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The American Journal of Tropical... Jun 2019, a worldwide-distributed soil-transmitted helminth, causes chronic infection which may be life threatening. Limitations of diagnostic tests and nonspecificity of... (Meta-Analysis)
Meta-Analysis
, a worldwide-distributed soil-transmitted helminth, causes chronic infection which may be life threatening. Limitations of diagnostic tests and nonspecificity of symptoms have hampered the estimation of the global morbidity due to strongyloidiasis. This work aimed at assessing -associated morbidity through a systematic review and meta-analysis of the available literature. MEDLINE, Embase, CENTRAL, LILACS, and trial registries (WHO portal) were searched. The study quality was assessed using the Newcastle-Ottawa scale. Odds ratios (ORs) of the association between symptoms and infection status and frequency of infection-associated symptoms were calculated. Six articles from five countries, including 6,014 individuals, were included in the meta-analysis-three were of low quality, one of high quality, and two of very high quality. Abdominal pain (OR 1.74 [CI 1.07-2.94]), diarrhea (OR 1.66 [CI 1.09-2.55]), and urticaria (OR 1.73 [CI 1.22-2.44]) were associated with infection. In 17 eligible studies, these symptoms were reported by a large proportion of the individuals with strongyloidiasis-abdominal pain by 53.1% individuals, diarrhea by 41.6%, and urticaria by 27.8%. After removing the low-quality studies, urticaria remained the only symptom significantly associated with infection (OR 1.42 [CI 1.24-1.61]). Limitations of evidence included the low number and quality of studies. Our findings especially highlight the appalling knowledge gap about clinical manifestations of this common yet neglected soil-transmitted helminthiasis. Further studies focusing on morbidity and risk factors for dissemination and mortality due to strongyloidiasis are absolutely needed to quantify the burden of infection and inform public health policies.
Topics: Abdominal Pain; Africa; Animals; Asia; Australia; Diarrhea; Female; Humans; Japan; Male; Odds Ratio; Risk Factors; Soil; Strongyloides stercoralis; Strongyloidiasis; Urticaria
PubMed: 30963990
DOI: 10.4269/ajtmh.18-0895 -
PLoS Neglected Tropical Diseases Jul 2021Viral and parasitic coinfections are known to lead to both enhanced disease progression and altered disease states. HTLV-1 and Strongyloides stercoralis are co-endemic...
Viral and parasitic coinfections are known to lead to both enhanced disease progression and altered disease states. HTLV-1 and Strongyloides stercoralis are co-endemic throughout much of their worldwide ranges resulting in a significant incidence of coinfection. Independently, HTLV-1 induces a Th1 response and S. stercoralis infection induces a Th2 response. However, coinfection with the two pathogens has been associated with the development of S. stercoralis hyperinfection and an alteration of the Th1/Th2 balance. In this study, a model of HTLV-1 and S. stercoralis coinfection in CD34+ umbilical cord blood hematopoietic stem cell engrafted humanized mice was established. An increased level of mortality was observed in the HTLV-1 and coinfected animals when compared to the S. stercoralis infected group. The mortality was not correlated with proviral loads or total viral RNA. Analysis of cytokine profiles showed a distinct shift towards Th1 responses in HTLV-1 infected animals, a shift towards Th2 cytokines in S. stercoralis infected animals and elevated TNF-α responses in coinfected animals. HTLV-1 infected and coinfection groups showed a significant, yet non-clonal expansion of the CD4+CD25+ T-cell population. Numbers of worms in the coinfection group did not differ from those of the S. stercoralis infected group and no autoinfective larvae were found. However, infective larvae recovered from the coinfection group showed an enhancement in growth, as was seen in mice with S. stercoralis hyperinfection caused by treatment with steroids. Humanized mice coinfected with S. stercoralis and HTLV-1 demonstrate features associated with human infection with these pathogens and provide a unique opportunity to study the interaction between these two infections in vivo in the context of human immune cells.
Topics: Animals; Antigens, CD34; Cell Line; Coinfection; Cytokines; Fetal Blood; HTLV-I Infections; Hematopoietic Stem Cells; Human T-lymphotropic virus 1; Larva; Mice; Mice, Inbred C57BL; Mice, Transgenic; Strongyloides stercoralis; Strongyloidiasis
PubMed: 34314415
DOI: 10.1371/journal.pntd.0009559 -
International Journal of Environmental... May 2016Strongyloidiasis is a disease caused by soil transmitted helminths of the Strongyloides genus. Currently, it is predominately described as a neglected tropical disease.... (Review)
Review
Strongyloidiasis is a disease caused by soil transmitted helminths of the Strongyloides genus. Currently, it is predominately described as a neglected tropical disease. However, this description is misleading as it focuses on the geographical location of the disease and not the primary consideration, which is the socioeconomic conditions and poor infrastructure found within endemic regions. This classification may result in misdiagnosis and mistreatment by physicians, but more importantly, it influences how the disease is fundamentally viewed. Strongyloidiasis must be first and foremost considered as a disease of disadvantage, to ensure the correct strategies and control measures are used to prevent infection. Changing how strongyloidiasis is perceived from a geographic and clinical issue to an environmental health issue represents the first step in identifying appropriate long term control measures. This includes emphasis on environmental health controls, such as better infrastructure, sanitation and living conditions. This review explores the global prevalence of strongyloidiasis in relation to its presence in subtropical, tropical and temperate climate zones with mild and cold winters, but also explores the corresponding socioeconomic conditions of these regions. The evidence shows that strongyloidiasis is primarily determined by the socioeconomic status of the communities rather than geographic or climatic conditions. It demonstrates that strongyloidiasis should no longer be referred to as a "tropical" disease but rather a disease of disadvantage. This philosophical shift will promote the development of correct control strategies for preventing this disease of disadvantage.
Topics: Animals; Humans; Prevalence; Social Class; Strongyloides stercoralis; Strongyloidiasis
PubMed: 27213420
DOI: 10.3390/ijerph13050517 -
Inflammatory Bowel Diseases Mar 2022
Topics: Animals; Colitis; Colitis, Ulcerative; Humans; Strongyloides stercoralis
PubMed: 34788803
DOI: 10.1093/ibd/izab261 -
Advances in Parasitology 2022Strongyloidiasis is the infection caused by soil-transmitted nematodes of Strongyloides species, infecting humans and some animals. Strongyloides stercoralis is the... (Review)
Review
Strongyloidiasis is the infection caused by soil-transmitted nematodes of Strongyloides species, infecting humans and some animals. Strongyloides stercoralis is the species with most clinical and epidemiological relevance in humans and dogs, due to its high prevalence and its capacity of inducing a life-threatening hyperinfection. Diagnosis of strongyloidiasis is challenging, due to the absence of a single reference standard test with high sensitivity and specificity, which also hampers the estimation of the accuracy of other diagnostic tests. In this chapter, we review the deployment and performance of the parasitological, immunological, molecular tests for the diagnosis of strongyloidiasis in humans and in dogs. Further, we comment the available evidence from genotyping studies that have addressed the zoonotic potential of S. stercoralis. Finally, we discuss the use of different diagnostic methods in relation to the purpose (i.e., screening, individual diagnosis, inclusion in a clinical trial) and the setting (endemic/non-endemic areas) and report the accuracy figures reported by systematic reviews on either parasitological, serological or molecular techniques published in literature.
Topics: Animals; Dogs; Humans; Pets; Prevalence; Strongyloides stercoralis; Strongyloidiasis
PubMed: 36088083
DOI: 10.1016/bs.apar.2022.07.001 -
Acta Tropica Jul 2016The soil-transmitted nematode, Strongyloides stercoralis is one of the most-neglected of all neglected tropical diseases. It is globally distributed, favouring the... (Review)
Review
The soil-transmitted nematode, Strongyloides stercoralis is one of the most-neglected of all neglected tropical diseases. It is globally distributed, favouring the humid, wet climates of the tropics and subtropics. Inadequate sanitary conditions promote the spread of S. stercoralis infection. In South-East Asia, many countries provide the ideal ecological and economic setting for high S. stercoralis infection rates. Yet, in most of these countries, little is known about the actual prevalence and distribution of S. stercoralis. One reason for this lack of knowledge pertains to the time- and resource-intensive diagnostic methods used to detect S. stercoralis infection. The Koga Agar culture method and the Baermann method are considered to be the best coprological diagnostic methods for field settings today. Both detect the parasite with high sensitivity. This sensitivity can be increased further by examining stool samples for several consecutive days, thereby increasing the chances of detecting low-intensity chronic infections. Diagnostic challenges, however, lead to the omission of S. stercoralis in studies of soil-transmitted helminths and few studies focus on S. stercoralis, specifically. These factors lead to an underreporting of the nematode's prevalence, not only in South-East Asia but worldwide. We have reviewed the scientific literature of the last 25 years and estimated country-wide prevalence rates for South-East Asia. We aim to summarise what is known today about the prevalence of S. stercoralis in South-East Asia, as well as to ascertain the risk factors and diagnostic methods most commonly applied.
Topics: Animals; Asia, Southeastern; Feces; Prevalence; Risk Factors; Soil; Strongyloides stercoralis; Strongyloidiasis; Tropical Medicine
PubMed: 25795619
DOI: 10.1016/j.actatropica.2015.03.008 -
Immunology Letters Dec 2016Strongyloides stercoralis is a helminth parasite that can infect millions of people worldwide, particularly in tropical, subtropical and temperate regions with poor... (Review)
Review
Strongyloides stercoralis is a helminth parasite that can infect millions of people worldwide, particularly in tropical, subtropical and temperate regions with poor sanitation. Several aspects of epidemiology, biology and host-parasite interactions of S. stercoralis have been studied, and substantial knowledge has been acquired; however, very few studies on immunotherapeutic control strategies to prevent infection and disease in humans have been conducted. Therefore, this article reviews the current progress and targets toward vaccine and passive immunization approaches for Strongyloides spp.
Topics: Animals; Host-Parasite Interactions; Humans; Immunization, Passive; Strongyloides stercoralis; Strongyloidiasis; Vaccines
PubMed: 27769813
DOI: 10.1016/j.imlet.2016.10.005 -
Clinical Microbiology and Infection :... Nov 2021The clinical and laboratory characterization of Strongyloides stercoralis infection at diagnosis and after treatment is still poorly defined. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The clinical and laboratory characterization of Strongyloides stercoralis infection at diagnosis and after treatment is still poorly defined.
OBJECTIVES
The primary objective was to describe the pattern and frequency of clinical and laboratory characteristics associated with S. stercoralis infection. The secondary objectives were (a) comparison of characteristics reported in endemic versus non-endemic areas; and (b) the evaluation of the resolution of identified characteristics after treatment.
METHODS
We searched PubMed, EMBASE, LILACS and CENTRAL up to May 2021. Eligible studies were randomized controlled trials (RCTs) for the treatment of S. stercoralis infection and prospective observational studies reporting data on symptoms caused by strongyloidiasis in individuals diagnosed with a highly specific test. Quality assessment was performed to assess the risk of bias. Demographic and clinical data were summarized using descriptive statistics. Meta-analysis was done by pooling the proportion of participants with symptoms with random effects model.
RESULTS
Twenty studies were included: nine RCTs and 13 observational studies. Overall, symptoms were reported in 50.4% cases (95% CI 47.6-53.1), and were more often reported in non-endemic (58.6%, 95% CI 55.0-62.2) than in endemic (35.7%, 95% CI 31.4-39.9) areas. The removal of an article of lower quality did not impact on figures. Frequency of symptoms tended to reduce after treatment. Three studies reported the proportion of participants with eosinophilia before and after treatment: 76.9% of participants (95% CI 73.4-80.4) had eosinophilia at diagnosis, reducing to 27.4% (95% CI 24.0-30.7) after treatment.
CONCLUSIONS
About half of infected people complain at least of one symptom and almost 70% have eosinophilia. The frequency of symptoms and eosinophilia decreased after treatment, though the association with cure is not clearly defined. Providing relief from symptoms and eosinophilia is another reason, in addition to prevention of disseminated disease, for promoting screening and treatment of individuals with strongyloidiasis.
Topics: Animals; Eosinophilia; Humans; Observational Studies as Topic; Randomized Controlled Trials as Topic; Strongyloides stercoralis; Strongyloidiasis
PubMed: 34325063
DOI: 10.1016/j.cmi.2021.07.016 -
Zhongguo Xue Xi Chong Bing Fang Zhi Za... Apr 2023is an opportunistic pathogenic parasite that can cause severe strongyloidiasis and even death among immunocompromised individuals. Previous clinical studies have... (Review)
Review
is an opportunistic pathogenic parasite that can cause severe strongyloidiasis and even death among immunocompromised individuals. Previous clinical studies have reported cases co-infected with and other pathogens, such as parasites, viruses, bacteria and fungi. This review summarizes strongyloidiasis patients co-infected with pathogens, and analyzes the impact of co-infection on strongyloidiasis, so as to provide insights into the reduction of the morbidity and mortality of disorders associated with infections.
Topics: Animals; Humans; Strongyloides stercoralis; Strongyloidiasis; Coinfection; Immunocompromised Host
PubMed: 37253572
DOI: 10.16250/j.32.1374.2022156 -
PloS One 2022Several studies have demonstrated that helminth infections provide a degree of protection against Type 2 diabetes mellitus (T2DM). However, the relationship between...
Association of Strongyloides stercoralis infection and type 2 diabetes mellitus in northeastern Thailand: Impact on diabetic complication-related renal biochemical parameters.
BACKGROUND
Several studies have demonstrated that helminth infections provide a degree of protection against Type 2 diabetes mellitus (T2DM). However, the relationship between Strongyloides stercoralis infection and T2DM has scarcely been investigated and the protective effect of infection against development of diabetic complications is unclear. In this study, we aimed to investigate the relationship between S. stercoralis infection and T2DM in a rural area of Khon Kaen Province, Thailand. The impact of S. stercoralis infection on diabetic complication-related kidney function biochemical parameters and body-mass index (BMI) was also assessed.
METHODOLOGY
Using a cross-sectional study design, S. stercoralis infection and T2DM assessments were conducted between October 2020 and May 2021. Associations between S. stercoralis infection, T2DM, and socioeconomic factors were analyzed using multivariable logistic regression analyses. Diabetic complication-related biochemical parameters relating largely to kidney function (estimated glomerular filtration rate (eGFR), urine albumin-to-creatinine ratio (UACR), serum creatinine, uric acid, alanine transaminase (ALT), and low-density lipoprotein cholesterol (LDL-C)) and BMI of participants with and without T2DM were compared between groups with or without S. stercoralis infection.
RESULTS
One hundred and seven out of 704 individuals (15.20%) were positive for S. stercoralis, and 283 people were diagnosed with T2DM. Of those with T2DM, 11.31% (32/283) were infected with S. stercoralis and of those without T2DM, 17.82% (75/421) were infected with S. stercoralis. Multivariate analysis revealed that T2DM was inversely correlated with S. stercoralis infection (Adjusted OR = 0.49; 95% CI: 0.30, 0.78; p = 0.003), while male, increasing age, lower education level, and alcohol intake were positively associated with infection. Those infected with S. stercoralis had lower eGFR levels and higher ALT and UACR levels than those in the uninfected group.
CONCLUSION
This finding indicates that S. stercoralis infection was inversely associated with T2DM in northeastern Thailand, but participants infected with S. stercoralis had lower eGFR levels and higher ALT and UACR levels. Infection with S. stercoralis might lead to worse complication-related renal biochemical parameters.
Topics: Animals; Cross-Sectional Studies; Diabetes Complications; Diabetes Mellitus, Type 2; Humans; Kidney; Male; Strongyloides stercoralis; Strongyloidiasis; Thailand
PubMed: 35639713
DOI: 10.1371/journal.pone.0269080