S. stercoralis represents a zoonosis acquired from dogs and cats remains unanswered. Over the past two decades various tools have been applied to genotype Strongyloides spp. The most commonly sequenced markers have been the hyper-variable regions I and IV of the 18S rRNA gene and selected portions of the cytochrome c oxidase subunit I gene. These markers have been sequenced and compared in Strongyloides from multiple hosts and geographical regions. More recently, a machine learning algorithm multi-locus sequence typing approach has been applied using these markers, while others have applied whole genome sequencing. Genotyping of Strongyloides from dogs, cats, NHPs and humans has identified that S. stercoralis likely originated in dogs and adapted to human hosts. It has also been demonstrated that S. stercoralis is distinct from S. f. fuelleborni and S. f. kellyi. Two distinct genetic clades of S. stercoralis exist, one restricted to dogs and another infecting humans, NHPs, dogs and cats. Genotyping of S. f. fuelleborni has identified two separate clades, one associated with African isolates and another Indochinese peninsular clade. This review summarises the history and development of genotyping tools for Strongyloides spp. It describes the findings of major studies to date in the context of the epidemiology and evolutionary biology of these helminths, with a specific focus on human-infecting species.
Topics: Animals; Cat Diseases; Cats; Dog Diseases; Dogs; Feces; Genetics, Population; Genotype; Multilocus Sequence Typing; Phylogeny; Primates; Public Health; Strongyloides stercoralis; Strongyloidiasis; Zoonoses
PubMed: 34757088
DOI: 10.1016/j.ijpara.2021.10.001 -
The Journal of Infectious Diseases May 2022Helminth infections may modulate the inflammatory response to Mycobacterium tuberculosis and influence disease presentation and outcome. Strongyloides stercoralis is...
BACKGROUND
Helminth infections may modulate the inflammatory response to Mycobacterium tuberculosis and influence disease presentation and outcome. Strongyloides stercoralis is common among populations with high tuberculosis prevalence. Our aim was to determine whether S. stercoralis coinfection influenced clinical presentation, cerebrospinal fluid (CSF) inflammation, and outcome from tuberculous meningitis (TBM).
METHODS
From June 2017 to December 2019, 668 Vietnamese adults with TBM, enrolled in the ACT HIV or LAST ACT trials (NCT03092817 and NCT03100786), underwent pretreatment S. stercoralis testing by serology, stool microscopy, and/or stool polymerase chain reaction. Comparisons of pretreatment TBM severity, CSF inflammation (including cytokines), and 3-month clinical end points were performed in groups with or without active S. stercoralis infection.
RESULTS
Overall, 9.4% participants (63 of 668) tested positive for S. stercoralis. Active S. stercoralis infection was significantly associated with reduced pretreatment CSF neutrophil counts (median [interquartile range], 3/μL [0-25/μL] vs 14 /μL [1-83/μL]; P = .04), and with reduced CSF interferon ɣ, interleukin 2, and tumor necrosis factor α concentrations (11.4 vs 56.0 pg/mL [P = .01], 33.1 vs 54.5 pg/mL [P = .03], and 4.5 vs 11.9 pg/mL [P = .02], respectively), compared with uninfected participants. Neurological complications by 3 months were significantly reduced in participants with active S. stercoralis infection compared with uninfected participants (3.8% [1 of 26] vs 30.0% [33 of 110], respectively; P = .01).
CONCLUSIONS
S. stercoralis coinfection may modulate the intracerebral inflammatory response to M. tuberculosis and improve TBM clinical outcomes.
Topics: Adult; Animals; Coinfection; Humans; Inflammation; Mycobacterium tuberculosis; Strongyloides stercoralis; Tuberculosis, Meningeal
PubMed: 33104201
DOI: 10.1093/infdis/jiaa672 -
Tropical Medicine & International... Mar 2023Strongyloidiasis is a nematode infection caused by Strongyloides stercoralis. Previous studies have addressed the possibility of the parasite to establish a complex... (Observational Study)
Observational Study
OBJECTIVES
Strongyloidiasis is a nematode infection caused by Strongyloides stercoralis. Previous studies have addressed the possibility of the parasite to establish a complex relationship with the host that could affect the risk of developing diabetes mellitus or modify its presentation. This study aims to evaluate the potential impact of strongyloidiasis in diabetes mellitus and other metabolic diseases.
METHODS
Case-control observational retrospective study that included 95 S. stercoralis-infected patients and 83 non-infected individuals. Epidemiological and clinical variables were retrieved from medical records, and a statistical analysis was carried out to explore any association between strongyloidiasis and diabetes mellitus and other metabolic diseases.
RESULTS
Most of the patients were men (99, 55.60%) with a mean age of 42.53 ± SD 14 years. Twelve (6.70%) patients were diabetic; 30 (16.90%) presented arterial hypertension; 28 (15.70%) had dyslipidaemia; and 10 (5.60%) had thyroid pathology. When comparing patients with strongyloidiasis and uninfected patients, no differences were found regarding diabetes mellitus or other metabolic diseases.
CONCLUSIONS
The results obtained in the present study do not confirm any type of association between strongyloidiasis and diabetes mellitus or other metabolic diseases.
Topics: Adult; Animals; Female; Humans; Male; Case-Control Studies; Diabetes Mellitus; Retrospective Studies; Strongyloides stercoralis; Strongyloidiasis
PubMed: 36651761
DOI: 10.1111/tmi.13853 -
Acta Parasitologica Jun 2022Strongyloidiasis is mainly prevalent in developing countries with poor economic and sanitary conditions. The clinical manifestations of Strongyloides stercoralis...
PURPOSE
Strongyloidiasis is mainly prevalent in developing countries with poor economic and sanitary conditions. The clinical manifestations of Strongyloides stercoralis infection are complex and diverse, lacking specificity, which can easily lead to misdiagnosis and delayed treatment.
METHODS
An elderly male patient, repeated cough and expectoration for 4 years, with exacerbation and dyspnea for 10 days, was admitted to hospital. Sputum culture and smear were taken for examination. Nematode larvae were found under the microscope. Nematodes were also found in feces.
RESULTS
Upon confirmation, the patient was diagnosed with a pulmonary infection caused by Strongyloides stercoralis. After treatment with albendazole, the symptoms improved, and the patient was discharged.
CONCLUSION
In this case report, combination of microscopic examination of sputum and alveolar lavage fluid and CT scan were used to quickly identify the cause of the patient, it provides a diagnostic basis and method for clinical treatment.
Topics: Aged; Animals; Feces; Humans; Male; Pneumonia; Strongyloides stercoralis; Strongyloidiasis
PubMed: 35175460
DOI: 10.1007/s11686-022-00527-3 -
Ineffectiveness of TF-Test® and Coproplus® Methods in Strongyloides stercoralis Infection Diagnosis.Acta Parasitologica Jun 2022S. stercoralis diagnosis is currently performed by parasitological methods, mainly by Baermann-Moraes (BM), although Agar Plate Culture (APC) presents a higher...
PURPOSE
S. stercoralis diagnosis is currently performed by parasitological methods, mainly by Baermann-Moraes (BM), although Agar Plate Culture (APC) presents a higher sensitivity. New techniques, such as TF-Test® and Coproplus® have been suggested as more practical alternatives. The aim of this study was to evaluate the sensitivity of TF-Test® and Coproplus®, compared with APC, BM and Spontaneous Sedimentation (SS) methods.
METHODS
One-hundred and forty male alcoholic patients, who provided three stools samples collected on alternate days, were included in this study. The most frequently found parasite was S. stercoralis, 20% (28/140), and the most sensitive method was APC, 96.4% (27/28), followed by BM, 89.3% (25/28) and SS, 57.1% (16/28). TF-Test® and Coproplus® presented a sensitivity of 46.4 (13/28) and 39.3% (11/28), respectively. In samples with a parasitic load of 1-10 larvae/g of feces, which occurred in 39.3% (11/28) of the infected patients, both the TF-Test® and Coproplus® methods demonstrated sensitivities of 18.2% (2/11), while APC and BM methods reached a sensitivity of 100% (11/11) (p < 0.05). For other intestinal helminth infections, TF-Test® and Coproplus® sensitivities were 22.2 (4/18) and 11.1% (2/18), respectively, this being lower than the SS, 66.7% (12/18) (p < 0.05). On the other hand, for protozoa infection diagnosis, TF-Test® and Coproplus® presented the highest sensitivities, 62.2 (46/74) and 43.2% (32/74), respectively.
CONCLUSION
TF-Test® and Coproplus® methods presented the lowest sensitivities for S. stercoralis and other helminth infection diagnosis; therefore, they can be indicated for use in parasitological diagnosis, only when associated with other more effective methods of helminth identification.
Topics: Alcoholism; Animals; Feces; Helminthiasis; Humans; Intestinal Diseases, Parasitic; Male; Strongyloides stercoralis; Strongyloidiasis
PubMed: 35048284
DOI: 10.1007/s11686-021-00484-3 -
Infectious Disease Clinics of North... Sep 2018Strongyloides stercoralis is a threadworm parasite with the unique capacity to complete its entire life cycle in a human host. Although asymptomatic in normal hosts, S... (Review)
Review
Strongyloides stercoralis is a threadworm parasite with the unique capacity to complete its entire life cycle in a human host. Although asymptomatic in normal hosts, S stercoralis infection in solid organ transplant recipients is often severe, disseminated, and fatal. Risk factors for disease acquisition include travel to endemic regions. Antihelminth therapy should be instituted before transplantation for optimal clinical outcomes. Herein we review the epidemiology, biology, immune response, and diagnostic and screening strategies, as well as treatment modalities for S stercoralis in the solid organ transplant population.
Topics: Animals; Anthelmintics; Humans; Organ Transplantation; Strongyloides stercoralis; Strongyloidiasis; Tissue Donors; Transplant Recipients
PubMed: 30146034
DOI: 10.1016/j.idc.2018.04.012 -
Epidemiology and Infection Nov 2017Strongyloidiasis is a neglected tropical disease caused by the roundworm Strongyloides stercoralis affecting 30-100 million people worldwide. Many Southeast-Asian...
Strongyloidiasis is a neglected tropical disease caused by the roundworm Strongyloides stercoralis affecting 30-100 million people worldwide. Many Southeast-Asian countries report a high prevalence of S. stercoralis infection, but there are little data from Vietnam. Here, we evaluated the seroprevalence of S. stercoralis related to geography, sex and age in Vietnam through serological testing of anonymized sera. Sera (n = 1710, 1340 adults and 270 children) from an anonymized age-stratified serum bank from four regions in Vietnam between 2012 and 2013 were tested using a commercial Strongyloides ratti immunoglobulin G ELISA. Seroreactivity was found in 29·1% (390/1340) of adults and 5·5% (15/270) of children. Male adults were more frequently seroreactive than females (33·3% vs. 24·9%, P = 0·001). The rural central highlands had the highest seroprevalence (42·4% of adults). Seroreactivity in the other regions was 29·9% (Hue) and 26·0% and 18·2% in the large urban centres of Hanoi and Ho Chi Minh City, respectively. We conclude that seroprevalence of S. stercoralis was high in the Vietnamese adult population, especially in rural areas.
Topics: Adolescent; Adult; Age Factors; Aged; Animals; Female; Humans; Male; Middle Aged; Rural Population; Seroepidemiologic Studies; Sex Factors; Strongyloides stercoralis; Strongyloidiasis; Vietnam
PubMed: 29039287
DOI: 10.1017/S0950268817002333 -
International Health Dec 2014Strongyloides stercoralis is one of the common parasites in tropical areas. It can result in severe clinical syndromes, hyperinfection syndrome or disseminated... (Review)
Review
Strongyloides stercoralis is one of the common parasites in tropical areas. It can result in severe clinical syndromes, hyperinfection syndrome or disseminated strongyloidiasis in immunocompromised patients. The treatment of strongyloidiasis is a challenge for clinicians in clinical practice. Failure of treatment is due to autoinfection caused by the parasite life cycle and impairment of host immunity. Ivermectin currently is the treatment of choice. When compared with thiabendazole, it has shown a similar efficacy with better tolerability. However, there is neither consensus in duration of treatment nor in repetition of doses. The keys for management of this tough parasite include proper evaluation and prevention. Stool examination with high sensitivity techniques such as Baermann technique, filter-paper culture and agar-plate culture and specific IgG serology should be used in evaluation for 1 to 2 years. Screening, both stool examination and serology, before patients have immunosuppressive treatment is needed to prevent the severe form of strongyloidiasis.
Topics: Animals; Anthelmintics; Antiparasitic Agents; Chronic Disease; Disease Management; Humans; Ivermectin; Strongyloides stercoralis; Strongyloidiasis; Thiabendazole
PubMed: 25173343
DOI: 10.1093/inthealth/ihu058