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Cachera L, Oehler E, Abdelmoumen K, Tardieu L, Thomas I, Lagrange M, Manaquin R, Quirin N, Sidibe M, Gbaguidi T, Davodoun T, Claudeon J, Vacher H, Roger PM, Markowicz S, Cabié A, Scemla A, Manchon R, Paccoud O, Pilmis B, Lanternier F, Lortholary O, Epelboin L. Prevention and management of infectious and tropical diseases in kidney transplant recipients residing in European outermost and overseas territories. Transpl Infect Dis 2024:e14386. [PMID: 39400485 DOI: 10.1111/tid.14386] [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: 08/04/2024] [Revised: 09/11/2024] [Accepted: 09/18/2024] [Indexed: 10/15/2024]
Abstract
BACKGROUND The European Union encompasses 30 outermost and overseas countries and territories (OCTs). Despite a recent increasing activity of renal transplantation in these territories, many patients still undergo transplantation in continental Europe, with follow-up care coordinated between health professionals from both their transplant center and their home region. Each territory has its unique infectious epidemiology which must be known to ensure appropriate care for kidney transplant recipients (KTRs). AIMS This paper proposes a pragmatic approach to optimize pre-transplant check-up and to provide an overview of the specific epidemiological features of each region. It offers practical algorithms to help practitioners in managing infected KTR living in these territories. This work advocates for increased collaborative research among European OCTs.
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Affiliation(s)
- Laurène Cachera
- Service de Microbiologie Clinique, Groupe Hospitalier Paris Saint Joseph, Paris, France
| | - Erwan Oehler
- Service de Médecine Interne, CHU de Polynésie Française, Papeete, French Polynesia
| | - Karim Abdelmoumen
- Service de Maladies Infectieuses et Tropicales, CH de Mayotte, Mamoudzou, Mayotte, France
| | - Laurène Tardieu
- Service de Néphrologie-Transplantation Rénale, CHU de Montpellier, Montpellier, France
| | - Ian Thomas
- Internal Medicine/Nephrology Department, Mount St John's Medical Center, Saint John's, Antigua and Barbuda
| | - Marie Lagrange
- Service de Maladies Infectieuses et Tropicales, CHU Félix Guyon, Saint Denis, La Réunion, France
| | - Rodolphe Manaquin
- Services de Maladies Infectieuses et Tropicales, CHU de La Réunion (site Sud), La Réunion, France
| | - Nicolas Quirin
- Service de Néphrologie-Hémodialyse, Centre Hospitalier Territorial Gastron-Bourret, Nouméa, Nouvelle-Calédonie, France
| | - Mohamed Sidibe
- Service de Néphrologie-Hémodialyse, Centre Hospitalier Territorial Gastron-Bourret, Nouméa, Nouvelle-Calédonie, France
| | - Tanguy Gbaguidi
- Service de Néphrologie-Hémodialyse, Centre Hospitalier de Cayenne, Guyane Française, France
| | - Timoté Davodoun
- Service de Néphrologie-Hémodialyse, Centre Hospitalier de Cayenne, Guyane Française, France
| | - Joelle Claudeon
- Service de Néphrologie, CHU de Guadeloupe, Pointe-à-Pître, Guadeloupe, France
| | - Henri Vacher
- Service de Néphrologie, CHU Félix Guyon, Saint Denis, La Réunion, France
| | - Pierre-Marie Roger
- Service de Maladies Infectieuses et Tropicales, CHU de Guadeloupe, Pointe-à-Pître, Guadeloupe, France
| | - Samuel Markowicz
- Service de Maladies Infectieuses et Tropicales, CHU de Guadeloupe, Pointe-à-Pître, Guadeloupe, France
| | - André Cabié
- Service de Maladies Infectieuses et Tropicales, CHU de Martinique, Fort-de-France, Martinique, France
- PCCEI, Univ Montpellier, INSERM, EFS, Montpellier, France
- CIC Antilles Guyane, INSERM CIC1424, Fort-de-France, France
| | - Anne Scemla
- Service de Néphrologie-Transplantation, CHU Necker-Enfants malades, Assistance Publique-Hôpitaux de Paris, Université-Paris Cité, Paris, France
| | - Romain Manchon
- Service de Maladies Infectieuses et Tropicales, CHU Necker-Enfants malades, Assistance Publique-Hôpitaux de Paris, Université-Paris Cité, Paris, France
| | - Olivier Paccoud
- Service de Maladies Infectieuses et Tropicales, CHU Necker-Enfants malades, Assistance Publique-Hôpitaux de Paris, Université-Paris Cité, Paris, France
| | - Benoît Pilmis
- Service de Microbiologie Clinique, Groupe Hospitalier Paris Saint Joseph, Paris, France
| | - Fanny Lanternier
- Service de Maladies Infectieuses et Tropicales, CHU Necker-Enfants malades, Assistance Publique-Hôpitaux de Paris, Université-Paris Cité, Paris, France
- CNR Mycoses Invasives, Groupe de Recherche Mycologie Translationnelle, Institut Pasteur, Université Paris Cité, Paris, France
| | - Olivier Lortholary
- Service de Maladies Infectieuses et Tropicales, CHU Necker-Enfants malades, Assistance Publique-Hôpitaux de Paris, Université-Paris Cité, Paris, France
- CNR Mycoses Invasives, Groupe de Recherche Mycologie Translationnelle, Institut Pasteur, Université Paris Cité, Paris, France
| | - Loïc Epelboin
- Unité de Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne, Guyane Française, France
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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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Rojas OC, Montoya AM, Villanueva-Lozano H, Carrion-Alvarez D. Severe strongyloidiasis: a systematic review and meta-analysis of 339 cases. Trans R Soc Trop Med Hyg 2023; 117:682-696. [PMID: 37300462 DOI: 10.1093/trstmh/trad032] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/15/2022] [Accepted: 05/16/2023] [Indexed: 06/12/2023] Open
Abstract
Strongyloidiasis is a parasitosis representing a significant public health problem in tropical countries. It is often asymptomatic in immunocompetent individuals but its mortality rate increases to approximately 87% in severe forms of the disease. We conducted a systematic review, including case reports and case series, of Strongyloides hyperinfection and dissemination from 1998 to 2020 searching PubMed, EBSCO and SciELO. Cases that met the inclusion criteria of the Preferred Reported Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist were analysed. Statistical analysis was performed using Fisher's exact test and Student's t-test and a Bonferroni correction for all the significant values. A total of 339 cases were included in this review. The mortality rate was 44.83%. The presence of infectious complications, septic shock and a lack of treatment were risk factors for a fatal outcome. Eosinophilia and ivermectin treatment were associated with an improved outcome.
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Affiliation(s)
- Olga C Rojas
- Departamento de Microbiología, Facultad de Medicina, Universidad Autónoma de Nuevo León, Facultad de Medicina, Dr Eleuterio Gonzalez Gonzalitos-Francisco I. Madero s/n 64460, Monterrey, Nuevo Leon, Mexico
| | - Alexandra M Montoya
- Departamento de Microbiología, Facultad de Medicina, Universidad Autónoma de Nuevo León, Facultad de Medicina, Dr Eleuterio Gonzalez Gonzalitos-Francisco I. Madero s/n 64460, Monterrey, Nuevo Leon, Mexico
| | - Hiram Villanueva-Lozano
- Departamento de Medicina Interna, Hospital Regional ISSSTE Monterrey, Av. Adolfo López Mateos, 122 Burócratas Federales 64380, Monterrey, Nuevo León, Mexico
| | - Diego Carrion-Alvarez
- Departamento de Medicina Interna, Hospital Regional ISSSTE Monterrey, Av. Adolfo López Mateos, 122 Burócratas Federales 64380, Monterrey, Nuevo León, Mexico
- Departamento de Ciencias Basicas, Universidad de Monterrey. N.L. Mexico. Av. Ignacio Morones Prieto 4500, San Pedro, Garza García, Nuevo Leon, Mexico
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Lupia T, Crisà E, Gaviraghi A, Rizzello B, Di Vincenzo A, Carnevale-Schianca F, Caravelli D, Fizzotti M, Tolomeo F, Vitolo U, De Benedetto I, Shbaklo N, Cerutti A, Fenu P, Gregorc V, Corcione S, Ghisetti V, De Rosa FG. Overlapping Infection by Strongyloides spp. and Cytomegalovirus in the Immunocompromised Host: A Comprehensive Review of the Literature. Trop Med Infect Dis 2023; 8:358. [PMID: 37505654 PMCID: PMC10385408 DOI: 10.3390/tropicalmed8070358] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/19/2023] [Accepted: 06/21/2023] [Indexed: 07/29/2023] Open
Abstract
Strongyloides and cytomegalovirus co-infections are rarely reported, even though they are distinguished by high morbidity and mortality, especially in immunocompromised hosts. We narratively reviewed the literature on reported cases of Strongyloides and CMV co-infections in immunosuppressed patients. Most cases occurred in males with a median age of 47 (IQR, 37-59). Strongyloides/CMV co-infections occurred among immunocompromised hosts, especially in solid organ transplants and hematological or rheumatological diseases. Most of the patients underwent a course of steroid treatment before the diagnosis of co-infections. Other common immunomodulatory agents were tacrolimus and mycophenolate. The first clinical manifestations of co-infections were mainly gastrointestinal, followed by respiratory symptoms. CMV was, in most patients, co-infected with an isolated reactivation, although Strongyloides manifested especially as hyperinfection syndrome. Ganciclovir and ivermectin are the mainstays of CMV and Strongyloides treatment. However, the treatment mortality reported in this narrative review is around 52.4%. Interestingly secondary bacterial infections are common in CMV/Strongyloides-infected patients.
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Affiliation(s)
- Tommaso Lupia
- Unit of Infectious Diseases, Cardinal Massaia, 14100 Asti, Italy
| | - Elena Crisà
- Unit of Oncology and Haematology, Candiolo Cancer Institute (FPO-IRCCS), Strada Provinciale 142, Km 3,95, 10060 Candiolo, Italy
| | - Alberto Gaviraghi
- Department of Medical Sciences, Infectious Diseases, University of Turin, 10126 Turin, Italy
| | - Barbara Rizzello
- Department of Medical Sciences, Infectious Diseases, University of Turin, 10126 Turin, Italy
| | | | - Fabrizio Carnevale-Schianca
- Unit of Oncology and Haematology, Candiolo Cancer Institute (FPO-IRCCS), Strada Provinciale 142, Km 3,95, 10060 Candiolo, Italy
| | - Daniela Caravelli
- Unit of Oncology and Haematology, Candiolo Cancer Institute (FPO-IRCCS), Strada Provinciale 142, Km 3,95, 10060 Candiolo, Italy
| | - Marco Fizzotti
- Unit of Oncology and Haematology, Candiolo Cancer Institute (FPO-IRCCS), Strada Provinciale 142, Km 3,95, 10060 Candiolo, Italy
| | - Francesco Tolomeo
- Unit of Oncology and Haematology, Candiolo Cancer Institute (FPO-IRCCS), Strada Provinciale 142, Km 3,95, 10060 Candiolo, Italy
| | - Umberto Vitolo
- Unit of Oncology and Haematology, Candiolo Cancer Institute (FPO-IRCCS), Strada Provinciale 142, Km 3,95, 10060 Candiolo, Italy
| | - Ilaria De Benedetto
- Department of Medical Sciences, Infectious Diseases, University of Turin, 10126 Turin, Italy
| | - Nour Shbaklo
- Department of Medical Sciences, Infectious Diseases, University of Turin, 10126 Turin, Italy
| | | | - Piero Fenu
- Healthcare Management, IRCCS Candiolo, 10100 Candiolo, Italy
| | - Vanesa Gregorc
- Unit of Oncology and Haematology, Candiolo Cancer Institute (FPO-IRCCS), Strada Provinciale 142, Km 3,95, 10060 Candiolo, Italy
| | - Silvia Corcione
- Department of Medical Sciences, Infectious Diseases, University of Turin, 10126 Turin, Italy
- School of Medicine, Tufts University, Boston, MA 02111, USA
| | - Valeria Ghisetti
- Microbiology Unit, Amedeo di Savoia Hospital, 10100 Turin, Italy
| | - Francesco Giuseppe De Rosa
- Unit of Infectious Diseases, Cardinal Massaia, 14100 Asti, Italy
- Department of Medical Sciences, Infectious Diseases, University of Turin, 10126 Turin, Italy
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Abad CLR, Bhaimia E, Schuetz AN, Razonable RR. A comprehensive review of Strongyloides stercoralis infection after solid organ and hematopoietic stem cell transplantation. Clin Transplant 2022; 36:e14795. [PMID: 35987856 PMCID: PMC10078215 DOI: 10.1111/ctr.14795] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/03/2022] [Accepted: 08/11/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND We reviewed the scientific literature to gain insight on the epidemiology and outcome of Strongyloides stercoralis infections after transplantation. METHODS CINAHL, PUBMED, and OVID/MEDLINE were reviewed from inception through March 31, 2022 using key words Strongyloides and transplantation. RESULTS Our review identified 108 episodes of Strongyloides infection among 91 solid organ transplant (SOT) and 15 hematopoietic cell transplant (HCT) recipients. Median time to infection was 10.8 (range, .14-417) and 8.8 (range, 0-208) weeks after SOT and HCT, respectively. Gastrointestinal symptoms were frequent (86/108 [79.6%]), while skin rash (22/108 [20.3%]) and fever (31/103 [30%]) were less common. Peripheral eosinophilia was observed in half of patients (41/77 [53.2%]). Bacteremia (31/59 [52.5%]) was frequently due to Gram-negative organisms (24/31 [77.4%]). Abnormal chest radiologic findings were reported in half (56/108 [51.9%]). The majority had hyperinfection syndrome (97/108 [89.8%]) while disseminated strongyloidiasis was less common (11/108 [10.2%]). Thirty-two cases were categorized as donor-derived infection (DDI), with donors (23/24 [95.8%]) who had traveled to or lived in endemic areas. Median time to DDI was 8 weeks (range .5-34.3 weeks) after transplantation. Treatment consisted of ivermectin (n = 26), a benzimidazole (n = 27), or both drugs (n = 28). There was high all-cause mortality (48/107, 44.9%) and a high Strongyloides-attributable mortality (32/49, 65.3%). CONCLUSIONS Strongyloidiasis should be strongly considered among recipients with epidemiologic risk factors for infection, even in the absence of eosinophilia or rash. A policy that provides guidance on pro-active screening is needed, to ensure preventive measures are provided to recipients at increased risk.
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Affiliation(s)
- Cybele Lara R Abad
- Department of Medicine, Division of Infectious Diseases, University of the Philippines-Manila, Philippine General Hospital, Manila, Philippines
| | - Eric Bhaimia
- Department of Medicine, Division of Public Health, Infectious Diseases and Occupational Medicine, and The William J Von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic College of Medicine and Sciences, Rochester, Minnesota, USA
| | - Audrey N Schuetz
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine and Sciences, Rochester, Minnesota, USA
| | - Raymund R Razonable
- Department of Medicine, Division of Public Health, Infectious Diseases and Occupational Medicine, and The William J Von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic College of Medicine and Sciences, Rochester, Minnesota, USA
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Endemic parasitic infections in donors and recipients of stem cell and solid organ transplants: focus on strongyloidiasis and Chagas disease. Curr Opin Infect Dis 2021; 34:323-332. [PMID: 34074878 DOI: 10.1097/qco.0000000000000741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The aim of the article is to review recent recommendations on the management of Strongyloidiasis and Chagas disease (ChD) in the context of stem-cell or solid-organ transplantation. RECENT FINDINGS An update on laboratory screening, detection of acute disease or reactivation and recommended preventive or therapeutic options in the transplant recipients and donors is presented. Recent epidemiological data showing new estimates on the worldwide burden of both diseases and changes in the classical distribution around the globe should increase awareness and will impact the evaluation and management of transplant recipients and donors in endemic and nonendemic regions. SUMMARY Strongyloidiasis and ChD are potentially life threatening if unnoticed in the context of stem-cell or solid-organ transplantation and should be considered in endemic and nonendemic areas. Effective strategies for detection, monitoring, prevention and management are available for both diseases.
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Ottino L, Buonfrate D, Paradies P, Bisoffi Z, Antonelli A, Rossolini GM, Gabrielli S, Bartoloni A, Zammarchi L. Autochthonous Human and Canine Strongyloides stercoralis Infection in Europe: Report of a Human Case in An Italian Teen and Systematic Review of the Literature. Pathogens 2020; 9:E439. [PMID: 32503315 PMCID: PMC7350350 DOI: 10.3390/pathogens9060439] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/30/2020] [Accepted: 06/01/2020] [Indexed: 12/14/2022] Open
Abstract
Autochthonous human and canine strongyloidiasis is reported in Europe but is unclear whether the transmission of infection still occurs. We report a previously unpublished human case in an Italian teen and perform a systematic review of literature on autochthonous human and canine strongyloidiasis in Europe to investigate the current dynamic of transmission. Overall, 109 papers published after 1987 were included and one previously unpublished Italian case was added. Eighty case reports were retrieved and 42 of them (52.5%) had severe strongyloidiasis. Most cases were diagnosed in Spain, Italy and France. The median age was 58, the most represented age group was 61-70 years, 11 patients were under 30, and 7 of them were diagnosed after 2000. Epidemiological studies on human strongyloidiasis showed prevalence ranging from 0.56% to 28%. Overall, agriculture work, mine work and walking barefoot were the most commonly reported risk factors for infection. Canine strongyloidiasis was reported mainly in Italy (68 cases), but a few cases occurred also in Iceland, Finland, England, Germany, France, Switzerland, Russia, Slovakia, Romania and Greece. Autochthonous strongyloidiasis is still reported in Europe and sporadic transmission still occurs. Health care professionals should be aware of this issue to identify infected subjects and avoid adverse outcomes, especially in immunosuppressed patients. Further investigations are needed to clarify the zoonotic transmission of this nematode.
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Affiliation(s)
- Letizia Ottino
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy; (L.O.); (A.A.); (G.M.R.); (A.B.)
| | - Dora Buonfrate
- IRCCS Sacro Cuore Don Calabria Hospital, Negrar, 37024 Verona, Italy; (D.B.); (Z.B.)
| | - Paola Paradies
- Department of Emergency and Organs Transplantation, Veterinary Section, Campus of Veterinary Medicine, University of Bari, 70124 Bari, Italy;
| | - Zeno Bisoffi
- IRCCS Sacro Cuore Don Calabria Hospital, Negrar, 37024 Verona, Italy; (D.B.); (Z.B.)
| | - Alberto Antonelli
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy; (L.O.); (A.A.); (G.M.R.); (A.B.)
- Microbiology and Virology Unit, Careggi University Hospital, 50134 Florence, Italy
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy; (L.O.); (A.A.); (G.M.R.); (A.B.)
- Microbiology and Virology Unit, Careggi University Hospital, 50134 Florence, Italy
| | - Simona Gabrielli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy;
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy; (L.O.); (A.A.); (G.M.R.); (A.B.)
- Infectious and Tropical Diseases Unit, Careggi University and Hospital, 50134 Florence, Italy
- Referral Center for Tropical Diseases of Tuscany, Careggi University Hospital, 50134 Florence, Italy
| | - Lorenzo Zammarchi
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy; (L.O.); (A.A.); (G.M.R.); (A.B.)
- Infectious and Tropical Diseases Unit, Careggi University and Hospital, 50134 Florence, Italy
- Referral Center for Tropical Diseases of Tuscany, Careggi University Hospital, 50134 Florence, Italy
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Norman FF, Chamorro S, Comeche B, Pérez-Molina JA, López-Vélez R. Update on the major imported helminth infections in travelers and migrants. Future Microbiol 2020; 15:437-444. [PMID: 32250168 DOI: 10.2217/fmb-2019-0273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Helminth infections cause considerable morbidity worldwide and may be frequently underdiagnosed especially in areas of lower endemicity. Patients may harbor latent infections that may become symptomatic years or decades after the initial exposure and timely diagnosis may be critical to prevent complications and improve outcomes. In this context, disease in special populations, such as immunosuppressed patients, may be of particular concern. Heightened awareness and recent diagnostic developments may contribute to the correct management of helminth infections in nonendemic regions. A review of the main helminth infections in travelers and migrants (strongyloidiasis, taeniasis-neurocysticercosis and schistosomiasis) is presented, focusing on epidemiology, developments in diagnosis, treatment and prevention.
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Affiliation(s)
- F F Norman
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Ctra Colmenar, Km 9100, 28034 Madrid, Spain
| | - S Chamorro
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Ctra Colmenar, Km 9100, 28034 Madrid, Spain
| | - B Comeche
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Ctra Colmenar, Km 9100, 28034 Madrid, Spain
| | - J A Pérez-Molina
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Ctra Colmenar, Km 9100, 28034 Madrid, Spain
| | - R López-Vélez
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Ctra Colmenar, Km 9100, 28034 Madrid, Spain
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Requena-Méndez A, Salas-Coronas J, Salvador F, Gomez-Junyent J, Villar-Garcia J, Santin M, Muñoz C, González-Cordón A, Cabezas Fernández MT, Sulleiro E, Arenas MDM, Somoza D, Vazquez-Villegas J, Treviño B, Rodríguez E, Valls ME, Llaberia-Marcual J, Subirá C, Muñoz J. High Prevalence of Strongyloidiasis in Spain: A Hospital-Based Study. Pathogens 2020; 9:pathogens9020107. [PMID: 32053864 PMCID: PMC7167856 DOI: 10.3390/pathogens9020107] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 02/07/2020] [Accepted: 02/08/2020] [Indexed: 01/20/2023] Open
Abstract
Introduction: Strongyloidiasis is a prevailing helminth infection ubiquitous in tropical and subtropical areas, however, seroprevalence data are scarce in migrant populations, particularly for those coming for Asia. Methods: This study aims at evaluating the prevalence of S. stercoralis at the hospital level in migrant populations or long term travellers being attended in out-patient and in-patient units as part of a systematic screening implemented in six Spanish hospitals. A cross-sectional study was conducted and systematic screening for S. stercoralis infection using serological tests was offered to all eligible participants. Results: The overall seroprevalence of S. stercoralis was 9.04% (95%CI 7.76-10.31). The seroprevalence of people with a risk of infection acquired in Africa and Latin America was 9.35% (95%CI 7.01-11.69), 9.22% (7.5-10.93), respectively. The number of individuals coming from Asian countries was significantly smaller and the overall prevalence in these countries was 2.9% (95%CI -0.3-6.2). The seroprevalence in units attending potentially immunosuppressed patients was significantly lower (5.64%) compared with other units of the hospital (10.20%) or Tropical diseases units (13.33%) (p < 0.001). Conclusions: We report a hospital-based strongyloidiasis seroprevalence of almost 10% in a mobile population coming from endemic areas suggesting the need of implementing strongyloidiasis screening in hospitalized patients coming from endemic areas, particularly if they are at risk of immunosuppression.
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Affiliation(s)
- Ana Requena-Méndez
- Barcelona Institute for Global Health, ISGlobal-Hospital Clinic, Universitat de Barcelona, 08036 Barcelona, Spain; (C.S.); (J.M.)
- Department of Global Public Health, Karolinska Institutet, 171 77 Solna, Sweden
- Correspondence: ; Tel.: +34-652-870-779
| | - Joaquin Salas-Coronas
- Tropical Medicine Unit. Hospital de Poniente, El Ejido, 04700 Almería, Spain; (J.S.-C.); (M.T.C.F.)
| | - Fernando Salvador
- Department of Infectious Diseases, Vall d’Hebron University Hospital, PROSICS Barcelona, 08035 Barcelona, Spain;
| | - Joan Gomez-Junyent
- Department of Infectious Diseases, Hospital Universitari Bellvitge, 08907 Barcelona, Spain; (J.G.-J.), (M.S.)
| | - Judith Villar-Garcia
- Infectious Diseases Department, Hospital del Mar-IMIM, 08003 Barcelona, Spain; (J.V.-G.); (M.d.M.A.)
| | - Miguel Santin
- Department of Infectious Diseases, Hospital Universitari Bellvitge, 08907 Barcelona, Spain; (J.G.-J.), (M.S.)
| | - Carme Muñoz
- Department of Microbiology, Hospital Sant Pau, 08041 Barcelona, Spain; (C.M.); (J.L.-M.)
| | | | | | - Elena Sulleiro
- Department of Microbiology, Vall d’Hebron University Hospital, PROSICS Barcelona, 08035 Barcelona, Spain;
| | - Maria del Mar Arenas
- Infectious Diseases Department, Hospital del Mar-IMIM, 08003 Barcelona, Spain; (J.V.-G.); (M.d.M.A.)
| | - Dolors Somoza
- Department of Microbiology. Hospital Universitari Bellvitge, 08907 Barcelona, Spain;
| | | | - Begoña Treviño
- Tropical Medicine Unit Vall d’Hebron-Drassanes, PROSICS Barcelona, 08035 Barcelona, Spain;
| | - Esperanza Rodríguez
- Parasitology Department, Centro Nacional de Microbiologia—Instituto de Salud Carlos III, 28020 Madrid, Spain;
| | | | - Jaume Llaberia-Marcual
- Department of Microbiology, Hospital Sant Pau, 08041 Barcelona, Spain; (C.M.); (J.L.-M.)
| | - Carme Subirá
- Barcelona Institute for Global Health, ISGlobal-Hospital Clinic, Universitat de Barcelona, 08036 Barcelona, Spain; (C.S.); (J.M.)
| | - Jose Muñoz
- Barcelona Institute for Global Health, ISGlobal-Hospital Clinic, Universitat de Barcelona, 08036 Barcelona, Spain; (C.S.); (J.M.)
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Norman FF, Comeche B, Chamorro S, López-Vélez R. Overcoming challenges in the diagnosis and treatment of parasitic infectious diseases in migrants. Expert Rev Anti Infect Ther 2020; 18:127-143. [PMID: 31914335 DOI: 10.1080/14787210.2020.1713099] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Introduction: Recent increases in population movements have created novel health challenges in many areas of the World, and health policies have been adapted accordingly in several countries. However, screening guidelines for infectious diseases are not standardized and generally do not include comprehensive screening for parasitic infections.Areas covered: Malaria, Chagas disease, leishmaniasis, amebiasis, filariases, strongyloidiasis, and schistosomiasis are reviewed, focusing on the challenges posed for their diagnosis and management in vulnerable populations such as migrants. The methodology included literature searches in public databases such as PubMed.gov and Google Scholar and search of the US National Library of Medicine online database of privately and publicly funded clinical studies (ClinicalTrials.gov) until November 2019.Expert opinion: Parasitic infections which may remain asymptomatic for prolonged periods, leading to chronic infection and complications, and/or may be transmitted in non-endemic areas are ideal candidates for screening. Proposed strategies to improve diagnosis in vulnerable groups such as migrants include facilitating access to healthcare in a multi-dimensional manner considering location, individual characteristics, and timing. Limitations and availability of specific diagnostic techniques should be addressed and focus on drug and vaccine development for these neglected infections should be prioritized through collaborative initiatives with public disclosure of results.
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Affiliation(s)
- Francesca F Norman
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Belen Comeche
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Sandra Chamorro
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Rogelio López-Vélez
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
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