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Ligero-López J, Corbacho-Loarte MD, Antón-Berenguer V, Merino-Fernández FJ, Rubio-Muñoz JM, Valle-Borrego B. A 14-year review (2007-2020) of helminthiasis epidemiology in a hospital in Southern Madrid, Spain. Eur J Clin Microbiol Infect Dis 2024; 43:659-671. [PMID: 38277032 DOI: 10.1007/s10096-024-04746-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 01/04/2024] [Indexed: 01/27/2024]
Abstract
PURPOSE Vast majority of helminth diseases remain neglected tropical diseases (NTDs), causing significant morbidity. The widespread and periodic distribution of antiparasitic drugs, remains the cornerstone for controlling these diseases. In Spain, most helminthiasis cases are imported, and suspicion and diagnosis have become increasingly important. Our primary objective is to present the epidemiological landscape of helminthiasis diagnoses within our facility, while also detailing the demographic characteristics of the affected population. METHODS A retrospective study was conducted at the Hospital Universitario Severo Ochoa (HUSO) from January 1, 2007, to December 31, 2020, encompassing all diagnosed cases of helminthiasis during this period. Comprehensive epidemiological, clinical, and microbiological data were gathered for all diagnosed patients. The study population comprised patients receiving treatment at the HUSO, as well as those receiving treatment at the Leganés and Fuenlabrada Primary Care Units. Subsequently, descriptive and comparative statistics were performed, comparing Spanish and foreign patients. RESULTS During this period, a total of 952 patients were diagnosed with some form of helminthiasis. Among them, 495 were Spanish, and 457 were foreign. The total number of helminths identified, including patients with multiple infections, was 1,010. Significant differences were observed between Africans and Americans in terms of age distribution, with a higher prevalence among Africans in the 0-15 age range and among Americans in the 31-60 age range. Variations were noted in the distribution of helminths, with S. stercoralis significantly affecting Americans. For Spanish patients, the presence of Trichuris trichiura and S. stercoralis was significantly associated with eosinophilia, whereas among foreign patients, it was associated with Trichuris trichiura, Ascaris lumbricoides among others. Regarding symptoms, skin manifestations were more frequent among Spanish, while digestive were more common among foreigners. CONCLUSIONS This study offers crucial epidemiological insights into helminth infections observed over time in a Madrid hospital. Although the prevalence of helminth infections has been decreasing, there is still a need for screening and diagnosing foreign patients.
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Affiliation(s)
- Jorge Ligero-López
- Microbiology and Parasitology Department, Hospital Universitario Severo Ochoa, Madrid, Spain.
- Clinical Microbiology and Parasitology Department, Hospital Clínico Universitario Lozano Blesa, C. de San Juan Bosco, 15, 50009, Zaragoza, Spain.
| | - María Dolores Corbacho-Loarte
- National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain
| | - Víctor Antón-Berenguer
- Microbiology and Parasitology Department, Hospital Universitario Severo Ochoa, Madrid, Spain
| | - Francisco Jesús Merino-Fernández
- Microbiology and Parasitology Department, Hospital Universitario Severo Ochoa, Madrid, Spain
- Faculty of Medicine, Alfonso X el Sabio University, Madrid, Spain
| | - José Miguel Rubio-Muñoz
- Malaria & Parasitic Emerging Diseases Laboratory, National Microbiology Center, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
- Centro de Investigación Biomédica En Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Beatriz Valle-Borrego
- Faculty of Medicine, Alfonso X el Sabio University, Madrid, Spain
- Internal Medicine, Emergency Department, Hospital Universitario Severo Ochoa, Madrid, Spain
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Requena-Méndez A, Roos E, van der Werff SD, Wyss K, Davidsson L, Naucler P, Färnert A, Asgeirsson H. Clinical presentation and diagnosis of imported strongyloidiasis at a tertiary hospital, Stockholm, Sweden. Travel Med Infect Dis 2023; 56:102666. [PMID: 37977232 DOI: 10.1016/j.tmaid.2023.102666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/18/2023] [Accepted: 11/06/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Since Strongyloides can persist in its host for decades, and cause life threatening infections data on prevalence, the burden and risk factors for infection is crucial in migrant populations. METHODS In this observational retrospective cohort study, we describe the epidemiological, clinical, and microbiological characteristics of imported strongyloidiasis diagnosed at the Karolinska University Hospital, Stockholm, Sweden, during 2010-2021. RESULTS We identified 98 individuals with strongyloidiasis, 89 (90.8%) born in endemic and 9 (9.2%) in non-endemic countries. Sub-Saharan Africa was the most common origin among the group born in endemic countries (62, 69.7%), (p < 0.005). There were 22 individuals with an underlying immunosuppressive condition. Gastrointestinal symptoms (53/98, 54.1%) were the symptoms most frequently described, and were more frequent in adults (57.0%) vs children (0%) (p = 0.013). Eosinophilia was detected in 74 (75.5%), being more frequent in the endemic-borne group (79.8% vs 33.3%, p = 0.002). Eight persons developed complications of strongyloidiasis because of either hyperinfection or disseminated disease. No people living with HIV with CD4 <500/mm3 (n = 6) developed severe strongyloidiasis. CONCLUSION A limited number of strongyloidiasis cases was identified, with few complicated cases in immunosuppressed patients. Further studies focusing on identifying and exploring the risk of complicated strongyloidiasis in immunosuppressed patients are needed.
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Affiliation(s)
- Ana Requena-Méndez
- Division of Infectious Diseases, Department of Medicine Solna Karolinska Institutet, Stockholm, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden; Barcelona Institute for Global Health, (ISGlobal, University of Barcelona), Spain; CIBERINFEC, ISCIII - CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Madrid, Spain.
| | - Emilia Roos
- Division of Infectious Diseases, Department of Medicine Solna Karolinska Institutet, Stockholm, Sweden
| | - Suzanne D van der Werff
- Division of Infectious Diseases, Department of Medicine Solna Karolinska Institutet, Stockholm, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Katja Wyss
- Division of Infectious Diseases, Department of Medicine Solna Karolinska Institutet, Stockholm, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | | | - Pontus Naucler
- Division of Infectious Diseases, Department of Medicine Solna Karolinska Institutet, Stockholm, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Anna Färnert
- Division of Infectious Diseases, Department of Medicine Solna Karolinska Institutet, Stockholm, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Hilmir Asgeirsson
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden; Division of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
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Time of incubation of agar-plate culture for the diagnosis of Strongyloides stercoralis infection. Acta Trop 2022; 226:106220. [PMID: 34757044 DOI: 10.1016/j.actatropica.2021.106220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 09/20/2021] [Accepted: 10/22/2021] [Indexed: 11/23/2022]
Abstract
PURPOSE Agar-plate culture (APC) remains the most sensitive parasitological technique for S. stercoralis diagnosis. Although it was first described three decades ago, the time of incubation of the plates is neither a commonly described feature nor usually standardized. The aim of the study was to analyze the required time to detect S. stercoralis larvae in APC. METHODS A prospective laboratory-based study including all patients with at least one positive APC was performed. The plates were incubated at room temperature for 7 days. Clinical, analytical and parasitological features including results of the direct visualization of the stool (DV) after formalin-ether concentration and time-to-detection (TTD) of the larvae in APC were recorded. RESULTS A total of 141 samples from 75 patients had a positive APC. In 49 of them (65.3%) three or more stool samples were processed for direct visualization (DV) and APC. Of these 49 patients, 8 (16.3%) were also diagnosed with DV and 41 (83.7%) were diagnosed only with APC. In 38 samples from 23 (30.7%) patients, the TTD was below 2 days, while in 27 samples from 13 (17.3%) patients, the larvae were detected on the 6th and 7th day. CONCLUSION Direct visualization failed to detect S. stercoralis in most of the patients that were diagnosed with APC. Incubation periods below 2 and 5 days would miss an important percentage of infections. At least 7 days of incubation of the APC are required to detect presumably low-burden chronic infections in non-endemic countries.
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Lucas Dato A, Pacheco-Tenza MI, Borrajo Brunete E, Martínez López B, García López M, González Cuello I, Gregori Colomé J, Navarro Cots M, Saugar JM, García-Vazquez E, Ruiz-Maciá JA, Llenas-García J. Strongyloidiasis in Southern Alicante (Spain): Comparative Retrospective Study of Autochthonous and Imported Cases. Pathogens 2020; 9:pathogens9080601. [PMID: 32717912 PMCID: PMC7460300 DOI: 10.3390/pathogens9080601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/14/2020] [Accepted: 07/20/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Strongyloidiasis is a parasitic disease with global prevalence. In Spain, autochthonous cases are concentrated in the Mediterranean basin. We aimed to analyze clinical and epidemiological characteristics of Strongyloides stercoralis infection in Vega Baja del Segura (Spain), comparing autochthonous versus imported cases. METHODS Observational retrospective study of all strongyloidiasis cases from January 2009 to January 2019. Cases were diagnosed by stool larvae visualization, positive culture, PCR, Strongyloides serology, and/or compatible histology. RESULTS We included 36 patients (21 men) with a mean age of 60.8 years ±17.6; 15 cases were autochthonous and 21 imported 80.9% from Latin America. Autochthonous cases were associated with older age (mean 71.3 vs. 53.3 years; p = 0.002), male sex (odds ratio (OR) 5.33; 95% confidence interval (CI) 1.15-24.68; p = 0.041), and agricultural activity (OR 13.5; 95% CI 2.4-73.7; p = 0.002). Fourteen were asymptomatic, three autochthonous cases presented with hyperinfection syndrome, and two patients died. There was no difference between autochthonous versus imported origin in eosinophilia at diagnosis (93.3% vs. 75%; p = 0.207), treatment received, or clinical response (85.7% vs. 88.9% cured; p = 1). CONCLUSION In our region, imported strongyloidiasis coexists with autochthonous cases, which are mainly in older male farmers who are diagnosed at more advanced stages. Systematic screening programs are needed.
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Affiliation(s)
- Ana Lucas Dato
- Internal Medicine Department, Hospital Vega Baja, 03314 Orihuela, Spain; (B.M.L.); (M.G.L.); (I.G.C.); (J.G.C.)
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (E.B.B.); (M.N.C.)
- Correspondence: (A.L.D.); (J.L.-G.)
| | - María Isabel Pacheco-Tenza
- Internal Medicine Department, Hospital Clínico Universitario Virgen de la Arrixaca, 30120 Murcia, Spain;
| | - Emilio Borrajo Brunete
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (E.B.B.); (M.N.C.)
- Microbiology Department, Hospital Vega Baja, 03314 Orihuela, Spain
| | - Belén Martínez López
- Internal Medicine Department, Hospital Vega Baja, 03314 Orihuela, Spain; (B.M.L.); (M.G.L.); (I.G.C.); (J.G.C.)
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (E.B.B.); (M.N.C.)
| | - María García López
- Internal Medicine Department, Hospital Vega Baja, 03314 Orihuela, Spain; (B.M.L.); (M.G.L.); (I.G.C.); (J.G.C.)
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (E.B.B.); (M.N.C.)
| | - Inmaculada González Cuello
- Internal Medicine Department, Hospital Vega Baja, 03314 Orihuela, Spain; (B.M.L.); (M.G.L.); (I.G.C.); (J.G.C.)
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (E.B.B.); (M.N.C.)
| | - Joan Gregori Colomé
- Internal Medicine Department, Hospital Vega Baja, 03314 Orihuela, Spain; (B.M.L.); (M.G.L.); (I.G.C.); (J.G.C.)
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (E.B.B.); (M.N.C.)
| | - María Navarro Cots
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (E.B.B.); (M.N.C.)
- Microbiology Department, Hospital Vega Baja, 03314 Orihuela, Spain
| | - José María Saugar
- Parasitology Department, Centro Nacional de Microbiología, Instituto Carlos III, 28903 Madrid, Spain;
| | - Elisa García-Vazquez
- Infectious Diseases Unit, Hospital Clínico Universitario Virgen de la Arrixaca, 30120 Murcia, Spain;
- Instituto Murciano de Investigación Biosanitaria (IMIB), Universidad de Murcia, 30120 Murcia, Spain
| | - José Antonio Ruiz-Maciá
- Pathological Department, Hospital Clínico Universitario Virgen de la Arrixaca, 30120 Murcia, Spain;
| | - Jara Llenas-García
- Internal Medicine Department, Hospital Vega Baja, 03314 Orihuela, Spain; (B.M.L.); (M.G.L.); (I.G.C.); (J.G.C.)
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain; (E.B.B.); (M.N.C.)
- Clinical Medicine Department, Universidad Miguel Hernández de Elche, 03202 Elche, Spain
- Correspondence: (A.L.D.); (J.L.-G.)
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Salvador F, Treviño B, Chamorro-Tojeiro S, Sánchez-Montalvá A, Herrero-Martínez JM, Rodríguez-Guardado A, Serre-Delcor N, Torrús D, Goikoetxea J, Zubero Z, Velasco M, Sulleiro E, Molina I, López-Vélez R, Pérez-Molina JA. Imported strongyloidiasis: Data from 1245 cases registered in the +REDIVI Spanish Collaborative Network (2009-2017). PLoS Negl Trop Dis 2019; 13:e0007399. [PMID: 31095570 PMCID: PMC6541302 DOI: 10.1371/journal.pntd.0007399] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 05/29/2019] [Accepted: 04/17/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Imported strongyloidiasis is increasingly being diagnosed in non-endemic areas. The aim of this study was to describe the epidemiological, clinical and microbiological characteristics of patients with imported strongyloidiasis in Spain. METHODOLOGY This is an observational retrospective study that included all patients diagnosed of strongyloidiasis registered in the +REDIVI Collaborative Network from 2009 to 2017. Demographic, epidemiological and clinical information was collected from the +REDIVI database, and extra information regarding microbiological techniques, treatment and follow-up was requested to participant centers. FINDINGS Overall, 1245 cases were included. Most of them were immigrants (66.9%), and South America was the most frequent area of origin. Detection of larvae in stool samples was observed in 21.9% of the patients, and serological tests allowed making the diagnosis in the rest of the cases. Eosinophilia was present in 82.2% of cases. Treatment with ivermectin (compared with albendazole) was the most strongly associated factor to achieve the cure (OR 2.34). CONCLUSIONS Given the long latency of the infection and the risk of developing a severe presentation, screening of S. stercoralis infection should be mandatory in patients coming from or had traveling to endemic areas, especially in those with immunosuppressant conditions.
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Affiliation(s)
- Fernando Salvador
- Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
- * E-mail:
| | - Begoña Treviño
- Tropical Medicine and International Health Unit Drassanes-Vall d’Hebron, PROSICS Barcelona, Barcelona, Spain
| | | | - Adrián Sánchez-Montalvá
- Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
| | | | | | - Núria Serre-Delcor
- Tropical Medicine and International Health Unit Drassanes-Vall d’Hebron, PROSICS Barcelona, Barcelona, Spain
| | - Diego Torrús
- Hospital General Universitario de Alicante, Alicante, Spain
| | | | | | - María Velasco
- Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Elena Sulleiro
- Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
| | - Israel Molina
- Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
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Occurrence, diagnosis and follow-up of canine strongyloidiosis in naturally infected shelter dogs. Parasitology 2018; 146:246-252. [PMID: 30058514 DOI: 10.1017/s0031182018001312] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Strongyloidiosis by Strongyloides stercoralis is a disease of increasing interest in human and animal medicine. The scientific knowledge on canine strongyloidiosis is hindered by the poor diagnostics available. To assess the most sensitive and specific diagnostic method, feces and blood from 100 shelter dogs were screened for S. stercoralis by coprological, molecular and serological tests. Thirty-six dogs (36%) scored positive to S. stercoralis by coprology (22.3% to Baermann) and/or 30% to real time-polymerase chain reaction (rt-PCR). According to two composite reference standards (CRS) based on all coprological methods and rt-PCR (first CRS) or in combination with serology (second CRS), the most sensitive test was IFAT (93.8%; CI 82.8-98.7), followed by rt-PCR (80.6%; 95% CI 64-91.8) and Baermann (60.6%; 95% CI 42.1-77.1). The inconsistent shedding of L1 during the 4-week follow-up in infected dogs suggests the importance of multiple faecal collections for a reliable diagnosis. A combination of serological and coprological tests is recommended for the surveillance and diagnosis of S. stercoralis infection in dogs.
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Pacheco-Tenza MI, Ruiz-Maciá JA, Navarro-Cots M, Gregori-Colomé J, Cepeda-Rodrigo JM, Llenas-García J. Strongyloides stercoralis infection in a Spanish regional hospital: Not just an imported disease. Enferm Infecc Microbiol Clin 2016; 36:24-28. [PMID: 27743682 DOI: 10.1016/j.eimc.2016.08.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 08/25/2016] [Accepted: 08/26/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Strongyloides stercoralis infection is more prevalent in tropical regions but autochthonous cases have been reported in Spain, mainly in La Safor (Valencia). The objective is to describe the strongyloidiasis cases registered in a regional hospital of Alicante province (Spain) and to determine if they were autochthonous cases. METHODS Retrospective study of all diagnosed cases of strongyloidiasis in Vega Baja Hospital (Orihuela, Alicante) between January 1999 and March 2016. RESULTS A total of 10 cases were found, four of which were autochthonous cases. Two of them presented with a hyper-infection syndrome, with a fatal outcome. All autochthonous cases were in patients ≥69years old with gastrointestinal, cutaneous, and/or respiratory symptoms. Serology was positive in the 8 cases studied. Larvae were found in histopathological samples of the gastrointestinal tract of three patients. CONCLUSIONS We communicate the first autochthonous cases of strongyloidiasis in the region of Vega Baja. Screening programs should be implemented, especially in immunosuppressed patients or patients under chronic corticosteroid treatment.
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Affiliation(s)
| | | | - María Navarro-Cots
- Servicio de Microbiología, Hospital Vega Baja, San Bartolomé, Alicante, España
| | - Joan Gregori-Colomé
- Servicio de Medicina Interna, Hospital Vega Baja, San Bartolomé, Alicante, España
| | | | - Jara Llenas-García
- Servicio de Medicina Interna, Hospital Vega Baja, San Bartolomé, Alicante, España; Servicio de Medicina Interna, Unidad de Enfermedades Infecciosas, Hospital General Universitario de Elche, Elche, Alicante, España.
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Beknazarova M, Whiley H, Ross K. Strongyloidiasis: A Disease of Socioeconomic Disadvantage. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E517. [PMID: 27213420 PMCID: PMC4881142 DOI: 10.3390/ijerph13050517] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 05/18/2016] [Accepted: 05/18/2016] [Indexed: 12/17/2022]
Abstract
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.
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Affiliation(s)
- Meruyert Beknazarova
- School of the Environment, Flinders University, GPO Box 2100, Adelaide 5001, Australia.
| | - Harriet Whiley
- School of the Environment, Flinders University, GPO Box 2100, Adelaide 5001, Australia.
| | - Kirstin Ross
- School of the Environment, Flinders University, GPO Box 2100, Adelaide 5001, Australia.
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Ivermectina subcutánea en estrongiloidiasis diseminada: a propósito de la autorización de un medicamento veterinario para uso humano. Med Clin (Barc) 2016; 146:376-7. [DOI: 10.1016/j.medcli.2015.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 10/18/2015] [Accepted: 10/22/2015] [Indexed: 11/18/2022]
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Ramos JM, León R, Andreu M, de las Parras ER, Rodríguez-Díaz JC, Esteban Á, Saugar JM, Torrús D. Serological study of Trypanosoma cruzi, Strongyloides stercoralis, HIV, human T cell lymphotropic virus (HTLV) and syphilis infections in asymptomatic Latin-American immigrants in Spain. Trans R Soc Trop Med Hyg 2016; 109:447-53. [PMID: 26065661 DOI: 10.1093/trstmh/trv043] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE We aimed to perform a serological screening for T. cruzi, Strongyloides stercoralis, HIV, human T cell lymphotropic virus (HTLV) and syphilis in Latin American immigrants admitted to hospital in Spain. METHODS We have carried out a cross-sectional study of Latin American immigrants admitted to the Hospital General Universitario Alicante (Spain) from June 2012 to May 2014, where screening of Chagas disease, strongyloidiasis, HTLV, HIV and syphilis was performed by serology. RESULTS A total 180 patients were included in the study. Patients' median age was 38 years old, 123 (68.3%; 123/180) were female and 57 (31.7%; 57/180) male. Five of the 180 (2.5%) patients were positive for Chagas disease; associated with knowledge about Chagas disease (p=0.005), previous contact with patients with Chagas disease (p=0.04) and being Bolivian (p<0.001). Forty-two of the 157 (26.8%) patients were positive for Strongyloides serology; associated positively with being male (p<0.001), eosinophilia (p=0.001), hyper-IgE (p<0.001) and being Ecuadorian (p=0.001), and negatively associated with being Colombian (p=0.03). Positive serology of latent syphilis was found in 1.8% (3/171) of patients. Serology of HTLV was negative in all cases. No new cases of HIV infection were diagnosed. CONCLUSIONS We propose that Latin American immigrant patients admitted to hospital in Spain be screened for strongyloidiasis, Chagas disease and syphilis by serology.
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Affiliation(s)
- José M Ramos
- Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante Spain Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Spain
| | - Rafael León
- Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante Spain
| | - Mariano Andreu
- Division of Microbiology, Hospital General Universitario de Alicante, Alicante, Spain Department of Microbiology, Universidad de Alicante, Alicante, Spain
| | | | - Juan C Rodríguez-Díaz
- Division of Microbiology, Hospital General Universitario de Alicante, Alicante, Spain Department of Microbiology, Universidad Miguel Hernandez de Elche, Spain
| | - Ángel Esteban
- Department of Clinical Laboratory, Hospital General Universitario de Alicante, Alicante, Spain
| | - José M Saugar
- Service of Parasitology, National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Diego Torrús
- Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante Spain
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Helminthosis and eosinophilia in Spain (1990-2015). Enferm Infecc Microbiol Clin 2016; 36:120-136. [PMID: 26827134 DOI: 10.1016/j.eimc.2015.11.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 11/29/2015] [Accepted: 11/30/2015] [Indexed: 12/16/2022]
Abstract
The finding of blood eosinophilia in a patient is a relatively frequent reason to refer him/her to a Clinical Department of Infectious Diseases. The doctor usually intends to rule out a parasitic disease in the autochthonous population, travelers or immigrants. It is uncommon for an eosinophilia to be produced by protozoa infection, whereas helminth parasites are more frequently associated with an increase of eosinophil counts in the infected patient. Eosinophilia can be the only abnormal finding, or it could be part of more complex clinical manifestations suffered by the patient. Furthermore, many, but not all, helminth infections are associated with eosinophilia, and the eosinophil level (low, high) differs according to parasite stages, helminth species, and worm co-infections. The purpose of the present article is to carry out a systematic review of cases and case series on helminth infections and eosinophilia reported in Spain from 1990 to 2015, making a distinction between autochthonous and imported (immigrants and travelers) cases, and studying their relationship with immunodepression situations.
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Schneider T, Anagnostopoulos I, Nassir M, Schwartz S. Enigmatic meningitis in a patient with T cell lymphoma. Ann Hematol 2015; 95:147-148. [PMID: 26359205 DOI: 10.1007/s00277-015-2496-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 09/02/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Thomas Schneider
- Department of Infectious Diseases, Charité Universitätsmedizin, Berlin, Germany
| | | | - Mani Nassir
- Department of Infectious Diseases, Charité Universitätsmedizin, Berlin, Germany
| | - Stefan Schwartz
- Department of Hematology and Oncology, Charité Universitätsmedizin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany.
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Hays R, Esterman A, Giacomin P, Loukas A, McDermott R. Does Strongyloides stercoralis infection protect against type 2 diabetes in humans? Evidence from Australian Aboriginal adults. Diabetes Res Clin Pract 2015; 107:355-61. [PMID: 25656764 DOI: 10.1016/j.diabres.2015.01.012] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Revised: 11/06/2014] [Accepted: 01/03/2015] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To explore the relationship between infection with Strongyloides stercoralis and the likelihood of having type 2 diabetes mellitus (T2DM). METHODS Cross-sectional survey of 259 Aboriginal adults living in a remote community in northern Australia during 2013. Prior infection with S. stercoralis was determined by ELISA testing on serum. Main outcomes were eosinophil count, T2DM diagnosis, HbA1c, BMI, fasting lipids, Hb, blood pressure. FINDINGS Ninety two participants (36%) had prior infection with S. stercoralis and 131 (51%) had T2DM. Those with previous S. stercoralis infection (ELISA titre ≥0.3) were 61% less likely to have a diagnosis of T2DM than those uninfected, adjusted for age, triglycerides, blood pressure and BMI using propensity score (adjusted OR=0.39, 0.23-0.67, P=0.001). INTERPRETATION In this remote community where prevalence of both S. stercoralis and T2DM is very high, infection with S. stercoralis appears to be associated with a significantly reduced risk of T2DM in adults. A plausible immunological mechanism has been identified in animal models. If confirmed, this result may have practical implications for the prevention of T2DM and associated metabolic disorders in humans. This finding should be explored further with larger longitudinal studies in transitional populations where the risk of both conditions is high. FUNDING No external funding was required for this study.
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Affiliation(s)
- Russell Hays
- Kimberley Aboriginal Medical Services Council, PO Box 1377, Broome 6725, WA, Australia; Adjunct Research Fellow James Cook University, James Cook University, Cairns Campus, McGregor Road, Smithfield 4878, QLD, Australia.
| | - Adrian Esterman
- Centre for Research Excellence in Chronic Disease Prevention, The Cairns Institute James Cook University, Cairns Campus, Room D3-131, McGregor Road, Smithfield 4878, QLD, Australia; Chair of Biostatistics, Sansom Institute of Health Service Research and School of Nursing and Midwifery, University of South Australia City East Campus, Centenary Building, North Terrace, Adelaide 5000, SA, Australia
| | - Paul Giacomin
- Centre for Biodiscovery and Molecular Development of Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns Campus, McGregor Road, Smithfield 4878, QLD, Australia
| | - Alex Loukas
- Centre for Biodiscovery and Molecular Development of Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns Campus, McGregor Road, Smithfield 4878, QLD, Australia
| | - Robyn McDermott
- Public Health Medicine, Centre for Chronic Disease Prevention, Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, PO Box 6811, Cairns 4870, QLD, Australia
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