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Nieves E, Fleitas P, Juárez M, Almazán C, Flores G, Alani J, Diaz R, Martos J, Cajal P, Cimino R, Krolewiecki A. Comparison of parasitological methods for the identification of soil-transmitted helminths, including Strongyloides stercoralis, in a regional reference laboratory in northwestern Argentina: An observational study. Parasite Epidemiol Control 2024; 26:e00370. [PMID: 39139793 PMCID: PMC11321430 DOI: 10.1016/j.parepi.2024.e00370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 06/03/2024] [Accepted: 07/18/2024] [Indexed: 08/15/2024] Open
Abstract
Soil-transmitted helminths (STH) are a significant public health problem in impoverished communities of tropical and subtropical areas. Improved diagnostic methods are crucial for Neglected Tropical Diseases programs, particularly for S. stercoralis, as traditional methods are inadequate. Thus, it is important to identify the most accurate and efficient methods for the diagnosis of STH. We performed a retrospective study analyzing laboratory data at the Instituto de Investigaciones de Enfermedades Tropicales from 2010 to 2019. The study included data from outpatients referred for stool analysis and public health interventions from urban and rural communities in northern Salta province, Argentina. Samples were included in this analysis if processed through sedimentation/concentration, Baermann, Harada-Mori and McMaster's, with a subgroup that also included Agar plate culture method (APC). Sensitivity was calculated against a composite reference standard. Of the 5625 samples collected, 944 qualified for this analysis, with a prevalence of 11.14% for A. lumbricoides, 8.16% for hookworm, 1.38% for T. trichiura, and 6.36% for S. stercoralis. The sedimentation/concentration method was the most sensitive for A. lumbricoides (96%), compared to the McMaster method, with a sensitivity of 62%. Similarly, for hookworms, sedimentation/concentration was more sensitive than McMaster's, Harada-Mori, and Baermann with sensitivities of 87%, 70%, 43%, and 13%, respectively. Most of these infections were of light intensity. For S. stercoralis, Baermann and sedimentation/concentration methods were the most sensitive, with 70% and 62% respectively, while Harada-Mori was the least sensitive. In a subset of 389 samples also analyzed by the APC, Baermann was more sensitive than APC for detecting S. stercoralis, and both methods were superior to Harada-Mori. Parasitological methods, mostly when used combined, offer adequate opportunities for the diagnosis of STH in clinical and public health laboratories. The incorporation of S. stercoralis into the control strategies of the World Health Organization requires rethinking the current diagnostic approach used for surveys. With sedimentation/concentration and Baermann appearing as the most sensitive methods for this species. Further studies, including implementation assessments, should help in identifying the most adequate and feasible all-STH diagnostic approach.
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Affiliation(s)
- Elvia Nieves
- Universidad Nacional de Salta, Sede Regional Orán, Instituto de Investigaciones de Enfermedades Tropicales, Salta, Argentina (IIET)
- Consejo Nacional de Investigaciones Científicas y Técnicas, Argentina (CONICET)
| | - Pedro Fleitas
- Instituto de Salud Global de Barcelona, Barcelona, Spain
| | - Marisa Juárez
- Universidad Nacional de Salta, Sede Regional Orán, Instituto de Investigaciones de Enfermedades Tropicales, Salta, Argentina (IIET)
- Universidad Nacional de Salta, Sede Regional Orán, Cátedra de Química Biológica, Salta, Argentina
| | - Cristina Almazán
- Universidad Nacional de Salta, Sede Regional Orán, Instituto de Investigaciones de Enfermedades Tropicales, Salta, Argentina (IIET)
- Consejo Nacional de Investigaciones Científicas y Técnicas, Argentina (CONICET)
| | - Gabriela Flores
- Universidad Nacional de Salta, Sede Regional Orán, Instituto de Investigaciones de Enfermedades Tropicales, Salta, Argentina (IIET)
| | - Jimena Alani
- Universidad Nacional de Salta, Sede Regional Orán, Instituto de Investigaciones de Enfermedades Tropicales, Salta, Argentina (IIET)
| | - Ramón Diaz
- Universidad Nacional de Salta, Sede Regional Orán, Instituto de Investigaciones de Enfermedades Tropicales, Salta, Argentina (IIET)
| | - Jorge Martos
- Universidad Nacional de Salta, Sede Regional Orán, Instituto de Investigaciones de Enfermedades Tropicales, Salta, Argentina (IIET)
| | - Pamela Cajal
- Universidad Nacional de Salta, Sede Regional Orán, Instituto de Investigaciones de Enfermedades Tropicales, Salta, Argentina (IIET)
- Hospital Señor del Milagro, Ministerio de Salud Pública, Salta, Argentina
- Universidad Nacional de Salta, Facultad de Ciencias de la Salud, Cátedra de Microbiología y Parasitología, Salta, Argentina
| | - Rubén Cimino
- Universidad Nacional de Salta, Sede Regional Orán, Instituto de Investigaciones de Enfermedades Tropicales, Salta, Argentina (IIET)
- Consejo Nacional de Investigaciones Científicas y Técnicas, Argentina (CONICET)
- Universidad Nacional de Salta, Facultad de Ciencias Naturales, Cátedra de Química Biológica, Salta, Argentina
| | - Alejandro Krolewiecki
- Universidad Nacional de Salta, Sede Regional Orán, Instituto de Investigaciones de Enfermedades Tropicales, Salta, Argentina (IIET)
- Consejo Nacional de Investigaciones Científicas y Técnicas, Argentina (CONICET)
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Gordon CA, Utzinger J, Muhi S, Becker SL, Keiser J, Khieu V, Gray DJ. Strongyloidiasis. Nat Rev Dis Primers 2024; 10:6. [PMID: 38272922 DOI: 10.1038/s41572-023-00490-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/18/2023] [Indexed: 01/27/2024]
Abstract
Strongyloidiasis is a neglected tropical disease caused primarily by the roundworm Strongyloides stercoralis. Strongyloidiasis is most prevalent in Southeast Asia and the Western Pacific. Although cases have been documented worldwide, global prevalence is largely unknown due to limited surveillance. Infection of the definitive human host occurs via direct skin penetration of the infective filariform larvae. Parasitic females reside in the small intestine and reproduce via parthenogenesis, where eggs hatch inside the host before rhabditiform larvae are excreted in faeces to begin the single generation free-living life cycle. Rhabditiform larvae can also develop directly into infectious filariform larvae in the gut and cause autoinfection. Although many are asymptomatic, infected individuals may report a range of non-specific gastrointestinal, respiratory or skin symptoms. Autoinfection may cause hyperinfection and disseminated strongyloidiasis in immunocompromised individuals, which is often fatal. Diagnosis requires direct examination of larvae in clinical specimens, positive serology or nucleic acid detection. However, there is a lack of standardization of techniques for all diagnostic types. Ivermectin is the treatment of choice. Control and elimination of strongyloidiasis will require a multifaceted, integrated approach, including highly sensitive and standardized diagnostics, active surveillance, health information, education and communication strategies, improved water, sanitation and hygiene, access to efficacious treatment, vaccine development and better integration and acknowledgement in current helminth control programmes.
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Affiliation(s)
- Catherine A Gordon
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Herston, Brisbane, Queensland, Australia.
- Faculty of Medicine, University of Queensland, St Lucia, Brisbane, Queensland, Australia.
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Stephen Muhi
- Victorian Infectious Diseases Service, The Royal Melbourne Hospital, Parkville, Victoria, Australia
- The University of Melbourne, Department of Microbiology and Immunology, Parkville, Victoria, Australia
| | - Sören L Becker
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
- Institute of Medical Microbiology and Hygiene, Saarland University, Homburg/Saar, Germany
| | - Jennifer Keiser
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Virak Khieu
- National Centre for Parasitology, Entomology and Malaria Control, Ministry of Health, Phnom Penh, Cambodia
| | - Darren J Gray
- Population Health Program, QIMR Berghofer Medical Research Institute, Herston, Brisbane, Queensland, Australia
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Marlais T, Bickford-Smith J, Talavera-López C, Le H, Chowdhury F, Miles MA. A comparative 'omics' approach for prediction of candidate Strongyloides stercoralis diagnostic coproantigens. PLoS Negl Trop Dis 2023; 17:e0010777. [PMID: 37068106 PMCID: PMC10138266 DOI: 10.1371/journal.pntd.0010777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 04/27/2023] [Accepted: 04/03/2023] [Indexed: 04/18/2023] Open
Abstract
Human infection with the intestinal nematode Strongyloides stercoralis is persistent unless effectively treated, and potentially fatal in immunosuppressed individuals. Epidemiological data are lacking, partially due to inadequate diagnosis. A rapid antigen detection test is a priority for population surveillance, validating cure after treatment, and for screening prior to immunosuppression. We used a targeted analysis of open access 'omics' data sets and used online predictors to identify S. stercoralis proteins that are predicted to be present in infected stool, Strongyloides-specific, and antigenic. Transcriptomic data from gut and non-gut dwelling life cycle stages of S. stercoralis revealed 328 proteins that are differentially expressed. Strongyloides ratti proteomic data for excreted and secreted (E/S) proteins were matched to S. stercoralis, giving 1,057 orthologues. Five parasitism-associated protein families (SCP/TAPS, prolyl oligopeptidase, transthyretin-like, aspartic peptidase, acetylcholinesterase) were compared phylogenetically between S. stercoralis and outgroups, and proteins with least homology to the outgroups were selected. Proteins that overlapped between the transcriptomic and proteomic datasets were analysed by multiple sequence alignment, epitope prediction and 3D structure modelling to reveal S. stercoralis candidate peptide/protein coproantigens. We describe 22 candidates from seven genes, across all five protein families for further investigation as potential S. stercoralis diagnostic coproantigens, identified using open access data and freely-available protein analysis tools. This powerful approach can be applied to many parasitic infections with 'omic' data to accelerate development of specific diagnostic assays for laboratory or point-of-care field application.
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Affiliation(s)
- Tegwen Marlais
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jack Bickford-Smith
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Carlos Talavera-López
- Institute of Computational Biology, Computational Health Centre, Helmholtz Munich, Neuherberg, Germany
| | - Hai Le
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Fatima Chowdhury
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Michael A Miles
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Scott J, Emeto TI, Melrose W, Warner J, Rush C. Seroepidemiology of Strongyloides spp. Infection in Balimo, Western Province, Papua New Guinea. Am J Trop Med Hyg 2023; 108:346-352. [PMID: 36572010 PMCID: PMC9896327 DOI: 10.4269/ajtmh.22-0408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 10/12/2022] [Indexed: 12/27/2022] Open
Abstract
Strongyloidiasis in Papua New Guinea (PNG) is poorly understood. There have been limited surveys describing the levels of endemicity in some regions of PNG, but in the Western Province, its occurrence and level of burden are unknown. This study aimed to determine the seroepidemiology of Strongyloides spp. seropositivity within a community located in the Balimo region of the Western Province. Plasma samples were collected from 120 adult participants and were subjected to anti-IgG Strongyloides spp. serological testing. Logistical regression analyses were performed to identify relationships between strongyloidiasis and attributes of sociodemography. In this cross-sectional cohort study, 22.5% (27/120; 95% CI: 15.9-30.8%) of participants were seropositive for strongyloidiasis. Participants with higher body mass indices were less likely to be seropositive for Strongyloides spp. infection (odds ratio [OR] = 0.85, P value = 0.008), and in the multivariable analysis, increasing units of age (adjusted OR [aOR] = 0.93, P value = 0.048) and participants ≤ 40 years old were associated with a decreased likelihood of Strongyloides spp. seropositivity (aOR = 0.07, P value = 0.034). The results from this study indicate that the occurrence of strongyloidiasis is high in the Western Province, PNG, and age is a determining factor of seroreactivity. This study provides evidence of endemic strongyloidiasis in this community and raises questions as to the impact of this neglected disease and other intestinal parasites on disease burden and comorbidities.
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Affiliation(s)
- Jessica Scott
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Australia
| | - Theophilus I. Emeto
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Australia
- World Health Organization Collaborating Centre for Vector-Borne and Neglected Tropical Diseases, James Cook University, Townsville, Australia
| | - Wayne Melrose
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - Jeffrey Warner
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Australia
| | - Catherine Rush
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Australia
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Leuenberger A, Koné BV, N’krumah RTAS, Koffi DY, Bonfoh B, Utzinger J, Pluschke G. Perceived water-related risk factors of Buruli ulcer in two villages of south-central Côte d'Ivoire. PLoS Negl Trop Dis 2022; 16:e0010927. [PMID: 36516125 PMCID: PMC9750022 DOI: 10.1371/journal.pntd.0010927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 11/01/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Buruli ulcer, caused by Mycobacterium ulcerans, is a neglected tropical skin disease that is primarily endemic in West and Central Africa, including Côte d'Ivoire. Studies indicate that M. ulcerans infections are caused by contact with an environmental reservoir of the bacteria, governed by specific human biological conditions. Yet, the nature of this reservoir and the exact mode of transmission remain unknown. METHODOLOGY To identify ecologic risk factors of Buruli ulcer in south-central Côte d'Ivoire, we pursued a qualitative study matched with geo-referencing inquiry. Embedded in a broader integrated wound management research project, we (i) mapped households and water sources of laboratory confirmed Buruli ulcer cases and (ii) interviewed 12 patients and four health care workers to assess exposure to surface water and to deepen the understanding of perceived transmission pathways. PRINCIPAL FINDINGS Water availability, accessibility, and affordability were reported as key determinants for choosing water resources. Furthermore, perceived risks were related to environmental, structural, and individual factors. Despite the presence of improved water sources (e.g., drilled wells), communities heavily relied on unprotected surface water for a multitude of activities. The nearby Bandama River and seasonal waterbodies were frequently used for washing, bathing, and collection of water for drinking and cooking. Many residents also reported to cross the river on a daily basis for agricultural chores, and hence, are exposed to stagnant water during farming activities. CONCLUSIONS/SIGNIFICANCE Our study in two Buruli ulcer endemic villages in south-central Côte d'Ivoire revealed a wide range of water-related domestic activities that might expose people to an increased risk of contracting the disease. Environmental, biological, social, and cultural risk factors are closely interlinked and should be considered in future investigations of Buruli ulcer transmission. Active participation of the communities is key to better understand their circumstances to advance research and fight against Buruli ulcer and other neglected tropical diseases.
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Affiliation(s)
- Andrea Leuenberger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Bognan V. Koné
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Raymond T. A. S. N’krumah
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Université Peleforo Gon Coulibaly de Korhogo, Korhogo, Côte d’Ivoire
| | - Didier Y. Koffi
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Programme National de Lutte contre l’Ulcère de Buruli, Abidjan, Côte d’Ivoire
| | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Gerd Pluschke
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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Scope and limitations of a multiplex conventional PCR for the diagnosis of S. stercoralis and hookworms. Braz J Infect Dis 2021; 25:101649. [PMID: 34774469 PMCID: PMC9392200 DOI: 10.1016/j.bjid.2021.101649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/23/2021] [Accepted: 10/17/2021] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Describe the diagnostic characteristics of a conventional multiplex PCR for the diagnosis of S. stercoralis, N. americanus and Ancylostomas spp. METHODS Fecal samples were collected from a cross-sectional study in Orán department, Salta province, Argentina. The stool samples were analyzed using concentration-sedimentation, Harada Mori, McMaster, and Baermann techniques. DNA was extracted from 50 mg fecal sample using the FastPrep® Spin Kit for Soil. Three pairs of primers were used for the amplification of three products of 101, 330, and 577 base pairs (bp) for S. stercoralis, N. americanus and Ancylostoma spp, respectively. The sensitivity and analytical specificity of multiplex PCR were evaluated, as well as the sensitivity and diagnostic specificity, using a composite standard and Bayesian approach. RESULTS AND CONCLUSIONS Multiplex PCR did not present cross-reaction with other intestinal parasites, and the detection limit for multiplex PCR was between 2 and 20 pg of genomic DNA. In addition it presented a diagnostic sensitivity of 97.4% for S. stercoralis and 90.3% for hookworms with a specificity of 100% and 87.6%, respectively. PCR identified a higher proportion (p <0.01) of coinfections (15.3%) than microscopic techniques (3.5%). Also, multiplex PCR showed that there was a positive association between S. stercoralis and hookworms (odds ratio = 2.12). However, this association was due to N. americanus (odds ratio= 3.22), since no association was observed between S. stercoralis and Ancylostoma spp. Neither was an association observed between the two species of hookworms.
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Hansen M, Bowden E, Currie BJ, Ward L, Andrews RM, Dhurrkay RG, Gurruwiwi GG, Kearns T. Strongyloides stercoralis seropositivity is not associated with increased symptoms in a remote Aboriginal community. Intern Med J 2021; 51:1286-1291. [PMID: 32372503 DOI: 10.1111/imj.14884] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/27/2020] [Accepted: 04/27/2020] [Indexed: 01/23/2023]
Abstract
BACKGROUND Strongyloides stercoralis is a soil-transmitted helminth, endemic in remote Aboriginal and Torres Strait Islander communities in northern Australia with estimates of prevalences up to 60%. Hyperinfection in the setting of immunosuppression is a rare, but well recognised cause of significant morbidity and mortality. However, the morbidity associated with chronic uncomplicated infection is less well characterised. AIMS To measure the prevalence of symptoms potentially attributable to S. stercoralis infection and their association with seropositivity. METHODS This retrospective matched case-control study reviewed records of primary healthcare presentations for symptoms in the 12 months before and after an ivermectin mass drug administration (MDA) in a remote Aboriginal community. RESULTS One hundred and seventy-five S. stercoralis seropositive cases were matched with 175 seronegative controls. The most frequently reported symptom overall in the 12 months prior to the MDA was cough followed by abdominal pain, weight loss/malnutrition, diarrhoea and pruritis. Seropositive cases were not more likely than matched controls to have symptoms typically attributed to strongyloidiasis. In the seropositive cohort, we found no difference in symptoms in the 12 months before and after an ivermectin MDA despite a reduction in seroprevalence. CONCLUSION We found no evidence to suggest that S. stercoralis seropositivity was associated with increased symptoms when compared to matched seronegative controls. Treatment with ivermectin did not reduce symptoms in seropositive cases. Without evidence to support that population-based screening or treatment programmes reduce symptoms, the emphasis must remain on identifying and managing those few individuals with immunosuppression that predisposes them to potentially life-threatening hyperinfection.
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Affiliation(s)
- Martin Hansen
- Infectious Diseases Department, Royal Darwin Hospital, Northern Territory, Australia
| | - Emily Bowden
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Bart J Currie
- Infectious Diseases Department, Royal Darwin Hospital, Northern Territory, Australia.,Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Linda Ward
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Ross M Andrews
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.,Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | | | | | - Therese Kearns
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
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Buonfrate D, Fittipaldo A, Vlieghe E, Bottieau E. Clinical and laboratory features of Strongyloides stercoralis infection at diagnosis and after treatment: a systematic review and meta-analysis. Clin Microbiol Infect 2021; 27:1621-1628. [PMID: 34325063 DOI: 10.1016/j.cmi.2021.07.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/08/2021] [Accepted: 07/11/2021] [Indexed: 11/25/2022]
Abstract
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.
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Affiliation(s)
- Dora Buonfrate
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy.
| | - Andrea Fittipaldo
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Erika Vlieghe
- Faculty of Medicine and Health Sciences, University of Antwerp, Belgium; Department of General Internal Medicine Infectious Diseases and Tropical Medicine, University Hospital Antwerp, Belgium
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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Ahmad H, Arifin N, Nolan TJ, Lok JB, Anuar NS, Noordin R. Strongyloides-Specific IgE Phage cDNA Clones and Development of a Novel ELISA for Strongyloidiasis. Diagnostics (Basel) 2021; 11:diagnostics11060985. [PMID: 34071716 PMCID: PMC8228214 DOI: 10.3390/diagnostics11060985] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 05/25/2021] [Indexed: 12/05/2022] Open
Abstract
Strongyloidiasis, caused mainly by the nematode Strongyloides stercoralis, is prevalent worldwide and potentially fatal in immunosuppressed patients. We report on a new IgE biomarker to diagnose Strongyloides infection. Sera from two groups infected with Strongyloides served as positive samples: Group 1A, in which infection was confirmed by stool-microscopy and/or stool-polymerase chain reaction (PCR) and was seropositive by an IgG-enzyme linked immunosorbent assay (ELISA) and an IgG4 rapid test, and Group 1B in which infection was confirmed by stool-PCR but was seronegative. Negative samples (controls) comprised infections with other parasites (Group II) and healthy donors (Group III). Immunoscreenings of an S. stercoralis complementary DNA (cDNA) library were performed, and the cDNA clone with the highest diagnostic potential (clone A133) was selected for recombinant protein production and then evaluated using IgE Western blot and ELISA. The Western blot showed that the recombinant protein (rA133) was 100% reactive with Group IA (n = 10) and Group IB (n = 5), and 96% non-reactive with Groups II and III (n = 25). Subsequently, the IgE-ELISA was developed and showed 100% diagnostic sensitivity in Groups IA (n = 32) and IB (n = 11); and 99.3% specificity in Groups II and III (n = 144). In conclusion, this study has identified rA133 as a novel recombinant protein with potential diagnostic value, and that the IgE-ELISA incorporating this protein may be useful for patient diagnosis and epidemiological studies.
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Affiliation(s)
- Hussain Ahmad
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Gelugor 11800, Malaysia; (H.A.); (N.A.); (N.S.A.)
- Department of Microbiology, Abdul Wali Khan University, Mardan 23200, Pakistan
| | - Norsyahida Arifin
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Gelugor 11800, Malaysia; (H.A.); (N.A.); (N.S.A.)
| | - Thomas J. Nolan
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (T.J.N.); (J.B.L.)
| | - James B. Lok
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (T.J.N.); (J.B.L.)
| | - Nor Suhada Anuar
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Gelugor 11800, Malaysia; (H.A.); (N.A.); (N.S.A.)
| | - Rahmah Noordin
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Gelugor 11800, Malaysia; (H.A.); (N.A.); (N.S.A.)
- Correspondence:
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Hailu T, Nibret E, Amor A, Munshea A, Anegagrie M. Agar Plate Culture: An Alternative Sensitive Routine Laboratory Detection Method for Strongyloides stercoralis and Hookworm Parasites. IRANIAN JOURNAL OF PARASITOLOGY 2021; 16:72-80. [PMID: 33786049 PMCID: PMC7988663 DOI: 10.18502/ijpa.v16i1.5514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: Human infection with Strongyloides stercoralis and hookworm parasites is usually under reported due to less sensitive diagnostic methods. Agar plate culture (APC) is the most sensitive technique for parasites having larval stage. However, using APC in routine diagnosis is uncommon. This study aimed to determine the detection rate and sensitivity of APC in comparison with formal ether concentration technique (FECT) and spontaneous tube sedimentation techniques (STSTs) for S. stercoralis and hookworm larvae. Methods: Stool samples collected from 844 schoolchildren in Amhara Regional State, northwestern Ethiopia in 2019, transported to nearby health institutions and processed by APC, FECT and STSTs. The prevalence of S. stercoralis and hookworm was computed by descriptive statistics and Chi-square. The diagnostic agreement among the three techniques was evaluated using Kappa value. Results: The overall prevalence of S. stercoralis and hookworm infections by combining the three methods was 13.2% (111/844) and 33.8% (277/844), respectively. Using APC alone, the prevalence of S. stercoralis and hookworm were found to be 10.9% (92/844) and 24.5% (207/844), respectively. Agar plate culture was 5.4 and 2.7 times respectively more sensitive than FECT and STST, with slight and fair agreement in the detection of S. stercoralis. Hookworm diagnostic agreement was moderate between APC and FECT, and APC and STST. The Kappa value between STST and FECT diagnostic methods was substantial. Conclusion: APC has a better detection rate of S stercoralis and hookworm larvae. Therefore, APC can be used as an alternative routine diagnostic method to S. stercoralis and hookworm co-endemic countries.
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Affiliation(s)
- Tadesse Hailu
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Endalkachew Nibret
- Biology Department, Science College, Bahir Dar University, Bahir Dar, Ethiopia
| | - Arancha Amor
- Mundo Sano Foundations, Institute of Health Carlos III, Madrid, Spain
| | - Abaineh Munshea
- Biology Department, Science College, Bahir Dar University, Bahir Dar, Ethiopia
| | - Melaku Anegagrie
- Mundo Sano Foundations, Institute of Health Carlos III, Madrid, Spain
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11
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Kridaningsih TN, Sukmana DJ, Mufidah H, Diptyanusa A, Kusumasari RA, Burdam FH, Kenangalem E, Poespoprodjo JR, Fuad A, Mahendradhata Y, Supargiyono S, Utzinger J, Becker SL, Murhandarwati EEH. Epidemiology and risk factors of Strongyloides stercoralis infection in Papua, Indonesia: a molecular diagnostic study. Acta Trop 2020; 209:105575. [PMID: 32505594 DOI: 10.1016/j.actatropica.2020.105575] [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: 03/09/2020] [Revised: 05/19/2020] [Accepted: 06/02/2020] [Indexed: 10/24/2022]
Abstract
Strongyloides stercoralis is a parasitic worm that is of considerable clinical relevance. Indeed, it may persist asymptomatically for many years, but can lead to potentially fatal dissemination when the host's immune status is impaired. As commonly employed stool microscopy techniques (e.g. Kato-Katz thick smear) fail to detect S. stercoralis, the epidemiology is poorly understood. In 2013, we conducted a cross-sectional household survey in the district of Mimika in Papua, Indonesia. A total of 331 individuals, aged 1 month to 44 years, had a single stool sample subjected to real-time polymerase chain reaction (PCR) for S. stercoralis diagnosis. The prevalence of S. stercoralis infection was 32.0% (106/331 individuals); higher than any of the three main soil-transmitted helminths (Ascaris lumbricoides, 23.9%; Trichuris trichiura, 18.4%; and hookworm, 17.2%). Amongst the S. stercoralis-infected individuals, 73.6% were concurrently infected with another helminth, with hookworm being the most frequent co-infection (27.4%). Fourteen percent of the S. stercoralis infections had low cycle threshold values on real-time PCR, which may indicate a higher infection intensity. Multivariate logistic regression analysis revealed that age ≥5 years (adjusted odds ratio (OR) 5.8, 95% confidence interval (CI): 3.1-10.8) was significantly associated with S. stercoralis infection. There is a need for in-depth clinical and diagnostic studies to elucidate the public health impact of S. stercoralis infection in Indonesia.
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12
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Turner HC, French MD, Montresor A, King CH, Rollinson D, Toor J. Economic evaluations of human schistosomiasis interventions: a systematic review and identification of associated research needs. Wellcome Open Res 2020; 5:45. [PMID: 32587899 PMCID: PMC7308887 DOI: 10.12688/wellcomeopenres.15754.2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Schistosomiasis is one of the most prevalent neglected tropical diseases (NTDs) with an estimated 229 million people requiring preventive treatment worldwide. Recommendations for preventive chemotherapy strategies have been made by the World Health Organization (WHO) whereby the frequency of treatment is determined by the settings prevalence. Despite recent progress, many countries still need to scale up treatment and important questions remain regarding optimal control strategies. This paper presents a systematic review of the economic evaluations of human schistosomiasis interventions. Methods: A systematic review of the literature was conducted on 22nd August 2019 using the PubMed (MEDLINE) and ISI Web of Science electronic databases. The focus was economic evaluations of schistosomiasis interventions, such as cost-effectiveness and cost-benefit analyses. No date or language stipulations were applied to the searches. Results: We identified 53 relevant health economic analyses of schistosomiasis interventions. Most studies related to Schistosoma japonicum followed by S. haematobium. Several studies also included other NTDs. In Africa, most studies evaluated preventive chemotherapy, whereas in China they mostly evaluated programmes using a combination of interventions (such as chemotherapy, snail control and health education). There was wide variation in the methodology and epidemiological settings investigated. A range of effectiveness metrics were used by the different studies. Conclusions: Due to the variation across the identified studies, it was not possible to make definitive policy recommendations. Although, in general, the current WHO recommended preventive chemotherapy approach to control schistosomiasis was found to be cost-effective. This finding has important implications for policymakers, advocacy groups and potential funders. However, there are several important inconsistencies and research gaps (such as how the health benefits of interventions are quantified) that need to be addressed to identify the resources required to achieve schistosomiasis control and elimination.
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Affiliation(s)
- Hugo C. Turner
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary’s Campus, Imperial College London, London, W2 1PG, UK
- Oxford University Clinical Research Unit, Wellcome Africa Asia Programme, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - Antonio Montresor
- Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Charles H. King
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, USA
| | - David Rollinson
- Global Schistosomiasis Alliance, Natural History Museum, London, UK
| | - Jaspreet Toor
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK
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13
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de Souza JN, Oliveira CDL, Araújo WAC, Souza ABS, Silva MLS, da Cruz IDR, Sampaio LM, dos Santos JSB, Teixeira MCA, Soares NM. Strongyloides stercoralis in Alcoholic Patients: Implications of Alcohol Intake in the Frequency of Infection and Parasite Load. Pathogens 2020; 9:pathogens9060422. [PMID: 32481753 PMCID: PMC7350291 DOI: 10.3390/pathogens9060422] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/23/2020] [Accepted: 05/26/2020] [Indexed: 01/08/2023] Open
Abstract
Strongyloides stercoralis infection in immunocompromised subjects, including chronic alcoholics, can lead to a severe disease. Moreover, its prevalence in alcoholic patients seems to be higher than that in the general population. The aims of this study were to evaluate the frequency of S. stercoralis infection in alcoholic patients and to investigate the influence of alcohol intake on the parasite load, as well as to evaluate the sensitivity of three different parasitological methods according to the larval output. Fecal samples of 1290 chronic alcoholic patients were examined by spontaneous sedimentation, Baermann-Moraes, and agar plate culture (APC) methods. S. stercoralis was the most frequent parasite found (14.5%; n = 187). Alcoholic individuals infected with Strongyloides stercoralis had a higher daily consumption of alcohol than those who were not infected, 528.6 and 403.0 g/day, respectively (p < 0.05). In addition, individuals with higher alcohol intake presented an increase in parasite load. The S. stercoralis diagnostic method with the highest sensitivity was APC, 97.9% (183/187). In conclusion, S. stercoralis seems to be the most frequent parasite found in alcoholic individuals from endemic areas and alcohol intake is positively associated with S. stercoralis larvae output. In addition, this study confirms that APC is the most sensitive parasitological method used for Strongyloides diagnosis.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Neci M. Soares
- Correspondence: or ; Tel.: +55-71-32836950; Fax: +55-71-32836919
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14
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Fleitas PE, Travacio M, Martí-Soler H, Socías ME, Lopez WR, Krolewiecki AJ. The Strongyloides stercoralis-hookworms association as a path to the estimation of the global burden of strongyloidiasis: A systematic review. PLoS Negl Trop Dis 2020; 14:e0008184. [PMID: 32282827 PMCID: PMC7188296 DOI: 10.1371/journal.pntd.0008184] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 04/28/2020] [Accepted: 02/29/2020] [Indexed: 12/21/2022] Open
Abstract
TRIAL REGISTRATION PROSPERO (registration code CRD42019131127).
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Affiliation(s)
- Pedro E. Fleitas
- Universidad Nacional de Salta, Instituto de Investigaciones de Enfermedades Tropicales/CONICET, Orán, Salta, Argentina
- Universidad Nacional de Salta, Cátedra de Química Biológica, Facultad de Ciencias Naturales, Salta, Salta, Argentina
| | - Marina Travacio
- Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica, Cátedra de Química General e Inorgánica, Buenos Aires, Argentina
| | - Helena Martí-Soler
- Universitat de Barcelona, ISGlobal, Hospital Clínic, Barcelona, Cataluña, Spain
| | - M. Eugenia Socías
- University of British Columbia, British Columbia Centre on Substance Use, Department of Medicine, Vancouver, BC, Canada
| | - Walter R. Lopez
- Universidad Nacional de Salta, Instituto de Investigaciones de Enfermedades Tropicales/CONICET, Orán, Salta, Argentina
| | - Alejandro J. Krolewiecki
- Universidad Nacional de Salta, Instituto de Investigaciones de Enfermedades Tropicales/CONICET, Orán, Salta, Argentina
- Universitat de Barcelona, ISGlobal, Hospital Clínic, Barcelona, Cataluña, Spain
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15
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Turner HC, French MD, Montresor A, King CH, Rollinson D, Toor J. Economic evaluations of human schistosomiasis interventions: a systematic review and identification of associated research needs. Wellcome Open Res 2020; 5:45. [PMID: 32587899 PMCID: PMC7308887 DOI: 10.12688/wellcomeopenres.15754.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2020] [Indexed: 11/05/2023] Open
Abstract
Background: Schistosomiasis is one of the most prevalent neglected tropical diseases (NTDs) with an estimated 229 million people requiring preventive treatment worldwide. Recommendations for preventive chemotherapy strategies have been made by the World Health Organization (WHO) whereby the frequency of treatment is determined by the settings prevalence. Despite recent progress, many countries still need to scale up treatment and important questions remain regarding optimal control strategies. This paper presents a systematic review of the economic evaluations of human schistosomiasis interventions. Methods: A systematic review of the literature was conducted on 22nd August 2019 using the PubMed (MEDLINE) and ISI Web of Science electronic databases. The focus was economic evaluations of schistosomiasis interventions, such as cost-effectiveness and cost-benefit analyses. No date or language stipulations were applied to the searches. Results: We identified 53 relevant health economic analyses of schistosomiasis interventions. Most studies related to Schistosoma japonicum followed by S. haematobium. Several studies also included other NTDs. In Africa, most studies evaluated preventive chemotherapy, whereas in China they mostly evaluated programmes using a combination of interventions (such as chemotherapy, snail control and health education). There was wide variation in the methodology and epidemiological settings investigated. A range of effectiveness metrics were used by the different studies. Conclusions: Due to the variation across the identified studies, it was not possible to make definitive policy recommendations. Although, in general, the current WHO recommended preventive chemotherapy approach to control schistosomiasis was found to be cost-effective. This finding has important implications for policymakers, advocacy groups and potential funders. However, there are several important inconsistencies and research gaps (such as how the health benefits of interventions are quantified) that need to be addressed to identify the resources required to achieve schistosomiasis control and elimination.
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Affiliation(s)
- Hugo C. Turner
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary’s Campus, Imperial College London, London, W2 1PG, UK
- Oxford University Clinical Research Unit, Wellcome Africa Asia Programme, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - Antonio Montresor
- Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Charles H. King
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, USA
| | - David Rollinson
- Global Schistosomiasis Alliance, Natural History Museum, London, UK
| | - Jaspreet Toor
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK
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16
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Sengthong C, Yingklang M, Intuyod K, Hongsrichan N, Pinlaor S. An optimized agar plate culture improves diagnostic efficiency for Strongyloides stercoralis infection in an endemic community. Parasitol Res 2020; 119:1409-1413. [PMID: 32086591 DOI: 10.1007/s00436-020-06626-2] [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] [Received: 07/26/2019] [Accepted: 02/14/2020] [Indexed: 02/05/2023]
Abstract
We aimed to compare the efficacy of modified agar plate fecal culture (mAPC) and standard agar plate culture (sAPC) for diagnosis of Strongyloides stercoralis infection in a community at Khon Kaen Province, Thailand. Fecal samples were collected from participants individually (n = 1076) and were tested using these two methods. Modified APC and sAPC detected 129 (11.99%) and 91 (8.46%) infected individuals, respectively. Thirty-eight participants were negative according to sAPC, but positive for mAPC. Moreover, in the participants who were positive for both methods, the number of worm developmental stages obtained was higher for mAPC than for sAPC. Our study suggests that mAPC is an effective and useful tool for S. stercoralis diagnosis and can be applied for mass-screening in community and/or control programs.
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Affiliation(s)
- Chatchawan Sengthong
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Medical Technology Unit of Bangkatum Hospital, Phitsanulok, 65110, Thailand.,Chronic Kidney Disease Prevention in the Northeastern Thailand, Khon Kaen, 40002, Thailand
| | - Manachai Yingklang
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Chronic Kidney Disease Prevention in the Northeastern Thailand, Khon Kaen, 40002, Thailand
| | - Kitti Intuyod
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Chronic Kidney Disease Prevention in the Northeastern Thailand, Khon Kaen, 40002, Thailand
| | - Nuttanan Hongsrichan
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Chronic Kidney Disease Prevention in the Northeastern Thailand, Khon Kaen, 40002, Thailand
| | - Somchai Pinlaor
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand. .,Chronic Kidney Disease Prevention in the Northeastern Thailand, Khon Kaen, 40002, Thailand.
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17
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Tamarozzi F, Martello E, Giorli G, Fittipaldo A, Staffolani S, Montresor A, Bisoffi Z, Buonfrate D. Morbidity Associated with Chronic Strongyloides stercoralis Infection: A Systematic Review and Meta-Analysis. Am J Trop Med Hyg 2020; 100:1305-1311. [PMID: 30963990 DOI: 10.4269/ajtmh.18-0895] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Strongyloides stercoralis, 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 S. stercoralis-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 S. stercoralis 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 S. stercoralis infection and inform public health policies.
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Affiliation(s)
| | - Elisa Martello
- Department of Veterinary Sciences, University of Turin, Turin, Italy
| | | | | | | | | | - Zeno Bisoffi
- Università degli Studi di Verona, Verona, Italy.,IRCCS Sacro Cuore Don Calabria Hospital, Verona, Italy
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18
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Abstract
Most of the 30 to 100 million people infected with Strongyloides stercoralis have subclinical (or asymptomatic) infections. These infections are commonly chronic and longstanding. A change in immune status can increase parasite numbers, leading to hyperinfection syndrome, dissemination, and death if unrecognized. The use of corticosteroids and HTLV-1 infection are most commonly associated with the hyperinfection syndrome. Strongyloides adult parasites reside in the small intestine and induce immune responses that are like other nematodes. Definitive diagnosis of S stercoralis infection is based on stool examinations for larvae. S stercoralis remains largely neglected.
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Affiliation(s)
- Alejandro Krolewiecki
- Institute for Tropical Diseases Research, Universidad Nacional de Salta/CONICET, Alvarado 751, Oran 4530, Salta, Argentina
| | - Thomas B Nutman
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Building 4 - Room B1-03, 4 Center Drive, Bethesda, MD 20892-0425, USA.
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19
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Strongyloides stercoralis: Spatial distribution of a highly prevalent and ubiquitous soil-transmitted helminth in Cambodia. PLoS Negl Trop Dis 2019; 13:e0006943. [PMID: 31220075 PMCID: PMC6586258 DOI: 10.1371/journal.pntd.0006943] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 03/21/2019] [Indexed: 12/13/2022] Open
Abstract
Background Strongyloides stercoralis is a neglected soil-transmitted helminth that occurs worldwide, though it is particularly endemic in tropical and subtropical areas. It can cause long-lasting and potentially fatal infections due to its ability to replicate within its host. S. stercoralis causes gastrointestinal and dermatological morbidity. The objective of this study was to assess the S. stercoralis infection risk and, using geostatistical models, to predict its geographical distribution in Cambodia. Methodology / Principal findings A nation-wide, community-based parasitological survey was conducted among the Cambodian population, aged 6 years and older. S. stercoralis was diagnosed using a serological diagnostic test that detects IgG antibodies in urine. Data on demography, hygiene and knowledge about helminth infection were collected. S. stercoralis prevalence among 7,246 participants with a complete data record was 30.5%, ranging from 10.9% to 48.2% across provinces. The parasite was ubiquitous in Cambodia; only five south-eastern provinces had prevalence rates below 20%. Infection risk increased with age for both men and women, although girls under the age of 13 and women aged 50 years and over had lower odds of infection than their male counterparts. Open defecation was associated with higher odds of infection, while having some knowledge of the health problems caused by worms was a protective factor. Infection risk was positively associated with nighttime maximum temperature, minimum rainfall, and distance to water; it was negatively associated with land occupied by rice fields. Conclusions / Significance S. stercoralis infection is rampant in Cambodia. Control programs delivering ivermectin are needed to manage the parasite. However, the high cost of this drug in Cambodia currently precludes the implementation of control initiatives. Donations, subsidies or affordable generics are needed so that S. stercoralis, which infects almost a third of the Cambodian population, can be addressed through an adequate control program. The threadworm, Strongyloides stercoralis, is a highly neglected worm infection, transmitted through infective larvae in the soil. Threadworms occur worldwide, particularly in tropical climates. It may cause long-lasting and potentially fatal infections due to the parasite’s ability to replicate within its host. This study aimed to assess the risk of threadworm infection at national level in Cambodia. We conducted a nation-wide, community-based parasitological survey of the Cambodian population, aged 6 years and over. The threadworm was diagnosed using a serological diagnostic test that detects antibodies in urine. Data on demography, hygiene and knowledge about helminth infection were collected. The purpose of this study was to predict the risk of S. stercoralis infection in unsurveyed locations, assess risk factors for infection, and map its geographical distribution in Cambodia. About one third (30.5%) of the enrolled study participants (n = 7,246) were infected with threadworms. At provincial level, the lowest and highest infection rates were 10.9% and 48.2%, respectively. Prevalence rates below 20% were found in just five south-eastern provinces. The risk of a threadworm infection increased with age for both men and women. Open defecation was associated with higher risk of infection, while having some knowledge of the health problems caused by worms was a protective factor. Infection risk was positively associated with environmental factors, such as nighttime maximum temperature, minimum rainfall, and distance to water; it was negatively associated with land occupied by rice fields. Threadworm infection is highly prevalent in Cambodia and adequate control measures, including access to treatment, are warranted to address the burden of this Neglected Tropical Disease (NTD) in Cambodia.
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Tuyizere A, Ndayambaje A, Walker TD, Bayingana C, Ntirenganya C, Dusabejambo V, Hale DC. Prevalence of Strongyloides stercoralis infection and other soil-transmitted helminths by cross-sectional survey in a rural community in Gisagara District, Southern Province, Rwanda. Trans R Soc Trop Med Hyg 2019; 112:97-102. [PMID: 29726969 PMCID: PMC5961251 DOI: 10.1093/trstmh/try036] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Indexed: 11/13/2022] Open
Abstract
Background Strongyloides stercoralis is one of the most neglected tropical diseases. Sparse, dated central African and Rwandan data on seroprevalence are available to guide public health efforts and clinical care. Methods In February 2016 we conducted a community-based cross-sectional study among 539 asymptomatic participants in a rural area in the Gisagara District, Southern Province, Rwanda. Direct faecal smear (DFS) and modified Koga agar plate culture (APC) were used to detect S. stercoralis infection in a single stool sample. Data on other soil-transmitted helminths diagnosed by DFS were also recorded. Results Four intestinal helminth infections were diagnosed, with S. stercoralis (17.4%) and hookworms (8.2%) seen most often. APC, compared with DFS, increased the diagnosis rate for S. stercoralis from 1.9% to 17.4% (p<0.01). The prevalence was higher in farmers and those with lower socio-economic status. Females were less often infected than males (odds ratio 0.6 [95% confidence interval 0.3 to 0.9], p=0.02). Conclusions S. stercoralis is highly prevalent among the general population in a rural area of Gisagara District, Southern Province, Rwanda. Access to effective diagnosis and treatment is needed for this neglected disease.
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Affiliation(s)
- Aloys Tuyizere
- Department of Internal Medicine, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Huye, Rwanda.,Department of Internal Medicine, University Teaching Hospital of Butare, Huye, Rwanda
| | - Alphonse Ndayambaje
- Department of Internal Medicine, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Huye, Rwanda.,Department of Internal Medicine, University Teaching Hospital of Butare, Huye, Rwanda
| | - Timothy D Walker
- Department of Internal Medicine, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Huye, Rwanda.,Department of Internal Medicine, University Teaching Hospital of Butare, Huye, Rwanda.,School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Claude Bayingana
- Department of Clinical Biology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Huye, Rwanda.,Department of Laboratory Medicine, University Teaching Hospital of Butare, Huye, Rwanda
| | - Cyprien Ntirenganya
- Department of Internal Medicine, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Huye, Rwanda.,Department of Internal Medicine, University Teaching Hospital of Butare, Huye, Rwanda
| | - Vincent Dusabejambo
- Department of Internal Medicine, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Huye, Rwanda.,Department of Internal Medicine, University Teaching Hospital of Kigali, Kigali, Rwanda
| | - DeVon C Hale
- Department of Internal Medicine, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Huye, Rwanda.,Department of Internal Medicine, University Teaching Hospital of Butare, Huye, Rwanda.,Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
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21
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Zhou S, Fu X, Pei P, Kucka M, Liu J, Tang L, Zhan T, He S, Chan YF, Rödelsperger C, Liu D, Streit A. Characterization of a non-sexual population of Strongyloides stercoralis with hybrid 18S rDNA haplotypes in Guangxi, Southern China. PLoS Negl Trop Dis 2019; 13:e0007396. [PMID: 31059500 PMCID: PMC6522072 DOI: 10.1371/journal.pntd.0007396] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 05/16/2019] [Accepted: 04/16/2019] [Indexed: 11/18/2022] Open
Abstract
Strongyloidiasis is a much-neglected but sometimes fatal soil born helminthiasis. The causing agent, the small intestinal parasitic nematode Strongyloides stercoralis can reproduce sexually through the indirect/heterogonic life cycle, or asexually through the auto-infective or the direct/homogonic life cycles. Usually, among the progeny of the parasitic females both, parthenogenetic parasitic (females only) and sexual free-living (females and males) individuals, are present simultaneously. We isolated S. stercoralis from people living in a village with a high incidence of parasitic helminths, in particular liver flukes (Clonorchis sinensis) and hookworms, in the southern Chinese province Guangxi. We determined nuclear and mitochondrial DNA sequences of individual S. stercoralis isolated from this village and from close by hospitals and we compared these S. stercoralis among themselves and with selected published S. stercoralis from other geographic locations. For comparison, we also analyzed the hookworms present in the same location. We found that, compared to earlier studies of S. stercoralis populations in South East Asia, all S. stercoralis sampled in our study area were very closely related, suggesting a recent common source of infection for all patients. In contrast, the hookworms from the same location, while all belonging to the species Necator americanus, showed rather extensive genetic diversity even within host individuals. Different from earlier studies conducted in other geographic locations, almost all S. stercoralis in this study appeared heterozygous for different sequence variants of the 18S rDNA hypervariable regions (HVR) I and IV. In contrast to earlier investigations, except for three males, all S. stercoralis we isolated in this study were infective larvae, suggesting that the sampled population reproduces predominantly, if not exclusively through the clonal life cycles. Consistently, whole genome sequencing of individual worms revealed higher heterozygosity than reported earlier for likely sexual populations of S. stercoralis. Elevated heterozygosity is frequently associated with asexual clonal reproduction.
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Affiliation(s)
- Siyu Zhou
- Department of Evolutionary Biology, Max-Planck-Institute for Developmental Biology, Tübingen, Germany
| | - Xiaoyin Fu
- Department of Parasitology, Guangxi Medical University, Nanning, China
| | - Pei Pei
- Department of Parasitology, Guangxi Medical University, Nanning, China
| | - Marek Kucka
- Friedrich Miescher Laboratory of the Max Planck Society, Tübingen, Germany
| | - Jing Liu
- Department of Parasitology, Guangxi Medical University, Nanning, China
| | - Lili Tang
- Department of Parasitology, Guangxi Medical University, Nanning, China
| | - Tingzheng Zhan
- Department of Parasitology, Guangxi Medical University, Nanning, China
| | - Shanshan He
- Department of Parasitology, Guangxi Medical University, Nanning, China
| | | | - Christian Rödelsperger
- Department of Evolutionary Biology, Max-Planck-Institute for Developmental Biology, Tübingen, Germany
| | - Dengyu Liu
- Department of Parasitology, Guangxi Medical University, Nanning, China
| | - Adrian Streit
- Department of Evolutionary Biology, Max-Planck-Institute for Developmental Biology, Tübingen, Germany
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22
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Hemmersbach-Miller M, Wolfe CR, Schmader KE. Solid organ transplantation in older adults. Infectious and other age-related considerations. ACTA ACUST UNITED AC 2019; 3. [PMID: 34113803 PMCID: PMC8189398 DOI: 10.21926/obm.transplant.1901046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
In the U.S., older adults aged 65 or above comprise nearly one quarter of the solid organ transplant (SOT) waitlists, and the number of transplants performed in this age group continues to increase. There are no specific guidelines for the assessment and follow up of the older SOT candidate or recipient. Older adults are at increased risk of infectious complications after SOT. Despite these complications and even with the use of suboptimal donors, overall outcomes are favorable. We provide an overview to specific consideration as they relate to the older SOT candidate and recipient.
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Affiliation(s)
- Marion Hemmersbach-Miller
- Division of Infectious Diseases, Duke University Medical Center, Durham NC, USA.,Duke Clinical Research Institute, Durham NC, USA
| | - Cameron R Wolfe
- Division of Infectious Diseases, Duke University Medical Center, Durham NC, USA
| | - Kenneth E Schmader
- Division of Geriatrics, Duke University Medical Center, Durham NC, USA.,GRECC, Durham VA, Durham NC. USA
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23
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Mutombo PN, Man NWY, Nejsum P, Ricketson R, Gordon CA, Robertson G, Clements ACA, Chacón-Fonseca N, Nissapatorn V, Webster JP, McLaws ML. Diagnosis and drug resistance of human soil-transmitted helminth infections: A public health perspective. ADVANCES IN PARASITOLOGY 2019; 104:247-326. [PMID: 31030770 DOI: 10.1016/bs.apar.2019.02.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Soil-transmitted helminth (STH) infections represent a major public health problem globally, particularly among socio-economically disadvantaged populations. Detection of STH infections is often challenging, requiring a combination of diagnostic techniques to achieve acceptable sensitivity and specificity, particularly in low infection-intensity situations. The microscopy-based Kato-Katz remains the most widely used method but has low sensitivity in the detection of, for instance, Strongyloides spp. infections, among others. Antigen/antibody assays can be more sensitive but are parasite species-specific. Highly sensitive PCR methods have been developed to be multiplexed to allow multi-species detection. Novel diagnostic tests for all STH species are needed for effective monitoring, evaluation of chemotherapy programmes, and to assess the potential emergence of parasite resistance. This review discusses available diagnostic methods for the different stages of STH control programmes, which vary in sensitivity and spectrum of detection requirements, and tools to evaluate drug efficacy and resistance.
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Affiliation(s)
- Polydor Ngoy Mutombo
- School of Public Health and Community Medicine, UNSW Medicine, UNSW, Sydney, NSW, Australia; Centre for Biomedical Research, Burnet Institute, Melbourne, VIC, Australia.
| | - Nicola W Y Man
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Peter Nejsum
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Robert Ricketson
- Hale O'mana'o Biomedical Research, Division of Emerging Pathogens, Edmond, OK, United States
| | - Catherine A Gordon
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Gemma Robertson
- Public and Environmental Health, Forensic and Scientific Services, Department of Health, Brisbane, QLD, Australia
| | | | - Nathalie Chacón-Fonseca
- Soil-Transmitted Helminths Section, Tropical Medicine Institute, Tropical Medicine Department, Faculty of Medicine, Central University of Venezuela, Caracas, Venezuela
| | - Veeranoot Nissapatorn
- School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand; Research Excellence Center for Innovation and Health Products (RECIHP), Walailak University, Nakhon Si Thammarat, Thailand
| | - Joanne P Webster
- Centre for Emerging, Endemic and Exotic Diseases (CEEED), Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, London, United Kingdom
| | - Mary-Louise McLaws
- School of Public Health and Community Medicine, UNSW Medicine, UNSW, Sydney, NSW, Australia.
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24
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Arifin N, Hanafiah KM, Ahmad H, Noordin R. Serodiagnosis and early detection of Strongyloides stercoralis infection. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2018; 52:371-378. [PMID: 30482708 DOI: 10.1016/j.jmii.2018.10.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 09/11/2018] [Accepted: 10/01/2018] [Indexed: 10/28/2022]
Abstract
Strongyloidiasis is a major neglected tropical disease with the potential of causing lifelong infection and mortality. One of the ways for effective control of this disease is developing improved diagnostics, particularly using serological approaches. A serological test can achieve high diagnostic sensitivity and specificity, has the potential for point-of-care translation, and can be used as a screening tool for early detection. More research is needed to find clinically important antibody biomarkers for early disease detection, mapping, and epidemiological surveillance. This article summarizes human strongyloidiasis and the available diagnostic tools for the disease, focusing on describing the current antibody assays for strongyloidiasis. Finally, prospects of developing a more effective serodiagnostic tool for strongyloidiasis are discussed.
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Affiliation(s)
- Norsyahida Arifin
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, 11800 Penang, Malaysia
| | | | - Hussain Ahmad
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, 11800 Penang, Malaysia; Department of Microbiology, Abdul Wali Khan University Mardan, KPK, Pakistan
| | - Rahmah Noordin
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, 11800 Penang, Malaysia.
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25
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Kristanti H, Meyanti F, Wijayanti MA, Mahendradhata Y, Polman K, Chappuis F, Utzinger J, Becker SL, Murhandarwati EEH. Diagnostic comparison of Baermann funnel, Koga agar plate culture and polymerase chain reaction for detection of human Strongyloides stercoralis infection in Maluku, Indonesia. Parasitol Res 2018; 117:3229-3235. [PMID: 30074085 DOI: 10.1007/s00436-018-6021-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 07/19/2018] [Indexed: 12/27/2022]
Abstract
Human infection with the nematode Strongyloides stercoralis, which may have a life-threatening course, primarily occurs in tropical settings. Epidemiological data on the occurrence of strongyloidiasis are scarce, and microscopic stool-based detection methods are insensitive. Polymerase chain reaction (PCR) assays have been developed, yet conflicting results have been reported. Our goal was to determine whether there was diagnostic agreement between an in-house PCR and two microscopic techniques, the Baermann funnel (BM) and the Koga agar plate culture (KAP) for the detection of S. stercoralis in stool samples. Eighty ethanol-fixed stool samples stemming from a cross-sectional survey in Maluku, Indonesia, were purposefully selected for PCR analysis. The final sample size comprised four groups, each with 20 samples: group 1, positive for S. stercoralis on both BM and KAP; group 2, positive only by BM; group 3, positive only by KAP; and group 4, negative on both BM and KAP. A Strongyloides-specific PCR targeting the internal transcribed spacer 2 (ITS2) region was carried out in an Indonesian reference laboratory. The overall agreement between PCR and microscopy was 61% (49/80 samples), being highest in group 1 (15/20, 75%) and lowest in group 3 (9/20, 45%). PCR revealed eight additional S. stercoralis infections in group 4. Future studies should elucidate the 'true' infection status of samples that are negative by PCR, but positive upon microscopy. Taken together, there is a lack of agreement between microscopy and PCR results for the diagnosis of human S. stercoralis infection in Indonesia. ClinicalTrials.gov (identifier: NCT02105714).
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Affiliation(s)
- Handriani Kristanti
- Postgraduate Programme of Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Fransiska Meyanti
- Centre for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Mahardika Agus Wijayanti
- Postgraduate Programme of Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Centre for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Department of Parasitology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Yodi Mahendradhata
- Centre for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Katja Polman
- Institute of Tropical Medicine, Antwerp, Belgium
| | - François Chappuis
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Sören L Becker
- Swiss Tropical and Public Health Institute, Basel, Switzerland.
- University of Basel, Basel, Switzerland.
- Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany.
| | - E Elsa Herdiana Murhandarwati
- Postgraduate Programme of Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
- Centre for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
- Department of Parasitology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
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26
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Raso G, Essé C, Dongo K, Ouattara M, Zouzou F, Hürlimann E, Koffi VA, Coulibaly G, Mahan V, Yapi RB, Koné S, Coulibaly JT, Meïté A, Guéhi-Kabran MC, Bonfoh B, N'Goran EK, Utzinger J. An Integrated Approach to Control Soil-Transmitted Helminthiasis, Schistosomiasis, Intestinal Protozoa Infection, and Diarrhea: Protocol for a Cluster Randomized Trial. JMIR Res Protoc 2018; 7:e145. [PMID: 29895511 PMCID: PMC6019843 DOI: 10.2196/resprot.9166] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 03/05/2018] [Accepted: 03/10/2018] [Indexed: 12/22/2022] Open
Abstract
Background The global strategy to control helminthiases (schistosomiasis and soil-transmitted helminthiasis) emphasizes preventive chemotherapy. However, in the absence of access to clean water, improved sanitation, and adequate hygiene, reinfection after treatment can occur rapidly. Integrated approaches might be necessary to sustain the benefits of preventive chemotherapy and make progress toward interruption of helminthiases transmission. Objective The aim of this study was to assess and quantify the effect of an integrated control package that consists of preventive chemotherapy, community-led total sanitation, and health education on soil-transmitted helminthiasis, schistosomiasis, intestinal protozoa infection, and diarrhea in rural Côte d’Ivoire. Methods In a first step, a community health education program was developed that includes an animated cartoon to promote improved hygiene and health targeting school-aged children, coupled with a health education theater for the entire community. In a second step, a cluster randomized trial was implemented in 56 communities of south-central Côte d’Ivoire with 4 intervention arms: (1) preventive chemotherapy; (2) preventive chemotherapy plus community-led total sanitation; (3) preventive chemotherapy plus health education; and (4) all 3 interventions combined. Before implementation of the aforementioned interventions, a baseline parasitologic, anthropometric, and hygiene-related knowledge, attitudes, practices, and beliefs survey was conducted. These surveys were repeated 18 and 39 months after the baseline cross-sectional survey to determine the effect of different interventions on helminth and intestinal protozoa infection, nutritional indicators, and knowledge, attitudes, practices, and beliefs. Monitoring of diarrhea was done over a 24-month period at 2-week intervals, starting right after the baseline survey. Results Key results from this cluster randomized trial will shed light on the effect of integrated approaches consisting of preventive chemotherapy, community-led total sanitation, and health education against infections with soil-transmitted helminths, schistosomes, an intestinal protozoa and prevention of diarrhea in a rural part of Côte d’Ivoire. Conclusions The research provided new insights into the acceptability, strengths, and limitations of an integrated community-based control package targeting helminthiases, intestinal protozoa infections, and diarrhea in rural communities of Côte d’Ivoire. In the longer term, the study will allow determining the effect of the integrated control approach on infection patterns with parasitic worms and intestinal protozoa, diarrheal incidence, anthropometric measures, and hygiene-related knowledge, attitudes, practices, and beliefs. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN): 53102033; http://www.isrctn.com/ISRCTN53102033 (Archived by WebCite at http://www.webcitation.org/6wpnXEiHo) Registered Report Identifier RR1-10.2196/9166
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Affiliation(s)
- Giovanna Raso
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Clémence Essé
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Unité de Formation et de Recherche Sciences de l'Homme et de la Société, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Kouassi Dongo
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Unité de Formation et de Recherche Sciences de Terre et des Ressources Minières, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Mamadou Ouattara
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Fabien Zouzou
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,FAIRMED, Bern, Switzerland
| | - Eveline Hürlimann
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Veronique A Koffi
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Unité de Formation et de Recherche Sciences de l'Homme et de la Société, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Gaoussou Coulibaly
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Virginie Mahan
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Unité de Formation et de Recherche Sciences de Terre et des Ressources Minières, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire.,UNICEF Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Richard B Yapi
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Siaka Koné
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Jean Tenena Coulibaly
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Aboulaye Meïté
- Programme National de Lutte contre les Maladies Tropicales Négligées à Chimiothérapie Préventive, Ministère de la Santé et de l'Hygiène Publique, Abidjan, Côte d'Ivoire
| | | | - Bassirou Bonfoh
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Eliézer Kouakou N'Goran
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
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27
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Wesołowska M, Rymer W, Kicia M, Popiołek M. Concurrent Infection of a Young Tourist by Hookworm and Strongyloides Stercoralis During Low Budget Travel in Southeast Asia. Helminthologia 2018; 55:166-172. [PMID: 31662643 PMCID: PMC6799555 DOI: 10.2478/helm-2018-0007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 01/18/2018] [Indexed: 11/21/2022] Open
Abstract
Strongyloidiasis and hookworm infections are neglected helminth diseases widespread in tropical and subtropical areas. In humans, particularly in immunocompromised patients infections potentially may lead to the life-threatening clinical conditions involving the respiratory as well as gastrointestinal systems. The increased number of tourists travelling to tropical regions is associated with more frequent infection with parasites such as Strongyloides and hookworm. The infection takes place when filariform larvae penetrate the skin exposed to soil, than migrate through the lungs and finally reach the intestine. Travelers are often not aware of how they could get infected. Physicians may suspect strongyloidiasis and hookworm infections in tourists with diarrhea returning from endemic areas, especially when an elevated eosinophilia is observed. In the literature there are many reports about the presence of parasites in indigenous communities, but very few are available regarding travelers. This paper describes a dual infection with hookworm and Strongyloides stercoralis in a young female tourist returning from Southeast Asia. To our knowledge, this is the first report of hookworm and Strongyloides stercoralis infection in a tourist from Europe, acquired in an endemic area.
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Affiliation(s)
- M. Wesołowska
- Department of Biology and Medical Parasitology, Wroclaw Medical University, J. Mikulicza-Radeckiego 9, 50-367Wrocław, Poland
| | - W. Rymer
- Department of Infectious Diseases, Hepatology and Acquired Immune Deficiencies, Wroclaw Medical University, Koszarowa 5, 51-149Wrocław, Poland
| | - M. Kicia
- Department of Biology and Medical Parasitology, Wroclaw Medical University, J. Mikulicza-Radeckiego 9, 50-367Wrocław, Poland
| | - M. Popiołek
- Department of Parasitology, Institute of Genetics and Microbiology, Wroclaw University, Przybyszewskiego 63, 51-148Wrocław, Poland
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28
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Eze IC, Esse C, Bassa FK, Koné S, Acka F, Yao L, Imboden M, Jaeger FN, Schindler C, Dosso M, Laubhouet-Koffi V, Kouassi D, N'Goran EK, Utzinger J, Bonfoh B, Probst-Hensch N. Côte d'Ivoire Dual Burden of Disease (CoDuBu): Study Protocol to Investigate the Co-occurrence of Chronic Infections and Noncommunicable Diseases in Rural Settings of Epidemiological Transition. JMIR Res Protoc 2017; 6:e210. [PMID: 29079553 PMCID: PMC5681722 DOI: 10.2196/resprot.8599] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 09/29/2017] [Accepted: 09/29/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Individual-level concomitance of infectious diseases and noncommunicable diseases (NCDs) is poorly studied, despite the reality of this dual disease burden for many low- and middle-income countries (LMICs). OBJECTIVE This study protocol describes the implementation of a cohort and biobank aiming for a better understanding of interrelation of helminth and Plasmodium infections with NCD phenotypes like metabolic syndrome, hypertension, and diabetes. METHODS A baseline cross-sectional population-based survey was conducted over one year, in the Taabo health and demographic surveillance system (HDSS) in south-central Côte d'Ivoire. We randomly identified 1020 consenting participants aged ≥18 years in three communities (Taabo-Cité, Amani-Ménou, and Tokohiri) reflecting varying stages of epidemiological transition. Participants underwent health examinations consisting of NCD phenotyping (anthropometry, blood pressure, renal function, glycemia, and lipids) and infectious disease testing (infections with soil-transmitted helminths, schistosomes, and Plasmodium). Individuals identified to have elevated blood pressure, glucose, lipids, or with infections were referred to the central/national health center for diagnostic confirmation and treatment. Aliquots of urine, stool, and venous blood were stored in a biobank for future exposome/phenome research. In-person interviews on sociodemographic attributes, risk factors for infectious diseases and NCDs, medication, vaccinations, and health care were also conducted. Appropriate statistical techniques will be applied in exploring the concomitance of infectious diseases and NCDs and their determinants. Participants' consent for follow-up contact was obtained. RESULTS Key results from this baseline study, which will be published in peer-reviewed literature, will provide information on the prevalence and co-occurrence of infectious diseases, NCDs, and their risk factors. The Taabo HDSS consists of rural and somewhat more urbanized areas, allowing for comparative studies at different levels of epidemiological transition. An HDSS setting is ideal as a basis for longitudinal studies since their sustainable field work teams hold close contact with the local population. CONCLUSIONS The collaboration between research institutions, public health organizations, health care providers, and staff from the Taabo HDSS in this study assures that the synthesized evidence will feed into health policy towards integrated infectious disease-NCD management. The preparation of health systems for the dual burden of disease is pressing in low- and middle-income countries. The established biobank will strengthen the local research capacity and offer opportunities for biomarker studies to deepen the understanding of the cross-talk between infectious diseases and NCDs. TRIAL REGISTRATION International Standard Randomized Controlled Trials Number (ISRCTN): 87099939; http://www.isrctn.com/ISRCTN87099939 (Archived by WebCite at http://www.webcitation.org/6uLEs1EsX).
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Affiliation(s)
- Ikenna C Eze
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Clémence Esse
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Institut d'Ethnosociologie, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Fidèle K Bassa
- Unite de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Siaka Koné
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Felix Acka
- Institut National de Santé Publique, Abidjan, Côte d'Ivoire
| | - Loukou Yao
- Ligue Ivoirienne contre l'Hypertension Artérielle et les Maladies Cardiovasculaire, Abidjan, Côte d'Ivoire
| | - Medea Imboden
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Fabienne N Jaeger
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Christian Schindler
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Mireille Dosso
- Institut Pasteur de Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Véronique Laubhouet-Koffi
- Ligue Ivoirienne contre l'Hypertension Artérielle et les Maladies Cardiovasculaire, Abidjan, Côte d'Ivoire
| | - Dinard Kouassi
- Institut National de Santé Publique, Abidjan, Côte d'Ivoire
| | - Eliézer K N'Goran
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Unite de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Bassirou Bonfoh
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
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Strongyloides stercoralis is associated with significant morbidity in rural Cambodia, including stunting in children. PLoS Negl Trop Dis 2017; 11:e0005685. [PMID: 29059195 PMCID: PMC5695629 DOI: 10.1371/journal.pntd.0005685] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 11/02/2017] [Accepted: 06/07/2017] [Indexed: 01/01/2023] Open
Abstract
Background Strongyloides stercoralis is a soil-transmitted nematode that can replicate within its host, leading to long-lasting and potentially fatal infections. It is ubiquitous and highly prevalent in Cambodia. The extent of morbidity associated with S. stercoralis infection is difficult to assess due to the broad spectrum of symptoms and, thus, remains uncertain. Methodology/Principal findings Clinical signs were compared among S. stercoralis infected vs. non-infected participants in a cross-sectional survey conducted in 2012 in eight villages of Northern Cambodia, and before and after treatment with a single oral dose of ivermectin (200μg/kg BW) among participants harboring S. stercoralis. Growth retardation among schoolchildren and adolescents was assessed using height-for-age and thinness using body mass index-for-age. S. stercoralis prevalence was 31.1% among 2,744 participants. Urticaria (55% vs. 47%, OR: 1.4, 95% CI: 1.1–1.6) and itching (52% vs. 48%, OR: 1.2, 95% CI: 1.0–1.4) were more frequently reported by infected participants. Gastrointestinal, dermatological, and respiratory symptoms were less prevalent in 103 mono-infected participants after treatment. Urticaria (66% vs. 11%, OR: 0.03, 95% CI: 0.01–0.1) and abdominal pain (81 vs. 27%, OR: 0.07, 95% CI: 0.02–0.2) mostly resolved by treatment. S. stercoralis infection was associated with stunting, with 2.5-fold higher odds in case of heavy infection. Conclusions/Significance The morbidity associated with S. stercoralis confirmed the importance of gastrointestinal and dermatological symptoms unrelated to parasite load, and long-term chronic effects when associated with malnutrition. The combination of high prevalence and morbidity calls for the integration of S. stercoralis into ongoing STH control measures in Cambodia. Strongyloides stercoralis is an intestinal parasite that infects humans by penetrating intact skin. It thrives particularly in tropical countries with poor sanitation. Because it can replicate within its host, it causes long-lasting infections and is potentially fatal in patients with a disseminated infection. S. stercoralis is largely neglected due to the difficulty in detecting it with standard field diagnostic techniques but has recently been found to be very common in Cambodia, with prevalence rates exceeding 40%. It is difficult to identify symptoms associated with infection in endemic areas because co-infections with other helminths or protozoan parasites, which cause similar health problems, are common. We compared clinical signs in infected vs. non-infected participants living in eight villages in Northern Cambodia, and before and after treatment with ivermectin, the drug of choice against S. stercoralis, among 103 patients infected with S. stercoralis only. We also assessed the association between infection and growth retardation among children and adolescents. Of the participants, 31.1% were infected with S. stercoralis. Infected participants were more likely to report itching and urticaria. After treatment, fewer participants reported urticaria, abdominal pain, vomiting and, to a lesser extent, nausea, diarrhea, cough, and tiredness. S. stercoralis infection was associated with growth retardation as expressed by stunting.
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Ketzis JK, Conan A. Estimating occurrence of Strongyloides stercoralis in the Caribbean island countries: Implications for monitoring and control. Acta Trop 2017; 171:90-95. [PMID: 28377220 DOI: 10.1016/j.actatropica.2017.03.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 03/31/2017] [Accepted: 03/31/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Few data are available for the prevalence of Strongyloides stercoralis in the Caribbean region. This frequently under diagnosed soil-transmitted helminth (STH) can result in long-term low intensity chronic infections that are asymptomatic or can cause varied intestinal disturbances. With autoinfections, infections lasting over 60 years can occur and hyperinfections lead to high morbidity and mortality. METHODOLOGY/PRINCIPAL FINDINGS Historical literature was searched to determine the prevalence of S. stercoralis in the Caribbean island countries with some additional countries and islands included for comparative data. A previously published model was used to calculate prevalence taking in to account the sensitivity of the diagnostic methods used. Data for 17 islands/Caribbean countries were found and sufficient data were located to calculate prevalence for 14 locations. Prevalence ranges from <1% to 20.3% and while it has decreased in many islands it has not decreased at the same rate as other STHs in the last 40 years within the Caribbean region. CONCLUSIONS/SIGNIFICANCE S. stercoralis continues to be an important STH within the Caribbean. Potential reasons for the current prevalence include: long lasting infections, populations not targeted with mass drug administration (MDA) programs being infected, low efficacy of commonly used drugs in MDA programs, and under-diagnosis resulting in infections not being treated.
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Affiliation(s)
- Jennifer K Ketzis
- Ross University School of Veterinary Medicine, Basseterre, St. Kitts, West Indies.
| | - Anne Conan
- Ross University School of Veterinary Medicine, Basseterre, St. Kitts, West Indies
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Kearns TM, Currie BJ, Cheng AC, McCarthy J, Carapetis JR, Holt DC, Page W, Shield J, Gundjirryirr R, Mulholland E, Ward L, Andrews RM. Strongyloides seroprevalence before and after an ivermectin mass drug administration in a remote Australian Aboriginal community. PLoS Negl Trop Dis 2017; 11:e0005607. [PMID: 28505198 PMCID: PMC5444847 DOI: 10.1371/journal.pntd.0005607] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 05/25/2017] [Accepted: 04/27/2017] [Indexed: 01/01/2023] Open
Abstract
Background Strongyloides seroprevalence is hyper-endemic in many Australian Aboriginal and Torres Strait Islander communities, ranging from 35–60%. We report the impact on Strongyloides seroprevalence after two oral ivermectin mass drug administrations (MDAs) delivered 12 months apart in a remote Australian Aboriginal community. Methods Utilizing a before and after study design, we measured Strongyloides seroprevalence through population census with sequential MDAs at baseline and month 12. Surveys at months 6 and 18 determined changes in serostatus. Serodiagnosis was undertaken by ELISA that used sonicated Strongyloides ratti antigen to detect anti-Strongyloides IgG. Non-pregnant participants weighing ≥15 kg were administered a single 200 μg/kg ivermectin dose, repeated after 10–42 days if Strongyloides and/or scabies was diagnosed; others followed a standard alternative algorithm. A questionnaire on clinical symptoms was administered to identify adverse events from treatment and self-reported symptoms associated with serostatus. Findings We surveyed 1013 participants at the baseline population census and 1060 (n = 700 from baseline cohort and 360 new entrants) at month 12. Strongyloides seroprevalence fell from 21% (175/818) at baseline to 5% at month 6. For participants from the baseline cohort this reduction was sustained at month 12 (34/618, 6%), falling to 2% at month 18 after the second MDA. For new entrants to the cohort at month 12, seroprevalence reduced from 25% (75/297) to 7% at month 18. Strongyloides positive seroconversions for the baseline cohort six months after each MDA were 2.5% (4/157) at month 6 and 1% at month 18, whilst failure to serorevert remained unchanged at 18%. At 12 months, eosinophilia was identified in 59% of baseline seropositive participants and 89% of seropositive new entrants, compared with 47%baseline seronegative participants and 51% seronegative new entrants. Seropositivity was not correlated with haemoglobin or any self-reported clinical symptoms. Clinical symptoms ascertained on the day of treatment and 24–72 hrs after, did not identify any adverse events. Significance Two community ivermectin MDAs delivered 12 months apart by trained Aboriginal researchers in collaboration with non-Indigenous researchers resulted in a sustained and significant reduction in Strongyloides seroprevalence over 18 months. Similar reductions were seen in the baseline cohort and new entrants. We were invited by one community in East Arnhem Land to develop and deliver an ivermectin MDA to reduce the prevalence of Strongyloides and scabies. We demonstrated a sustained reduction in Strongyloides seroprevalence following the ivermectin MDA. Strongyloides is endemic in many Australian Aboriginal and Torres Strait Islander communities with seroprevalence ranging from 35–60%. Utilizing a before and after study design, we measured Strongyloides seroprevalence by ELISA through population census with sequential MDAs at baseline and month 12. Strongyloides seroprevalence reduced from 21% at baseline to 5% at month 6 after the first MDA. For the baseline cohort this reduction was sustained at month 12, falling to 2% at month 18 after the second MDA. For new entrants to the cohort at month 12, seroprevalence reduced from 25% to 7%.
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Affiliation(s)
- Therese M. Kearns
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- * E-mail:
| | - Bart J. Currie
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Allen C. Cheng
- School of Public Health and Preventive Medicine, Monash University and Infection Prevention and Healthcare Epidemiology Unit, Alfred Health Melbourne, Australia
| | - James McCarthy
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Jonathan R. Carapetis
- Telethon Kids Institute, University of Western Australia and Princess Margaret Hospital for Children, Perth, Australia
| | - Deborah C. Holt
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Wendy Page
- Miwatj Health Aboriginal Corporation, Nhulunbuy, Australia
| | - Jennifer Shield
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Roslyn Gundjirryirr
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | | | - Linda Ward
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Ross M. Andrews
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
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Pocaterra LA, Ferrara G, Peñaranda R, Rojas E, Pérez-Chacón G, Hernán A, Certad G, Goldstein C, Núñez L. Improved Detection of Strongyloides stercoralis in Modified Agar Plate Cultures. Am J Trop Med Hyg 2017; 96:863-865. [PMID: 28115668 DOI: 10.4269/ajtmh.16-0414] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AbstractA modification of Koga agar plate culture was performed, consisting of a 2 × 2-cm cellophane paper centered on the agar plate to prevent bacterial contamination of the agar and daily dish examinations (days 2-5). Between January 2000 and July 2005, we examined 1,708 infection-suspected patients, of which 147 (8.6%) harbored S. stercoralis. Single modified agar plate cultures exhibited superior sensitivity (93.2%), compared with different three-sample screening methods (sensitivity-Baermann: 76.6%, formalin-ethyl acetate: 22%, and direct smear: 15.3%). Agar plate cultures stand out as helpful alternatives for improved detection and therapy monitoring in poor countries and endemic areas. Combined with Baermann methods, they provide increased probability for S. stercoralis detection.
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Affiliation(s)
- Leonor A Pocaterra
- Cátedra de Parasitología, Escuela de Medicina "José María Vargas," Universidad Central de Venezuela, Caracas, Venezuela
| | - Giuseppe Ferrara
- Laboratorio de Parasitosis Intestinales, Escuela de Medicina "José María Vargas," Universidad Central de Venezuela, Caracas, Venezuela
| | - Rosaura Peñaranda
- Cátedra de Parasitología, Escuela de Medicina "José María Vargas," Universidad Central de Venezuela, Caracas, Venezuela
| | - Elsy Rojas
- Laboratorio de Parasitosis Intestinales, Escuela de Medicina "José María Vargas," Universidad Central de Venezuela, Caracas, Venezuela
| | - Gladymar Pérez-Chacón
- Cátedra de Parasitología, Escuela de Medicina "José María Vargas," Universidad Central de Venezuela, Caracas, Venezuela
| | - Aurora Hernán
- Cátedra de Parasitología, Escuela de Medicina "José María Vargas," Universidad Central de Venezuela, Caracas, Venezuela
| | - Gabriela Certad
- Cátedra de Parasitología, Escuela de Medicina "José María Vargas," Universidad Central de Venezuela, Caracas, Venezuela
| | - Carlos Goldstein
- Medicina Interna-Hematología, Centro Médico de Caracas, Caracas, Venezuela
| | - Luz Núñez
- Cátedra de Parasitología, Escuela de Medicina "José María Vargas," Universidad Central de Venezuela, Caracas, Venezuela
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Tsegay G, Tamiru A, Amberbir T, Davey G, Deribe K. Willingness to pay for footwear, and associated factors related to podoconiosis in northern Ethiopia. Int Health 2016; 8:345-53. [PMID: 27620919 PMCID: PMC5039822 DOI: 10.1093/inthealth/ihw033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 04/14/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In Northern Ethiopia, use of footwear by the rural community is limited, and non-governmental organizations provide footwear for school children as a means of preventing podoconiosis. However, this is not a sustainable strategy. This study assessed willingness to pay for footwear among people with and without podoconiosis. METHODS A comparative cross-sectional community-based study was conducted in Mecha and Gozamen woredas among randomly selected people with and without podoconiosis. Trained health extension workers collected data using an interviewer-administered structured questionnaire. The data were entered into EPI-Data and exported to SPSS version 16.0 statistical software package for analysis. RESULTS The willingness to pay for footwear among people with and without podoconiosis was 72.3% and 76.7% respectively (p=0.30). People with podoconiosis in the lower quintiles of economic status were less likely to be willing to pay for footwear than those in the higher quintiles. CONCLUSIONS There is substantial willingness to pay for footwear. The expressed willingness to pay indicates demand for footwear in the community, suggesting an opportunity for shoe companies. There are still a substantial proportion of individuals not willing to pay for footwear. This requires intensified public education and social transformation to bring about change in behavior towards footwear use if elimination of podoconiosis within our generation is to be achieved.
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Affiliation(s)
- Girmay Tsegay
- School of Public Health, College of Medicine and Health Sciences, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Abreham Tamiru
- National Podoconiosis Action Network, Addis Ababa, Ethiopia
| | - Tsige Amberbir
- International Orthodox Christian Charities, Addis Ababa, Ethiopia
| | - Gail Davey
- Wellcome Trust Brighton & Sussex Centre for Global Health Research, Brighton, BN1 9PX, UK
| | - Kebede Deribe
- Wellcome Trust Brighton & Sussex Centre for Global Health Research, Brighton, BN1 9PX, UK Schools of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
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StrongNet: An International Network to Improve Diagnostics and Access to Treatment for Strongyloidiasis Control. PLoS Negl Trop Dis 2016; 10:e0004898. [PMID: 27607192 PMCID: PMC5015896 DOI: 10.1371/journal.pntd.0004898] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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O'Connell EM, Nutman TB. Molecular Diagnostics for Soil-Transmitted Helminths. Am J Trop Med Hyg 2016; 95:508-513. [PMID: 27481053 PMCID: PMC5014250 DOI: 10.4269/ajtmh.16-0266] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 06/29/2016] [Indexed: 12/18/2022] Open
Abstract
Historically, the diagnosis of soil-transmitted helminths (STHs) (e.g., Strongyloides stercoralis, Trichuris trichiura, Ancylostoma duodenale, Necator americanus, and Ascaris lumbricoides) has relied on often-insensitive microscopy techniques. Over the past several years, there has been an effort to use molecular diagnostics, particularly quantitative polymerase chain reaction (qPCR), to detect intestinal pathogens. While some platforms have been approved by regulatory bodies (e.g., Food and Drug Administration) to detect intestinal bacteria, viruses, and protozoa, there are no approved tests currently available for STH. Although studies comparing qPCR to microscopy methods for STH are imperfect, due in large part to a lack of a sufficient gold standard, they do show a significant increase in sensitivity and specificity of qPCR compared with microscopic techniques. These studies, as well as the advantages and disadvantages of using qPCR for STH diagnosis, are discussed. Guidelines for those designing future studies utilizing qPCR are proposed for optimizing results, as is the proposition for using standardized molecular diagnostics routinely for STH in clinical laboratories and for field-based studies when possible.
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Affiliation(s)
- Elise M O'Connell
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Thomas B Nutman
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
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Forrer A, Khieu V, Schindler C, Schär F, Marti H, Char MC, Muth S, Odermatt P. Ivermectin Treatment and Sanitation Effectively Reduce Strongyloides stercoralis Infection Risk in Rural Communities in Cambodia. PLoS Negl Trop Dis 2016; 10:e0004909. [PMID: 27548286 PMCID: PMC4993485 DOI: 10.1371/journal.pntd.0004909] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 07/17/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Strongyloides stercoralis is the only soil-transmitted helminth with the ability to replicate within its host, leading to long-lasting and potentially fatal infections. It is ubiquitous and its worldwide prevalence has recently been estimated to be at least half that of hookworm. Information on the epidemiology of S. stercoralis remains scarce and modalities for its large-scale control are yet to be determined. METHODOLOGY/PRINCIPAL FINDINGS A community-based two-year cohort study was conducted among the general population in a rural province in North Cambodia. At each survey, participants infected with S. stercoralis were treated with a single oral dose of ivermectin (200μg/kg BW). Diagnosis was performed using a combination of the Baermann method and Koga agar plate culture on two stool samples. The cohort included participants from eight villages who were either positive or negative for S. stercoralis at baseline. Mixed logistic regression models were employed to assess risk factors for S. stercoralis infection at baseline and re-infection at follow-up. A total of 3,096 participants were examined at baseline, revealing a S. stercoralis prevalence of 33.1%. Of these participants, 1,269 were followed-up over two years. Re-infection and infection rates among positive and negative participants at baseline were 14.4% and 9.6% at the first and 11.0% and 11.5% at the second follow-up, respectively. At follow-up, all age groups were at similar risk of acquiring an infection, while infection risk significantly decreased with increasing village sanitation coverage. CONCLUSIONS/SIGNIFICANCE Chemotherapy-based control of S. stercoralis is feasible and highly beneficial, particularly in combination with improved sanitation. The impact of community-based ivermectin treatment on S. stercoralis was high, with over 85% of villagers remaining negative one year after treatment. The integration of S. stercoralis into existing STH control programs should be considered without further delay.
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Affiliation(s)
- Armelle Forrer
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Virak Khieu
- National Centre for Parasitology, Entomology and Malaria Control, Ministry of Health, Phnom Penh, Cambodia
| | - Christian Schindler
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Fabian Schär
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Hanspeter Marti
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Meng Chuor Char
- National Centre for Parasitology, Entomology and Malaria Control, Ministry of Health, Phnom Penh, Cambodia
| | - Sinuon Muth
- National Centre for Parasitology, Entomology and Malaria Control, Ministry of Health, Phnom Penh, Cambodia
| | - Peter Odermatt
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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Lo NC, Bogoch II, Blackburn BG, Raso G, N'Goran EK, Coulibaly JT, Becker SL, Abrams HB, Utzinger J, Andrews JR. Comparison of community-wide, integrated mass drug administration strategies for schistosomiasis and soil-transmitted helminthiasis: a cost-effectiveness modelling study. LANCET GLOBAL HEALTH 2016; 3:e629-38. [PMID: 26385302 DOI: 10.1016/s2214-109x(15)00047-9] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 04/19/2015] [Accepted: 05/14/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND More than 1·5 billion people are affected by schistosomiasis or soil-transmitted helminthiasis. WHO's recommendations for mass drug administration (MDA) against these parasitic infections emphasise treatment of school-aged children, using separate treatment guidelines for these two helminthiases groups. We aimed to evaluate the cost-effectiveness of expanding integrated MDA to the entire community in four settings in Côte d'Ivoire. METHODS We extended previously published, dynamic, age-structured models of helminthiases transmission to simulate costs and disability averted with integrated MDA (of praziquantel and albendazole) for schistosomiasis and soil-transmitted helminthiasis. We calibrated the model to data for prevalence and intensity of species-specific helminth infection from surveys undertaken in four communities in Côte d'Ivoire between March, 1997, and September, 2010. We simulated a 15-year treatment programme with 75% coverage in only school-aged children; school-aged children and preschool-aged children; adults; and the entire community. Treatment costs were estimated at US$0·74 for school-aged children and $1·74 for preschool-aged children and adults. The incremental cost-effectiveness ratio (ICER) was calculated in 2014 US dollars per disability-adjusted life-year (DALY) averted. FINDINGS Expanded community-wide treatment was highly cost effective compared with treatment of only school-aged children (ICER $167 per DALY averted) and WHO guidelines (ICER $127 per DALY averted), and remained highly cost effective even if treatment costs for preschool-aged children and adults were ten times greater than those for school-aged children. Community-wide treatment remained highly cost effective even when elimination of helminth infections was not achieved. These findings were robust across the four diverse communities in Côte d'Ivoire, only one of which would have received annual MDA for both schistosomiasis and soil-transmitted helminthiasis under the latest WHO guidelines. Treatment every 6 months was also highly cost effective in three out of four communities. INTERPRETATION Integrated, community-wide MDA programmes for schistosomiasis and soil-transmitted helminthiasis can be highly cost effective, even in communities with low disease burden in any helminth group. These results support an urgent need to re-evaluate current global guidelines for helminthiases control programmes to include community-wide treatment, increased treatment frequency, and consideration for lowered prevalence thresholds for integrated treatment. FUNDING Stanford University Medical Scholars Programme, Mount Sinai Hospital-University Health Network AMO Innovation Fund.
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Affiliation(s)
- Nathan C Lo
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA.
| | - Isaac I Bogoch
- Department of Medicine, University of Toronto, Toronto, ON, Canada; Division of General Internal Medicine, Toronto General Hospital, University Health Network, Toronto, ON, Canada; Division of Infectious Diseases, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Brian G Blackburn
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Giovanna Raso
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Eliézer K N'Goran
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Jean T Coulibaly
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Sören L Becker
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Institute of Medical Microbiology and Hygiene, Saarland University, Homburg/Saar, Germany
| | - Howard B Abrams
- Department of Medicine, University of Toronto, Toronto, ON, Canada; Division of General Internal Medicine, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Jason R Andrews
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Kaminsky RLG, Reyes-García SZ, Zambrano LI. Unsuspected Strongyloides stercoralis infection in hospital patients with comorbidity in need of proper management. BMC Infect Dis 2016; 16:98. [PMID: 26923091 PMCID: PMC4770549 DOI: 10.1186/s12879-016-1424-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 02/10/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Investigate the role of latent strongyloidiasis infection in patients at the University Hospital, Honduras. METHODS Prospective observational cohort study during 20 non consecutive months from March 2009 to February 2011. Epidemiological and clinical data obtained from patients excreting Strongyloides stercoralis larvae in stool who consulted at the hospital were recorded and analyzed. RESULTS Thirty five (5 %) of 712 patients had S. stercoralis larvae in one stool sample; 62.8 % came from rural areas and 91.7 % were poor; 68.5 % (24/35) were 21 years old or older. Eight patients (22.8 %) had no predisposing illness; 3 (8.6 %) received steroid treatment, 29/35 (82.8 %) presented with persistent diarrhea and 24/35 (68.5 %) presented following comorbidities: HIV/AIDS (31.4 %), alcoholism alone (11.4 %) or with other associated illness (8.6 %), malignancy (8.6 %), renal failure (5.7 %) and hyperthyroidism (2.8 %). A combination of symptoms suggestive of strongyloidiasis but indistinguishable from those potentially associated to their comorbid condition included severe epigastric pain, diarrhea of weeks duration, peripheral eosinophilia, astenia, adynamia, fever, anemia and weight loss in 85.7 % of the cases, 3 of whom described skin lesions compatible with larva currens. None of the diagnostic clinical impressions mentioned Strongyloides infection. Ten strongyloidiasis patients received partial treatment with albendazole or ivermectin. Incomplete data, underestimation of the parasitic infection and no laboratory follow-up of the patients limited our observations. CONCLUSIONS Strongyloides stercoralis is an unsuspected and neglected parasitic infection by health personnel in Honduras. Lack of awareness of its importance represents a strong barrier to proper treatment and follow-up, posing a threat of possible fatal complications in patients with comorbid conditions.
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Affiliation(s)
- Rina Lisette Girard Kaminsky
- Department of Pediatric, School of Medical Sciences, National Autonomous University of Honduras, and Parasitology Service, Department of Clinical Laboratory, University Hospital, Tegucigalpa, Honduras.
| | - Selvin Zacarías Reyes-García
- Department of Morphological Sciences, School of Medical Sciences, National Autonomous University of Honduras, Tegucigalpa, Honduras.
| | - Lysien Ivania Zambrano
- Department of Morphological Sciences, School of Medical Sciences, National Autonomous University of Honduras, Tegucigalpa, Honduras.
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Bassa FK, Ouattara M, Silué KD, Adiossan LG, Baikoro N, Koné S, N'Cho M, Traoré M, Bonfoh B, Utzinger J, N'Goran EK. Epidemiology of malaria in the Taabo health and demographic surveillance system, south-central Côte d'Ivoire. Malar J 2016; 15:9. [PMID: 26739224 PMCID: PMC4704401 DOI: 10.1186/s12936-015-1076-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 12/23/2015] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND A deep understanding of the local epidemiology of malaria is essential for the design and implementation of setting-specific control and elimination efforts. In Côte d'Ivoire, new initiatives are underway to reduce the burden of malaria, which requires high-quality longitudinal data. The epidemiology of malaria was studied in the Taabo health and demographic surveillance system (HDSS) in south-central Côte d'Ivoire and implications for control are discussed. METHODS Two cross-sectional surveys were carried out in the rainy season of June/July in 2010 and 2011. Inhabitants of approximately 7% of randomly selected households in the Taabo HDSS were invited to participate. People were clinically examined, ear temperature was measured and spleen size determined. Finger-prick blood samples were collected and subjected to a rapid diagnostic test (RDT). Additionally, thick and thin blood films were prepared on microscope slides and diagnosed under a microscope for Plasmodium infection and parasitaemia. Haemoglobin (Hb) level was determined using a HemoCue device. RESULTS A total of 1187 and 1264 people in 2010 and 2011, respectively, had complete data records. The prevalence of Plasmodium infection was 46.0% in 2010 and 56.6% in 2011, owing to a statistically significant difference (p < 0.05). Males showed a higher Plasmodium infection prevalence than females (49.6 and 62.8% versus 42.6 and 51.2%; respectively, in 2010 and 2011; both p < 0.05). The highest malaria prevalence was observed among infants and young children (aged ≤9 years). The risk of Plasmodium infection was significantly higher in villages compared to small hamlets and urban settings (p < 0.05). Fever, Hb level and splenomegaly were associated with parasitaemia. CONCLUSION Malaria is highly endemic in the Taabo HDSS in south-central Côte d'Ivoire with considerable spatial heterogeneity of Plasmodium infection. There is a pressing need to scale-up control interventions against malaria.
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Affiliation(s)
- Fidèle K Bassa
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire.
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.
| | - Mamadou Ouattara
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire.
| | - Kigbafori D Silué
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire.
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.
| | | | - Nahoua Baikoro
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.
| | - Siaka Koné
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.
| | - Moussan N'Cho
- Centre de Recherche et de Lutte contre le Paludisme, Institut National de la Santé Publique, Abidjan, Côte d'Ivoire.
| | - Mahamadou Traoré
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.
| | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.
- University of Basel, Basel, Switzerland.
| | - Eliézer K N'Goran
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire.
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.
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Becker SL, Piraisoody N, Kramme S, Marti H, Silué KD, Panning M, Nickel B, Kern WV, Herrmann M, Hatz CF, N’Goran EK, Utzinger J, von Müller L. Real-time PCR for detection of Strongyloides stercoralis in human stool samples from Côte d'Ivoire: diagnostic accuracy, inter-laboratory comparison and patterns of hookworm co-infection. Acta Trop 2015. [PMID: 26215130 DOI: 10.1016/j.actatropica.2015.07.019] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Human infections with the helminth species Strongyloides stercoralis encompass a wide clinical spectrum, ranging from asymptomatic carriage to life-threatening disease. The diagnosis of S. stercoralis is cumbersome and the sensitivity of conventional stool microscopy is low. New molecular tools have been developed to increase sensitivity. We compared the diagnostic accuracy of real-time PCR with microscopy for the detection of S. stercoralis and hookworm in human stool samples, and investigated the inter-laboratory agreement of S. stercoralis-specific real-time PCR in two European laboratories. Stool specimens from 256 randomly selected individuals in rural Côte d'Ivoire were examined using three microscopic techniques (i.e. Kato-Katz, Koga agar plate (KAP) and Baermann (BM)). Additionally, ethanol-fixed stool aliquots were subjected to molecular diagnosis. The prevalence of S. stercoralis and hookworm infection was 21.9% and 52.0%, respectively, whilst co-infections were detected in 35 (13.7%) participants. The diagnostic agreement between real-time PCR and microscopy was excellent when both KAP and BM tested positive for S. stercoralis, but was considerably lower when only one microscopic technique was positive. The sensitivity of KAP, BM and real-time PCR for detection of S. stercoralis as compared to a combination of all diagnostic techniques was 21.4%, 37.5% and 76.8%, respectively. The inter-laboratory agreement of S. stercoralis-specific PCR was substantial (κ=0.63, p<0.001). We conclude that a combination of real-time PCR and stool microscopy shows high accuracy for S. stercoralis diagnosis. Besides high sensitivity, PCR may also enhance specificity by reducing microscopic misdiagnosis of morphologically similar helminth larvae (i.e. hookworm and S. stercoralis) in settings where both helminth species co-exist.
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Polman K, Becker SL, Alirol E, Bhatta NK, Bhattarai NR, Bottieau E, Bratschi MW, Burza S, Coulibaly JT, Doumbia MN, Horié NS, Jacobs J, Khanal B, Landouré A, Mahendradhata Y, Meheus F, Mertens P, Meyanti F, Murhandarwati EH, N'Goran EK, Peeling RW, Ravinetto R, Rijal S, Sacko M, Saye R, Schneeberger PHH, Schurmans C, Silué KD, Thobari JA, Traoré MS, van Lieshout L, van Loen H, Verdonck K, von Müller L, Yansouni CP, Yao JA, Yao PK, Yap P, Boelaert M, Chappuis F, Utzinger J. Diagnosis of neglected tropical diseases among patients with persistent digestive disorders (diarrhoea and/or abdominal pain ≥14 days): Pierrea multi-country, prospective, non-experimental case-control study. BMC Infect Dis 2015; 15:338. [PMID: 26282537 PMCID: PMC4539676 DOI: 10.1186/s12879-015-1074-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 07/30/2015] [Indexed: 12/22/2022] Open
Abstract
Background Diarrhoea still accounts for considerable mortality and morbidity worldwide. The highest burden is concentrated in tropical areas where populations lack access to clean water, adequate sanitation and hygiene. In contrast to acute diarrhoea (<14 days), the spectrum of pathogens that may give rise to persistent diarrhoea (≥14 days) and persistent abdominal pain is poorly understood. It is conceivable that pathogens causing neglected tropical diseases play a major role, but few studies investigated this issue. Clinical management and diagnostic work-up of persistent digestive disorders in the tropics therefore remain inadequate. Hence, important aspects regarding the pathogenesis, epidemiology, clinical symptomatology and treatment options for patients presenting with persistent diarrhoea and persistent abdominal pain should be investigated in multi-centric clinical studies. Methods/Design This multi-country, prospective, non-experimental case–control study will assess persistent diarrhoea (≥14 days; in individuals aged ≥1 year) and persistent abdominal pain (≥14 days; in children/adolescents aged 1–18 years) in up to 2000 symptomatic patients and 2000 matched controls. Subjects from Côte d’Ivoire, Indonesia, Mali and Nepal will be clinically examined and interviewed using a detailed case report form. Additionally, each participant will provide a stool sample that will be examined using a suite of diagnostic methods (i.e., microscopic techniques, rapid diagnostic tests, stool culture and polymerase chain reaction) for the presence of bacterial and parasitic pathogens. Treatment will be offered to all infected participants and the clinical treatment response will be recorded. Data obtained will be utilised to develop patient-centred clinical algorithms that will be validated in primary health care centres in the four study countries in subsequent studies. Discussion Our research will deepen the understanding of the importance of persistent diarrhoea and related digestive disorders in the tropics. A diversity of intestinal pathogens will be assessed for potential associations with persistent diarrhoea and persistent abdominal pain. Different diagnostic methods will be compared, clinical symptoms investigated and diagnosis-treatment algorithms developed for validation in selected primary health care centres. The findings from this study will improve differential diagnosis and evidence-based clinical management of digestive syndromes in the tropics. Trial registration ClinicalTrials.gov; identifier: NCT02105714.
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Affiliation(s)
- Katja Polman
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
| | - Sören L Becker
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland. .,Institute of Medical Microbiology and Hygiene, Saarland University, Homburg/Saar, Germany.
| | - Emilie Alirol
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland.
| | - Nisha K Bhatta
- Department of Paediatrics and Adolescent Medicine, B P Koirala Institute of Health Sciences, Dharan, Nepal.
| | - Narayan R Bhattarai
- Department of Microbiology, B P Koirala Institute of Health Sciences, Dharan, Nepal.
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
| | - Martin W Bratschi
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
| | - Sakib Burza
- London School of Hygiene and Tropical Medicine, London, United Kingdom.
| | - Jean T Coulibaly
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland. .,Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire. .,Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.
| | - Mama N Doumbia
- Institut National de Recherche en Santé Publique, Bamako, Mali.
| | - Ninon S Horié
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland.
| | - Jan Jacobs
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
| | - Basudha Khanal
- Department of Microbiology, B P Koirala Institute of Health Sciences, Dharan, Nepal.
| | - Aly Landouré
- Institut National de Recherche en Santé Publique, Bamako, Mali.
| | - Yodi Mahendradhata
- Centre for Tropical Medicine, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia.
| | - Filip Meheus
- University of Cape Town, Cape Town, South Africa.
| | | | - Fransiska Meyanti
- Centre for Tropical Medicine, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia.
| | - Elsa H Murhandarwati
- Centre for Tropical Medicine, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia.
| | - Eliézer K N'Goran
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire. .,Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.
| | - Rosanna W Peeling
- London School of Hygiene and Tropical Medicine, London, United Kingdom.
| | - Raffaella Ravinetto
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium. .,Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.
| | - Suman Rijal
- Department of Internal Medicine, B P Koirala Institute of Health Sciences, Dharan, Nepal.
| | - Moussa Sacko
- Institut National de Recherche en Santé Publique, Bamako, Mali.
| | - Rénion Saye
- Institut National de Recherche en Santé Publique, Bamako, Mali.
| | - Pierre H H Schneeberger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland. .,Department of Epidemiology and Molecular Diagnostics, Agroscope Changins-Wädenswil ACW, Wädenswil, Switzerland. .,Department of Virology, Spiez Laboratory, Federal Office for Civil Protection, Spiez, Switzerland.
| | - Céline Schurmans
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
| | - Kigbafori D Silué
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire. .,Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.
| | - Jarir A Thobari
- Centre for Tropical Medicine, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia.
| | | | - Lisette van Lieshout
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Harry van Loen
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
| | - Kristien Verdonck
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
| | - Lutz von Müller
- Institute of Medical Microbiology and Hygiene, Saarland University, Homburg/Saar, Germany.
| | - Cédric P Yansouni
- Divisions of Infectious Diseases and Medical Microbiology, J.D. MacLean Centre for Tropical Diseases, McGill University Health Centre, Montreal, Canada.
| | - Joel A Yao
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire. .,Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.
| | - Patrick K Yao
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire.
| | - Peiling Yap
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
| | - Marleen Boelaert
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
| | - François Chappuis
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland.
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
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Salim N, Knopp S, Lweno O, Abdul U, Mohamed A, Schindler T, Rothen J, Masimba J, Kwaba D, Mohammed AS, Althaus F, Abdulla S, Tanner M, Daubenberger C, Genton B. Distribution and risk factors for Plasmodium and helminth co-infections: a cross-sectional survey among children in Bagamoyo district, coastal region of Tanzania. PLoS Negl Trop Dis 2015; 9:e0003660. [PMID: 25837022 PMCID: PMC4383605 DOI: 10.1371/journal.pntd.0003660] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 02/28/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Plasmodium and soil transmitted helminth infections (STH) are a major public health problem, particularly among children. There are conflicting findings on potential association between these two parasites. This study investigated the Plasmodium and helminth co-infections among children aged 2 months to 9 years living in Bagamoyo district, coastal region of Tanzania. METHODS A community-based cross-sectional survey was conducted among 1033 children. Stool, urine and blood samples were examined using a broad set of quality controlled diagnostic methods for common STH (Ascaris lumbricoides, hookworm, Strongyloides stercoralis, Enterobius vermicularis, Trichuris trichura), schistosoma species and Wuchereria bancrofti. Blood slides and malaria rapid diagnostic tests (mRDTs) were utilized for Plasmodium diagnosis. RESULTS Out of 992 children analyzed, the prevalence of Plasmodium infection was 13% (130/992), helminth 28.5% (283/992); 5% (50/992) had co-infection with Plasmodium and helminth. The prevalence rate of Plasmodium, specific STH and co-infections increased significantly with age (p < 0.001), with older children mostly affected except for S. stercoralis monoinfection and co-infections. Spatial variations of co-infection prevalence were observed between and within villages. There was a trend for STH infections to be associated with Plasmodium infection [OR adjusted for age group 1.4, 95% CI (1.0-2.1)], which was more marked for S. stercoralis (OR = 2.2, 95% CI (1.1-4.3). Age and not schooling were risk factors for Plasmodium and STH co-infection. CONCLUSION The findings suggest that STH and Plasmodium infections tend to occur in the same children, with increasing prevalence of co-infection with age. This calls for an integrated approach such as using mass chemotherapy with dual effect (e.g., ivermectin) coupled with improved housing, sanitation and hygiene for the control of both parasitic infections.
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Affiliation(s)
- Nahya Salim
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania
- Department of Pediatrics and Child Health, Muhimbili University Health and Allied Sciences (MUHAS), Dar es Salaam, United Republic of Tanzania
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail: (NS)
| | - Stefanie Knopp
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Department of Life Sciences, Wolfson Wellcome Biomedical Laboratories, Natural History Museum, London, United Kingdom
| | - Omar Lweno
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania
| | - Ummi Abdul
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania
| | - Ali Mohamed
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania
| | - Tobias Schindler
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania
- University of Basel, Basel, Switzerland
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Julian Rothen
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania
- University of Basel, Basel, Switzerland
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - John Masimba
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania
| | - Denis Kwaba
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania
| | - Alisa S. Mohammed
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania
| | - Fabrice Althaus
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Salim Abdulla
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania
| | - Marcel Tanner
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Claudia Daubenberger
- University of Basel, Basel, Switzerland
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Blaise Genton
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Department of Ambulatory Care and Community Medicine, Infectious Disease Service, Lausanne University Hospital, Lausanne, Switzerland
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Toledo R, Muñoz-Antoli C, Esteban JG. Strongyloidiasis with emphasis on human infections and its different clinical forms. ADVANCES IN PARASITOLOGY 2015; 88:165-241. [PMID: 25911368 DOI: 10.1016/bs.apar.2015.02.005] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Strongyloidiasis (caused by Strongyloides stercoralis, and to a lesser extent by Strongyloides fuelleborni) is one of the most neglected tropical diseases with endemic areas and affecting more than 100 million people worldwide. Chronic infections in endemic areas can be maintained for decades through the autoinfective cycle with the L3 filariform larvae. In these endemic areas, misdiagnosis, inadequate treatment and the facilitation of the hyperinfection syndrome by immunosuppression are frequent and contribute to a high mortality rate. Despite the serious health impact of strongyloidiasis, it is a neglected disease and very little is known about this parasite and the disease when compared to other helminth infections. Control of the disease is difficult because of the many gaps in our knowledge of strongyloidiasis. We examine the recent literature on different aspects of strongyloidiasis with emphasis in those aspects that need further research.
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Affiliation(s)
- Rafael Toledo
- Departamento de Parasitología, Universidad de Valencia, Valencia, Spain
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Salim N, Schindler T, Abdul U, Rothen J, Genton B, Lweno O, Mohammed AS, Masimba J, Kwaba D, Abdulla S, Tanner M, Daubenberger C, Knopp S. Enterobiasis and strongyloidiasis and associated co-infections and morbidity markers in infants, preschool- and school-aged children from rural coastal Tanzania: a cross-sectional study. BMC Infect Dis 2014; 14:644. [PMID: 25486986 PMCID: PMC4271451 DOI: 10.1186/s12879-014-0644-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 11/20/2014] [Indexed: 11/24/2022] Open
Abstract
Background There is a paucity of data pertaining to the epidemiology and public health impact of Enterobius vermicularis and Strongyloides stercoralis infections. We aimed to determine the extent of enterobiasis, strongyloidiasis, and other helminth infections and their association with asymptomatic Plasmodium parasitaemia, anaemia, nutritional status, and blood cell counts in infants, preschool-aged (PSAC), and school-aged children (SAC) from rural coastal Tanzania. Methods A total of 1,033 children were included in a cross-sectional study implemented in the Bagamoyo district in 2011/2012. Faecal samples were examined for intestinal helminth infections using a broad set of quality controlled methods. Finger-prick blood samples were subjected to filariasis and Plasmodium parasitaemia testing and full blood cell count examination. Weight, length/height, and/or mid-upper arm circumference were measured and the nutritional status determined in accordance with age. Results E. vermicularis infections were found in 4.2% of infants, 16.7%, of PSAC, and 26.3% of SAC. S. stercoralis infections were detected in 5.8%, 7.5%, and 7.1% of infants, PSAC, and SAC, respectively. Multivariable regression analyses revealed higher odds of enterobiasis in children of all age-groups with a reported anthelminthic treatment history over the past six months (odds ratio (OR): 2.15; 95% confidence interval (CI): 1.22 - 3.79) and in SAC with a higher temperature (OR: 2.21; CI: 1.13 - 4.33). Strongyloidiasis was associated with eosinophilia (OR: 2.04; CI: 1.20-3.48) and with Trichuris trichiura infections (OR: 4.13; CI: 1.04-16.52) in children of all age-groups, and with asymptomatic Plasmodium parasitaemia (OR: 13.03; CI: 1.34 - 127.23) in infants. None of the investigated helminthiases impacted significantly on the nutritional status and anaemia, but moderate asymptomatic Plasmodium parasitaemia was a strong predictor for anaemia in children aged older than two years (OR: 2.69; 95% CI: 1.23 – 5.86). Conclusions E. vermicularis and S. stercoralis infections were moderately prevalent in children from rural coastal Tanzania. Our data can contribute to inform yet missing global burden of disease and prevalence estimates for strongyloidiasis and enterobiasis. The association between S stercoralis and asymptomatic Plasmodium parasitaemia found here warrants further comprehensive investigations. Electronic supplementary material The online version of this article (doi:10.1186/s12879-014-0644-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nahya Salim
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania. .,Department of Pediatrics and Child Health, Muhimbili University Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania. .,Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
| | - Tobias Schindler
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania. .,University of Basel, Basel, Switzerland. .,Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.
| | - Ummi Abdul
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania.
| | - Julian Rothen
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania. .,University of Basel, Basel, Switzerland. .,Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.
| | - Blaise Genton
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland. .,Department of Ambulatory Care and Community Medicine, Infectious Disease Service, Lausanne University Hospital, Lausanne, Switzerland.
| | - Omar Lweno
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania.
| | - Alisa S Mohammed
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania.
| | - John Masimba
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania.
| | - Denis Kwaba
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania.
| | - Salim Abdulla
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania.
| | - Marcel Tanner
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
| | - Claudia Daubenberger
- University of Basel, Basel, Switzerland. .,Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.
| | - Stefanie Knopp
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland. .,Department of Life Sciences, Wolfson Wellcome Biomedical Laboratories, Natural History Museum, London, United Kingdom.
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Koné S, Baikoro N, N'Guessan Y, Jaeger FN, Silué KD, Fürst T, Hürlimann E, Ouattara M, Séka MCY, N'Guessan NA, Esso ELJC, Zouzou F, Boti LI, Gonety PT, Adiossan LG, Dao D, Tschannen AB, von Stamm T, Bonfoh B, Tanner M, Utzinger J, N'Goran EK. Health & Demographic Surveillance System Profile: The Taabo Health and Demographic Surveillance System, Côte d'Ivoire. Int J Epidemiol 2014; 44:87-97. [PMID: 25433704 DOI: 10.1093/ije/dyu221] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
The Taabo Health and Demographic Surveillance System (HDSS) is located in south-central Côte d'Ivoire, approximately 150 km north-west of Abidjan. The Taabo HDSS started surveillance activities in early 2009 and the man-made Lake Taabo is a key eco-epidemiological feature. Since inception, there has been a strong interest in research and integrated control of water-associated diseases such as schistosomiasis and malaria. The Taabo HDSS has generated setting-specific evidence on the impact of targeted interventions against malaria, schistosomiasis and other neglected tropical diseases. The Taabo HDSS consists of a small town, 13 villages and over 100 hamlets. At the end of 2013, a total population of 42 480 inhabitants drawn from 6707 households was under surveillance. Verbal autopsies have been conducted to determine causes of death. Repeated cross-sectional epidemiological surveys on approximately 5-7% of the population and specific, layered-on haematological, parasitological and questionnaire surveys have been conducted. The Taabo HDSS provides a database for surveys, facilitates interdisciplinary research, as well as surveillance, and provides a platform for the evaluation of health interventions. Requests to collaborate and to access data are welcome and should be addressed to the secretariat of the Centre Suisse de Recherches Scientifiques en Côte d'Ivoire: [secretariat@csrs.ci].
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Affiliation(s)
- Siaka Koné
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Nahoua Baikoro
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Yao N'Guessan
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Fabienne N Jaeger
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Kigbafori D Silué
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Thomas Fürst
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Eveline Hürlimann
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Mamadou Ouattara
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Marie-Chantal Y Séka
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Nicaise A N'Guessan
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Emmanuel L J C Esso
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Fabien Zouzou
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Louis I Boti
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Prosper T Gonety
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Lukas G Adiossan
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Daouda Dao
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Andres B Tschannen
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Thomas von Stamm
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Marcel Tanner
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Jürg Utzinger
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Eliézer K N'Goran
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire, Centre for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
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Khieu V, Schär F, Forrer A, Hattendorf J, Marti H, Duong S, Vounatsou P, Muth S, Odermatt P. High prevalence and spatial distribution of Strongyloides stercoralis in rural Cambodia. PLoS Negl Trop Dis 2014; 8:e2854. [PMID: 24921627 PMCID: PMC4055527 DOI: 10.1371/journal.pntd.0002854] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Accepted: 03/29/2014] [Indexed: 11/21/2022] Open
Abstract
Background The threadworm, Strongyloides stercoralis, endemic in tropical and temperate climates, is a neglected tropical disease. Its diagnosis requires specific methods, and accurate information on its geographic distribution and global burden are lacking. We predicted prevalence, using Bayesian geostatistical modeling, and determined risk factors in northern Cambodia. Methods From February to June 2010, we performed a cross-sectional study among 2,396 participants from 60 villages in Preah Vihear Province, northern Cambodia. Two stool specimens per participant were examined using Koga agar plate culture and the Baermann method for detecting S. stercoralis infection. Environmental data was linked to parasitological and questionnaire data by location. Bayesian mixed logistic models were used to explore the spatial correlation of S. stercoralis infection risk. Bayesian Kriging was employed to predict risk at non-surveyed locations. Principal Findings Of the 2,396 participants, 44.7% were infected with S. stercoralis. Of 1,071 strongyloidiasis cases, 339 (31.6%) were among schoolchildren and 425 (39.7%) were found in individuals under 16 years. The incidence of S. stercoralis infection statistically increased with age. Infection among male participants was significantly higher than among females (OR: 1.7; 95% CI: 1.4–2.0; P<0.001). Participants who defecated in latrines were infected significantly less than those who did not (OR: 0.6; 95% CI: 0.4–0.8; P = 0.001). Strongyloidiasis cases would be reduced by 39% if all participants defecated in latrines. Incidence of S. stercoralis infections did not show a strong tendency toward spatial clustering in this province. The risk of infection significantly decreased with increasing rainfall and soil organic carbon content, and increased in areas with rice fields. Conclusions/Significance Prevalence of S. stercoralis in rural Cambodia is very high and school-aged children and adults over 45 years were the most at risk for infection. Lack of access to adequate treatment for chronic uncomplicated strongyloidiasis is an urgent issue in Cambodia. We would expect to see similar prevalence rates elsewhere in Southeast Asia and other tropical resource poor countries. Data on the prevalence and distribution of Strongyloides stercoralis (threadworm) is scarce in many resource-poor countries. We carried out a cross-sectional study during the dry season among 2,396 rural Cambodians of all ages. We used a rigorous diagnostic approach, involving two stool samples per person and two examination techniques, namely, Koga agar plate culture and the Baermann method. We predicted the spatial distribution of S. stercoralis using Bayesian Kriging analysis. Almost half of the participants (44.7%) were infected with S. stercoralis. Of the S. stercoralis cases, 39.7% involved participants under 16 years old. S. stercoralis infection prevalence was significantly higher in males than in females. Participants younger than 10 years old had a lower risk of infection than did older participants. Furthermore, our study showed that toilet use could prevent threadworm infections by 39%. Infection prevalence in the province was negatively associated with rainfall and soil organic content and positively associated with land covered by rice fields. We conclude that access to adequate treatment for S. stercoralis must be addressed in Cambodia. Infection prevalence is likely to be similar in other countries of the region and the developing world.
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Affiliation(s)
- Virak Khieu
- National Centre for Parasitology, Entomology and Malaria Control, Ministry of Health, Phnom Penh, Cambodia; Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Fabian Schär
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Armelle Forrer
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Jan Hattendorf
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Hanspeter Marti
- University of Basel, Basel, Switzerland; Medical Department and Diagnostics, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Socheat Duong
- National Centre for Parasitology, Entomology and Malaria Control, Ministry of Health, Phnom Penh, Cambodia
| | - Penelope Vounatsou
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Sinuon Muth
- National Centre for Parasitology, Entomology and Malaria Control, Ministry of Health, Phnom Penh, Cambodia
| | - Peter Odermatt
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
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Khieu V, Schär F, Marti H, Bless PJ, Char MC, Muth S, Odermatt P. Prevalence and risk factors of Strongyloides stercoralis in Takeo Province, Cambodia. Parasit Vectors 2014; 7:221. [PMID: 24886763 PMCID: PMC4029906 DOI: 10.1186/1756-3305-7-221] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Accepted: 04/28/2014] [Indexed: 11/12/2022] Open
Abstract
Background The threadworm Strongyloides stercoralis, the most neglected helminth, affects an estimated 30-100 million people worldwide. Information on S. stercoralis infection is scarce in tropical and sub-tropical resource poor countries, including Cambodia. We determined S. stercoralis infection prevalence and risk factors for infection in the general population in Southern Cambodia. Methods A cross-sectional study was carried out between January and April 2011 among 2,861 participants living in 60 villages of Takeo province, using Koga-agar plate culture, the Baermann technique and the Kato-Katz technique on a single stool sample. Results Eight intestinal helminth species were diagnosed. Hookworm (31.4%) and S. stercoralis (21.0%) occurred most frequently. Prevalence of S. stercoralis infection increased with age. In all age groups a higher prevalence was found among males than among females (OR: 1.7; 95% CI: 1.4 – 2.0; P < 0.001). Participants who had a latrine at home were significantly less frequently infected with S. stercoralis than those who did not (OR: 0.7; 95% CI: 0.4 – 0.8; P = 0.003). Muscle pain (OR: 1.3; 95% CI: 1.0 – 1.6; P = 0.028) and urticaria (OR: 1.4; 95% CI: 1.1 – 1.8; P = 0.001) were significantly associated with S. stercoralis infection. Conclusions S. stercoralis is highly prevalent among the general Cambodian population and should no longer be neglected. Access to adequate diagnosis and treatment is urgently needed.
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Affiliation(s)
| | | | | | | | | | | | - Peter Odermatt
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.
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Knopp S, Salim N, Schindler T, Karagiannis Voules DA, Rothen J, Lweno O, Mohammed AS, Singo R, Benninghoff M, Nsojo AA, Genton B, Daubenberger C. Diagnostic accuracy of Kato-Katz, FLOTAC, Baermann, and PCR methods for the detection of light-intensity hookworm and Strongyloides stercoralis infections in Tanzania. Am J Trop Med Hyg 2014; 90:535-545. [PMID: 24445211 PMCID: PMC3945701 DOI: 10.4269/ajtmh.13-0268] [Citation(s) in RCA: 111] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Sensitive diagnostic tools are crucial for an accurate assessment of helminth infections in low-endemicity areas. We examined stool samples from Tanzanian individuals and compared the diagnostic accuracy of a real-time polymerase chain reaction (PCR) with the FLOTAC technique and the Kato-Katz method for hookworm and the Baermann method for Strongyloides stercoralis detection. Only FLOTAC had a higher sensitivity than the Kato-Katz method for hookworm diagnosis; the sensitivities of PCR and the Kato-Katz method were equal. PCR had a very low sensitivity for S. stercoralis detection. The cycle threshold values of the PCR were negatively correlated with the logarithm of hookworm egg and S. stercoralis larvae counts. The median larvae count was significantly lower in PCR false negatives than true positives. All methods failed to detect very low-intensity infections. New diagnostic approaches are needed for monitoring of progressing helminth control programs, confirmation of elimination, or surveillance of disease recrudescence.
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Affiliation(s)
- Stefanie Knopp
- *Address correspondence to Stefanie Knopp, Swiss Tropical and Public Health Institute, PO Box, 4002 Basel, Switzerland. E-mail:
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Naves MM, Costa-Cruz JM. High prevalence of Strongyloides stercoralis infection among the elderly in Brazil. Rev Inst Med Trop Sao Paulo 2014; 55:309-13. [PMID: 24037284 PMCID: PMC4105067 DOI: 10.1590/s0036-46652013000500003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Accepted: 02/20/2013] [Indexed: 11/22/2022] Open
Abstract
Little is known about the frequency of intestinal parasites in the elderly due to a lack of attention given to the occurrence of these infections among older adults. This study compares the frequency of Strongyloides stercoralis and other enteroparasites between elderly living in nursing homes (n = 100) and those noninstitutionalized (n = 100) from Uberlândia, state of Minas Gerais, southeastern Brazil, associated with data of epidemiological and socio-demographic conditions. Through coproparasitological examination of both groups, enteroparasites were detected in 15 of 200 individuals examined (7.5%; CI: 5.1- 9.9). S. stercoralis was the most frequent parasite 10/200 (5%; CI: 4.2-5.8), being significantly higher in males and in individuals with autonomy for daily living activities. There were no statistical differences in the prevalence of parasites between the two groups compared. In conclusion, S. stercoralis infection was highly prevalent in elderly patients and it does not depend on whether the individual was institutionalized or not.
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Affiliation(s)
- Maria Margarida Naves
- Laboratório de Diagnóstico de Parasitoses, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brasil
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