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Zhao H, Bradbury RS. Feline strongyloidiasis: An insight into its global prevalence and transmission cycle. One Health 2024; 19:100842. [PMID: 39026543 PMCID: PMC11255105 DOI: 10.1016/j.onehlt.2024.100842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 06/19/2024] [Indexed: 07/20/2024] Open
Abstract
The potential cross-transmission of Strongyloides stercoralis between dogs and humans has become an increasing focus of strongyloidiasis research and control programs. However, the role of cats and wild felids in the maintenance and transmission cycles of human and canine strongyloidiasis has received sparse attention. Feline strongyloidiasis epidemiology remain enigmatic. We conducted a systematic review and meta-analysis to assess the global prevalence of Strongyloides spp. in felines and reviewed cross-species infection studies to elucidate the transmission cycle of some feline Strongyloides species. Literature searched from seven databases identified 42 eligible prevalence studies published between 1985 and 2024. Of these, 44 datasets from 40 studies were included in the meta-analysis. Using a random effect model combined with the Rogan-Gladen method, we estimated the pooled global prevalence of Strongyloides spp. in felines at 13.3% (95% CI: 8.3-18.3%), with rates of 12.2% (95% CI: 6.7-17.8%) in domestic cats (Felis catus) and 20.0% (95% CI: 14.9-25.2%) in wild felids. Feline strongyloidiasis was distributed across all six WHO regions, with Africa (49.7%; 95% CI: 40.0-59.3%) and the Western Pacific (46.9%; 95% CI: 42.6-51.1%) showing the highest pooled prevalence. Subgroup analysis revealed a significantly higher prevalence of Strongyloides infection in stray domestic cats (29.2%; 95% CI: 6.3-52.1%) compared to pet cats (9.3%; 95% CI: 3.7-14.9) and shelter cats (4.4; 95% CI: 0-9.0). Historical cross-species transmission studies demonstrated variable susceptibility of cats to human- or canine-derived S. stercoralis. It remains inconclusive whether cats act as a reservoir for S. stercoralis infection in humans or vice versa. Feline strongyloidiasis is a prevalent condition in wild, stray, pet and shelter cats. Much of the available prevalence data does not discriminate to species level, and the role of cross-species transmission in feline S. stercoralis infections remains obscure. Future studies would benefit from utilising molecular genotyping tools to enable species-level phylogenetic differentiation.
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Affiliation(s)
- Huan Zhao
- College of Public Health, Medical & Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia
| | - Richard Stewart Bradbury
- College of Public Health, Medical & Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia
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Weerasekera CJ, Gunathilaka N, Menike C, Anpahalan P, Perera N, de Silva NR, Wickremasinghe R. Detection of human strongyloidiasis among patients with a high risk of complications attending selected tertiary care hospitals in Colombo, Sri Lanka using molecular and serological diagnostic tools. Parasit Vectors 2024; 17:427. [PMID: 39394172 PMCID: PMC11470637 DOI: 10.1186/s13071-024-06508-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 09/25/2024] [Indexed: 10/13/2024] Open
Abstract
BACKGROUND Strongyloidiasis a neglected tropical disease is known to cause severe disease among immunosuppressed and has not been studied extensively in Sri Lanka. Parasitological diagnostic approaches based on faecal microscopy and culture often fail to detect low-intensity infections. This study investigates the presence of strongyloidiasis among selected immunocompromised individuals using parasitological, molecular and serological techniques. METHODS Adult patients with immunocompromising conditions admitted to three tertiary care hospitals in Sri Lanka were recruited. A faecal sample and 2 ml of venous blood were collected. The faecal samples were subjected to direct faecal smear and cultures (agar plate, charcoal and Harada-Mori) and polymerase chain reaction (PCR) using species specific primers designed for Strongyloides stercoralis. The presence of Strongyloides IgG antibodies was tested in the collected serum samples using DRG Strongyloides IgG enzyme-linked immunosorbent assay (ELISA) kits. The PCR products of the positive samples were sequenced using Sanger sequencing method. RESULTS A total of 260 patients were recruited to this study, out of which 160 provided faecal samples and 122 provided blood samples. Out of the 160 faecal samples, none were positive for strongyloidiasis by direct smear, charcoal and Harada-Mori cultures. Only one sample (0.6%) was positive by agar plate culture. Out of the 123 samples subjected to PCR, 14 (11.4%), including the culture positive patient, were positive for S. stercoralis. Sequencing results of the PCR products indicated 100% similarity to S. stercoralis. Out of the 122 serum samples subjected to ELISA, 20 (16.4%), including the culture positive patient, were positive for Strongyloides IgG antibodies. However, sociodemographic, exposure factors, clinical features were not significantly associated with the presence of strongyloidiasis infection. CONCLUSIONS Strongyloidiasis is present among the immunocompromised population in Sri Lanka, even in the absence of a significant relationship with associated factors. It is advisable to screen such patients with highly sensitive tests such as PCR for early diagnosis and treatment.
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Zainol DA, Anuar NS, Abdul Halim NSS, Kaur M, Noordin R, Rahumatullah A. Systematic Review of Strongyloides stercoralis Infection Diagnosis in Southeast Asia: Insights from Parasitological, Molecular, and Serological Approaches. Am J Trop Med Hyg 2024; 111:724-735. [PMID: 39137756 PMCID: PMC11448514 DOI: 10.4269/ajtmh.23-0599] [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: 09/08/2023] [Accepted: 05/13/2024] [Indexed: 08/15/2024] Open
Abstract
Accurate diagnosis of strongyloidiasis is crucial for effective treatment and prevention of complications. We reviewed the current landscape of diagnostic assays used in detecting Strongyloides infection in Southeast Asia. A literature search was performed using Scopus, PubMed, and Web of Science databases spanning the last three decades. Based on the exclusion and inclusion criteria, 52 papers were included in this review. We outlined the diagnostic methods used and their advantages and drawbacks. Insensitive parasitological methods were commonly used, thus underscoring the underestimation of Strongyloides infection rates in Southeast Asia. A combination of diagnostic methods (i.e., microscopy, molecular techniques, and serology) is preferred because it leads to more effective detection and higher prevalence rates. New approaches have been developed, including urine ELISAs and rapid lateral flow tests. Improving and standardizing diagnostics and making them more accessible can improve Strongyloides prevalence estimates and facilitate control efforts.
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Affiliation(s)
- Dinie Adila Zainol
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Penang, Malaysia
| | - Nor Suhada Anuar
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Penang, Malaysia
| | - Nur Shuhaidatul Sarmiza Abdul Halim
- Neurorehabilitation Engineering and Assistance Systems Research (NEAR), School of Mechanical Engineering, Engineering Campus, Universiti Sains Malaysia (USM), Penang, Malaysia
| | - Mansheender Kaur
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Penang, Malaysia
| | - Rahmah Noordin
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Anizah Rahumatullah
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Penang, Malaysia
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Nickel B, Krebs C, Ruf MT, Anuar NS, Noordin R. An evaluation of a lateral flow rapid diagnostic test for Strongyloides stercoralis infection. Acta Trop 2024; 258:107336. [PMID: 39098752 DOI: 10.1016/j.actatropica.2024.107336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 06/04/2024] [Accepted: 07/25/2024] [Indexed: 08/06/2024]
Abstract
Strongyloides stercoralis in humans often presents as a chronic asymptomatic infection. Diagnosis can be challenging due to the limited sensitivity of faecal-based parasitological techniques. A prototype lateral flow rapid diagnostic test (RDT) for the detection of specific antibodies against Strongyloides stercoralis (SsRapid) was evaluated using 143 samples from the serum bank of the Swiss Tropical and Public Health Institute. Group 1 (n = 30) comprised serum samples from larvae-positive individuals; the RDT's diagnostic sensitivity was 97 % (29/30). Group II comprised serum samples from patients with other parasitic infections (n = 86) and Swiss blood donors (n = 27); the RDT's diagnostic specificity for this group was 90 % (102/113). The RDT showed good diagnostic performance and is a promising point-of-care test for detecting human Strongyloides stercoralis infection.
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Affiliation(s)
- Beatrice Nickel
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Christina Krebs
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Marie-Therese Ruf
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Nor Suhada Anuar
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, Penang, 11800, Malaysia
| | - Rahmah Noordin
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, 56000, Malaysia.
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Hogan JI, Mehta SA. Strongyloides stercoralis infection in solid organ transplant recipients. Curr Opin Infect Dis 2024; 37:367-375. [PMID: 39082077 DOI: 10.1097/qco.0000000000001046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2024]
Abstract
PURPOSE OF REVIEW Strongyloides stercoralis infection remains of concern due to its high associated morbidity among solid organ transplant recipients (SOTR) and the risk of donor-derived infection (DDI). We review key aspects of epidemiology to inform screening for and treatment of chronic infection among organ transplant candidates to reduce the risk of infectious complications in the posttransplant setting. RECENT FINDINGS In this work, we offer guidance regarding the optimal management of Strongyloides hyperinfection syndrome and disseminated infection and offer recommendations regarding posttreatment surveillance and the potential need for repeat treatment during subsequent periods of augmented immunosuppression. This review also provides updated recommendations for screening of deceased and living donors as recently proposed by the Organ Procurement and Transplantation Network's Ad Hoc Disease Transmission Advisory Committee. SUMMARY Risk reduction of Strongyloides infection in the SOTR population can be further enhanced by optimized treatment of infection, posttreatment surveillance during at-risk periods and recent proposed policy shifts to universal donor screening.
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Affiliation(s)
| | - Sapna A Mehta
- NYU Grossman School of Medicine
- NYU Langone Transplant Institute, New York, New York, USA
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Cambra-Pellejà M, Valderas-García E, Balaña-Fouce R, de la Vega J, del Olmo E, Antwi-Ekwuruke J, Linnemann L, Heepmann L, Breloer M, Martínez-Valladares M. Evaluating alternative compounds for strongyloidiasis therapy: Novel insights from larval migration inhibition test. PLoS Negl Trop Dis 2024; 18:e0012532. [PMID: 39374184 PMCID: PMC11458022 DOI: 10.1371/journal.pntd.0012532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 09/12/2024] [Indexed: 10/09/2024] Open
Abstract
Strongyloidiasis is a neglected tropical disease estimated to affect more than 600 million people worldwide. Recently, the World Health Organization road map on neglected tropical diseases 2021-2030 has put the focus on strongyloidiasis, including this disease within its mass drug administration campaigns. With the use of ivermectin in extensive treatment of all populations at-risk, identifying effective therapeutic alternatives is crucial in case ivermectin resistance arises. The objective of the present study was the development of a larval migration inhibition assay to evaluate the anthelmintic efficacy of commercial drugs and diamine and aminoalcohol derivatives against infective Strongyloides ratti third stage larvae. Through this technique, we successfully screened and estimated the in vitro anthelmintic efficacy of six commercial drugs, seven diamine derivatives and eight aminoalcohol derivatives. Unexpectedly, the half-maximal effective concentration of ivermectin and moxidectin (2.21 and 2.34 μM, respectively) were observed as the highest value obtained among all commercial drugs tested by this in vitro technique. Moreover, some diamine and aminoalcohol derivatives showed superior efficacy inhibiting S. ratti motility compared to ivermectin, with five compounds (AA23, AA34, AO2 AO7 and AO14b) also displaying selectivity indexes on HepG2 and Caco2 higher than 1. These findings underscore the potential of these derivatives as promising alternatives for strongyloidiasis treatment, warranting further investigation and in vivo efficacy assessment.
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Affiliation(s)
- María Cambra-Pellejà
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad de León, Campus de Vegazana, León, Spain
- Instituto de Ganadería de Montaña (CSIC-Universidad de León), Grulleros, León, Spain
| | - Elora Valderas-García
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad de León, Campus de Vegazana, León, Spain
| | - Rafael Balaña-Fouce
- Departamento de Ciencias Biomédicas, Institute of Biomedicine (IBIOMED), Universidad de León, León, Spain
| | - Jennifer de la Vega
- Departamento de Ciencias Farmacéuticas: Química Farmacéutica, Facultad de Farmacia, Universidad de Salamanca, CIETUS, IBSAL, Salamanca, Spain
| | - Esther del Olmo
- Departamento de Ciencias Farmacéuticas: Química Farmacéutica, Facultad de Farmacia, Universidad de Salamanca, CIETUS, IBSAL, Salamanca, Spain
| | - Jennifer Antwi-Ekwuruke
- Bernhard Nocht Institute for Tropical Medicine, Section Interface, Helminth Immunology Group Hamburg, Germany
| | - Lara Linnemann
- Bernhard Nocht Institute for Tropical Medicine, Section Interface, Helminth Immunology Group Hamburg, Germany
| | - Lennart Heepmann
- Bernhard Nocht Institute for Tropical Medicine, Section Interface, Helminth Immunology Group Hamburg, Germany
| | - Minka Breloer
- Bernhard Nocht Institute for Tropical Medicine, Section Interface, Helminth Immunology Group Hamburg, Germany
- Department of Biology, University of Hamburg, Hambug, Germany
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Marín M, Sánchez-Montejo J, Ramos S, Muro A, López-Abán J, Peláez R. Deciphering Chemical Rules for Drug Penetration into Strongyloides. Pharmaceutics 2024; 16:1224. [PMID: 39339260 PMCID: PMC11434980 DOI: 10.3390/pharmaceutics16091224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2024] [Revised: 09/05/2024] [Accepted: 09/17/2024] [Indexed: 09/30/2024] Open
Abstract
Background: Strongyloidiasis, a parasitic infection, presents a significant public health challenge in tropical regions due to the limited repertoire of effective treatments. The screening of chemical libraries against the therapeutically relevant third-stage larvae (L3) of the model parasite Strongyloides venezuelensis yielded meager success rates. This situation is reminiscent of Gram-negative bacteria, where drug entry is a limiting factor. Methods: Here, we set out to determine whether similar barriers are in place and establish whether structural and property requirements exist for anti-strongyloides drug discovery. We focused on dyes as their uptake and effects on viability can be independently assessed in the multicellular parasite, thus providing a means to study the possibility of similar entry rules. We tested different dyes in in vitro assays on L3s. Results: We found that staining was necessary to reduce parasite viability, with some dyes achieving anti-strongyloides effects at concentrations similar to those of the reference drug, ivermectin (IV). Some dyes also showed activity against female adults at concentrations well below that of ivermectin. Unfortunately, the most potent dye, Methylene Blue, was unable to prevent the infection in a preliminary in vivo mouse model assay, presumably due to fast dye clearance. Structural analysis showed that positive charges facilitated the access of the compounds to the L3 tissue, thus providing a structural tool for the introduction of activity. For female adults, low globularity is additionally required. As a proof of concept, we added a positive charge to an inactive compound of one of our chemical libraries and re-determined the activity. Conclusions: These findings allow us to establish structural rules for parasite entry that could be of interest for future drug screening or drug development campaigns. These rules might also be applicable to other related parasites.
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Affiliation(s)
- Miguel Marín
- Laboratorio de Química Orgánica y Farmacéutica, Departamento de Ciencias Farmacéuticas, Universidad de Salamanca, Campus Miguel de Unamuno, E-37007 Salamanca, Spain; (M.M.); (S.R.)
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Farmacia, Universidad de Salamanca, Campus Miguel de Unamuno, E-37007 Salamanca, Spain
- Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Facultad de Farmacia, Universidad de Salamanca, Campus Miguel de Unamuno, E-37007 Salamanca, Spain
| | - Javier Sánchez-Montejo
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), E-37007 Salamanca, Spain; (J.S.-M.); (A.M.)
| | - Sergio Ramos
- Laboratorio de Química Orgánica y Farmacéutica, Departamento de Ciencias Farmacéuticas, Universidad de Salamanca, Campus Miguel de Unamuno, E-37007 Salamanca, Spain; (M.M.); (S.R.)
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Farmacia, Universidad de Salamanca, Campus Miguel de Unamuno, E-37007 Salamanca, Spain
- Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Facultad de Farmacia, Universidad de Salamanca, Campus Miguel de Unamuno, E-37007 Salamanca, Spain
| | - Antonio Muro
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), E-37007 Salamanca, Spain; (J.S.-M.); (A.M.)
| | - Julio López-Abán
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), E-37007 Salamanca, Spain; (J.S.-M.); (A.M.)
| | - Rafael Peláez
- Laboratorio de Química Orgánica y Farmacéutica, Departamento de Ciencias Farmacéuticas, Universidad de Salamanca, Campus Miguel de Unamuno, E-37007 Salamanca, Spain; (M.M.); (S.R.)
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Farmacia, Universidad de Salamanca, Campus Miguel de Unamuno, E-37007 Salamanca, Spain
- Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Facultad de Farmacia, Universidad de Salamanca, Campus Miguel de Unamuno, E-37007 Salamanca, Spain
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Servián A, Garimano N, Santini MS. Systematic review and meta-analysis of soil-transmitted helminth infections in South America (2000-2024). Acta Trop 2024; 260:107400. [PMID: 39265755 DOI: 10.1016/j.actatropica.2024.107400] [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: 07/18/2024] [Revised: 08/27/2024] [Accepted: 09/09/2024] [Indexed: 09/14/2024]
Abstract
Soil-transmitted helminths (STHs) are parasitic nematodes commonly found in tropical and subtropical regions, where poor sanitation makes them a significant public health concern. This study provides a comprehensive review and meta-analysis of human STH infections across 13 South American countries from 2000 to 2023. It covers these infections' prevalence, distribution, and diagnosis, highlighting the environmental factors influencing transmission pathways. The review identified 134 studies on human STH infections, revealing Brazil as the most researched country. The meta-analysis found prevalence rates of Ascaris lumbricoides, Trichuris trichiura, hookworms, and Strongyloides stercoralis below 20 %, with notable heterogeneity across studies. Most studies used conventional microscopy for diagnosis, pointing out the need for implementing advanced diagnostic tools. Environmental and climatic factors, including temperature annual range, vegetation density, soil types, and properties were significant predictors of STH prevalence. The study calls for more research performing advanced diagnostic methods and broader geographical coverage to address existing data gaps. Furthermore, it emphasizes the need for holistic public health policies integrating biomedical and environmental approaches to ensure effective disease management.
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Affiliation(s)
- Andrea Servián
- Instituto Nacional de Parasitología "Dr. Mario Fatala Chaben"- ANLIS Malbrán, Ciudad Autónoma de Buenos Aires (CABA, 1063), Buenos Aires, Argentina.
| | - Nicolás Garimano
- Instituto Nacional de Parasitología "Dr. Mario Fatala Chaben"- ANLIS Malbrán, Ciudad Autónoma de Buenos Aires (CABA, 1063), Buenos Aires, Argentina
| | - María Soledad Santini
- Instituto Nacional de Parasitología "Dr. Mario Fatala Chaben"- ANLIS Malbrán, Ciudad Autónoma de Buenos Aires (CABA, 1063), Buenos Aires, Argentina; CONICET: CONICET Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
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Carinton D, Teodósio R, Belo S, L Maurício I. Strongyloides stercoralis in Low-Income Immigrants from Portuguese Speaking African Countries in Lisbon, Portugal. ACTA MEDICA PORT 2024; 37:668-669. [PMID: 39226557 DOI: 10.20344/amp.21782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 06/18/2024] [Indexed: 09/05/2024]
Affiliation(s)
- Diamarize Carinton
- Instituto de Higiene e Medicina Tropical (IHMT). Universidade NOVA de Lisboa. Lisboa. Portugal
| | - Rosa Teodósio
- Unidade de Ensino e Investigação de Clínica Tropical. Global Health and Tropical Medicine (GHTM). Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL). Instituto de Higiene e Medicina Tropical (IHMT). Universidade NOVA de Lisboa. Lisboa. Portugal
| | - Silvana Belo
- Unidade de Ensino e Investigação de Parasitologia Médica. Global Health and Tropical Medicine (GHTM). Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL). Instituto de Higiene e Medicina Tropical (IHMT). Universidade NOVA de Lisboa. Lisboa. Portugal
| | - Isabel L Maurício
- Unidade de Ensino e Investigação de Parasitologia Médica. Global Health and Tropical Medicine (GHTM). Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL). Instituto de Higiene e Medicina Tropical (IHMT). Universidade NOVA de Lisboa. Lisboa. Portugal
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Santarém VA, Pinto GLB, Ferreira IB, Ribeiro J, Filho RTDS, Meisel DMC, Gryschek RCB, Lescano SAZ, Giuffrida R, Kmetiuk LB, de Paula FM, Biondo AW. A silent threat behind bars: Serosurvey and associated risk factors for strongyloidiasis in female inmates and correctional officers. Acta Trop 2024; 257:107301. [PMID: 38955318 DOI: 10.1016/j.actatropica.2024.107301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 06/04/2024] [Accepted: 06/21/2024] [Indexed: 07/04/2024]
Abstract
Strongyloidiasis has been a neglected parasitic infection caused by Strongyloides genus parasites. Despite assessment of S. stercoralis exposure in different vulnerable populations, seroprevalence in inmates worldwide remains to be fully established. Due to poor sanitation and lack of personal hygienic practices, incarcerated individuals have been considered prone to spread infectious illnesses. Accordingly, the present study has assessed exposure and associated risk factors for strongyloidiasis in women inmates and correctional officers at the Women's State Penitentiary of Parana, part of the third largest incarceration complex in Brazil at the time. Blood samplings were performed in 2020 and 2021from a total of 503 women inmates and 92 correctional officers. Participants voluntarily responded to an epidemiological questionnaire to assess associated risk factors to strongyloidiasis. Serological analysis was performed by ELISA for anti-S. stercoralis IgG detection. Statistical analysis was performed using R software, adopting a 5% level of significance. The data were submitted to univariate analysis by chi-square or Fisher´s Exact test for assessing the association among seropositivity and the variables. The variables with p-value < 0.2 in the univariate analysis were considered fit to be included in the logistic regression. In overall, 356/503 (70.8%; 95% CI: 66.7-74.6) inmates were seropositive for anti-S. stercoralis antibodies, with no statistically associated risk factor to seropositivity. A total of 57/92 (62.0%; 95% CI: 51.8-71.2) correctional officers were seropositive, and logistic regression revealed that individuals older than 50 years were more likely seropositive. In conclusion, the high endemicity observed herein has indicated a history of previous exposure to S. stercoralis and warned for a systematic strongyloidiasis screening for inmates, to prevent long term morbidity and disseminated infection during incarceration.
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Affiliation(s)
- Vamilton Alvares Santarém
- Graduate College in Animal Sciences, University of Western São Paulo (UNOESTE), Presidente Prudente, SP 19050-920, Brazil
| | - Gabriel Luís Brucinski Pinto
- Graduate College of Cell and Molecular Biology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários, 1540, Juvevê, Curitiba, PR 80035-050, Brazil
| | - Isabella Braghin Ferreira
- Graduate College in Animal Sciences, University of Western São Paulo (UNOESTE), Presidente Prudente, SP 19050-920, Brazil
| | - Juliano Ribeiro
- Graduate College of Cell and Molecular Biology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários, 1540, Juvevê, Curitiba, PR 80035-050, Brazil
| | | | - Dirce Mary Correa Meisel
- Laboratory of Medical Investigation (LIM/06), Clinical Hospital of the University of São Paulo, SP, Brazil
| | | | | | - Rogério Giuffrida
- Graduate College in Animal Sciences, University of Western São Paulo (UNOESTE), Presidente Prudente, SP 19050-920, Brazil
| | - Louise Bach Kmetiuk
- Zoonoses Surveillance Unit, Municipal Secretary of Health, Curitiba, PR, Brazil
| | - Fabiana Martins de Paula
- Laboratory of Medical Investigation (LIM/06), Clinical Hospital of the University of São Paulo, SP, Brazil
| | - Alexander Welker Biondo
- Graduate College of Cell and Molecular Biology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários, 1540, Juvevê, Curitiba, PR 80035-050, Brazil.
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de Ree V, Nath TC, Barua P, Harbecke D, Lee D, Rödelsperger C, Streit A. Genomic analysis of Strongyloides stercoralis and Strongyloides fuelleborni in Bangladesh. PLoS Negl Trop Dis 2024; 18:e0012440. [PMID: 39226300 PMCID: PMC11407627 DOI: 10.1371/journal.pntd.0012440] [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: 03/28/2024] [Revised: 09/17/2024] [Accepted: 08/07/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND About 600 million people are estimated to be infected with Strongyloides stercoralis, the species that causes most of the human strongyloidiasis cases. S. stercoralis can also infect non-human primates (NHPs), dogs and cats, rendering these animals putative sources for zoonotic human S. stercoralis infection. S. fuelleborni is normally found in old world NHPs but occasionally also infects humans, mainly in Africa. Dogs in southeast Asia carry at least two types of Strongyloides, only one of which appears to be shared with humans ("dog only" and "human and dog" types). For S. stercoralis with molecular taxonomic information, there is a strong sampling bias towards southeast and east Asia and Australia. METHODOLOGY/PRINCIPLE FINDINGS In order to extend the geographic range of sampling, we collected human and dog derived Strongyloides spp. and hookworms from two locations in Bangladesh and subjected them to molecular taxonomic and genomic analysis based on nuclear and mitochondrial sequences. All hookworms found were Necator americanus. Contrary to earlier studies in Asia, we noticed a rather high incidence of S. fuelleborni in humans. Also in this study, we found the two types of S. stercoralis and no indication for genetic isolation from the southeast Asian populations. However, we found one genomically "dog only" type S. stercoralis in a human sample and we found two worms in a dog sample that had a nuclear genome of the "dog only" but a mitochondrial genome of the "human and dog" type. CONCLUSIONS/SIGNIFICANCE S. fuelleborni may play a more prominent role as a human parasite in certain places in Asia than previously thought. The introgression of a mitochondria haplotype into the "dog only" population suggests that rare interbreeding between the two S. stercoralis types does occur and that exchange of genetic properties, for example a drug resistance, between the two types is conceivable.
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Affiliation(s)
- Veroni de Ree
- Department of Integrative Evolutionary Biology, Max Planck Institute for Biology Tübingen, Tübingen, Germany
| | | | | | - Dorothee Harbecke
- Department of Integrative Evolutionary Biology, Max Planck Institute for Biology Tübingen, Tübingen, Germany
| | - Dongmin Lee
- International Parasite Resource Bank, Chungbuk National University, Seowon-gu, Korea
| | - Christian Rödelsperger
- Department of Integrative Evolutionary Biology, Max Planck Institute for Biology Tübingen, Tübingen, Germany
| | - Adrian Streit
- Department of Integrative Evolutionary Biology, Max Planck Institute for Biology Tübingen, Tübingen, Germany
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12
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Lucas Dato A, Wikman-Jorgensen P, Borrajo Brunete E, Hernández Rabadán MD, García-Morante H, Merino Trigueros MA, Saugar Cruz JM, García-Vazquez E, Llenas-García J. Concomitant Serological and Molecular Methods for Strongyloides stercoralis Screening in an Endemic Area of Spain. Trop Med Infect Dis 2024; 9:194. [PMID: 39330883 PMCID: PMC11435527 DOI: 10.3390/tropicalmed9090194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Accepted: 08/17/2024] [Indexed: 09/28/2024] Open
Abstract
Strongyloidiasis is a widespread parasitic disease that can be life-threatening in immunosuppressed people. In the Mediterranean basin, autochthonous cases coexist with imported ones. We aimed to assess the utility of different screening methods, along with the frequency of strongyloidiasis and its associated risk factors in migrants and the native population. This cross-sectional study took place from 2019 to 2022 in the area of the Vega Baja Hospital in Alicante, Spain. Screening was performed in people who were immunosuppressed, at risk of immunosuppression, with blood asymptomatic eosinophilia, and in asymptomatic people from highly endemic countries. Screening methods were serological techniques (ELISA), stool parasitological tests (fecal concentration methods and agar plate culture), and a stool molecular test (PCR). Of the 168 participants (62.5% males, 53.0% migrants, 36.3% immunosuppressed, median age 57 years), 14 (8.3%) had confirmed strongyloidiasis, where 6 were confirmed by serology, 4 by PCR, and 4 by both methods. Overall, 9% of the migrants and 7.6% of the native-born patients were infected. Elevated IgE and hemoglobin and Latin American origin were associated with strongyloidiasis diagnosis. Screening with serology alone would have missed 28.6% of cases. We conclude that strongyloidiasis prevalence is high in our population, both in native and migrant groups, and stool PCR is a useful tool to increase case detection.
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Affiliation(s)
- Ana Lucas Dato
- Internal Medicine/Infectious Diseases Department, Vega Baja Hospital-Orihuela, 03314 Alicante, Spain
- Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO), 46020 Valencia, Spain
| | - Philp Wikman-Jorgensen
- Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO), 46020 Valencia, Spain
- Internal Medicine/Infectious Diseases Department, Elda General University Hospital, 03600 Alicante, Spain
- Department of Clinical Medicine, Miguel Hernandez University of Elche, 03202 Elche, Spain
| | | | - María Dolores Hernández Rabadán
- Internal Medicine/Infectious Diseases Department, Vega Baja Hospital-Orihuela, 03314 Alicante, Spain
- Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO), 46020 Valencia, Spain
| | - Hilarión García-Morante
- Internal Medicine/Infectious Diseases Department, Vega Baja Hospital-Orihuela, 03314 Alicante, Spain
- Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO), 46020 Valencia, Spain
| | - María Adelino Merino Trigueros
- Internal Medicine/Infectious Diseases Department, Vega Baja Hospital-Orihuela, 03314 Alicante, Spain
- Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO), 46020 Valencia, Spain
| | - José María Saugar Cruz
- Laboratory of Reference and Research in Parasitology, Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28222 Majadahonda, Spain
- Biomedical Research Networking Center of Infectious Diseases (CIBERINFEC), Carlos III Institute, 28029 Madrid, Spain
| | - Elisa García-Vazquez
- Infectious Diseases Unit, Hospital Virgen de la Arrixaca, 30120 Murcia, Spain
- Medicine Department, University of Murcia, 30003 Murcia, Spain
| | - Jara Llenas-García
- Internal Medicine/Infectious Diseases Department, Vega Baja Hospital-Orihuela, 03314 Alicante, Spain
- Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO), 46020 Valencia, Spain
- Department of Clinical Medicine, Miguel Hernandez University of Elche, 03202 Elche, Spain
- Biomedical Research Networking Center of Infectious Diseases (CIBERINFEC), Carlos III Institute, 28029 Madrid, Spain
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13
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Patel R, Bryant AS, Castelletto ML, Walsh B, Akimori D, Hallem EA. The generation of stable transgenic lines in the human-infective nematode Strongyloides stercoralis. G3 (BETHESDA, MD.) 2024; 14:jkae122. [PMID: 38839055 PMCID: PMC11304987 DOI: 10.1093/g3journal/jkae122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/13/2024] [Accepted: 05/23/2024] [Indexed: 06/07/2024]
Abstract
The skin-penetrating gastrointestinal parasitic nematode Strongyloides stercoralis causes strongyloidiasis, which is a neglected tropical disease that is associated with severe chronic illness and fatalities. Unlike other human-infective nematodes, S. stercoralis cycles through a single free-living generation and thus serves as a genetically tractable model organism for understanding the mechanisms that enable parasitism. Techniques such as CRISPR/Cas9-mediated mutagenesis and transgenesis are now routinely performed in S. stercoralis by introducing exogenous DNA into free-living adults and then screening their F1 progeny for transgenic or mutant larvae. However, transgenesis in S. stercoralis has been severely hindered by the inability to establish stable transgenic lines that can be propagated for multiple generations through a host; to date, studies of transgenic S. stercoralis have been limited to heterogeneous populations of transgenic F1 larvae. Here, we develop an efficient pipeline for the generation of stable transgenic lines in S. stercoralis. We also show that this approach can be used to efficiently generate stable transgenic lines in the rat-infective nematode Strongyloides ratti. The ability to generate stable transgenic lines circumvents the limitations of working with heterogeneous F1 populations, such as variable transgene expression and the inability to generate transgenics of all life stages. Our transgenesis approach will enable novel lines of inquiry into parasite biology, such as transgene-based comparisons between free-living and parasitic generations.
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Affiliation(s)
- Ruhi Patel
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Astra S Bryant
- Department of Physiology and Biophysics, University of Washington, Seattle, WA 98195, USA
| | - Michelle L Castelletto
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Breanna Walsh
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, Los Angeles, CA 90095, USA
- Molecular Biology Interdepartmental PhD Program, University of California, Los Angeles, Los Angeles, CA 90095, USA
- Medical Scientist Training Program, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Damia Akimori
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, Los Angeles, CA 90095, USA
- Molecular Biology Interdepartmental PhD Program, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Elissa A Hallem
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, Los Angeles, CA 90095, USA
- Molecular Biology Institute, University of California, Los Angeles, Los Angeles, CA 90095, USA
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14
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Pomari E, Orza P, Bernardi M, Fracchetti F, Campedelli I, De Marta P, Recchia A, Paradies P, Buonfrate D. A Pilot Study for the Characterization of Bacillus spp. and Analysis of Possible B. thuringiensis/ Strongyloides stercoralis Correlation. Microorganisms 2024; 12:1603. [PMID: 39203445 PMCID: PMC11356623 DOI: 10.3390/microorganisms12081603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Revised: 07/31/2024] [Accepted: 08/02/2024] [Indexed: 09/03/2024] Open
Abstract
Differentiating between Bacillus species is relevant in human medicine. Bacillus thuringiensis toxins might be effective against Strongyloides stercoralis, a nematode causing relevant human morbidity. Our first objective was to evaluate genomic and MALDI-TOF identification methods for B. thuringiensis. Our secondary objective was to evaluate a possible negative selection pressure of B. thuringiensis against S. stercoralis. PCR and Sanger were compared to MALDI-TOF on a collection of 44 B. cereus group strains. B. thuringiensis toxin genes were searched on 17 stool samples from S. stercoralis-infected and uninfected dogs. Metagenomic 16S rRNA was used for microbiome composition. The inter-rate agreement between PCR, Sanger, and MALDI-TOF was 0.631 k (p-value = 6.4 × 10-10). B. thuringiensis toxins were not found in dogs' stool. Bacteroidota and Bacillota were the major phyla in the dogs' microbiome (both represented >20% of the total bacterial community). Prevotella was underrepresented in all Strongyloides-positive dogs. However, the general composition of bacterial communities was not significantly linked with S. stercoralis infection. The genomic methods allowed accurate differentiation between B. thuringiensis and B. cereus. There was no association between B. thuringiensis and S. stercoralis infection, but further studies are needed to confirm this finding. We provide the first descriptive results about bacterial fecal composition in dogs with S. stercoralis infection.
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Affiliation(s)
- Elena Pomari
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, 37024 Verona, Italy; (P.O.); (M.B.); (D.B.)
| | - Pierantonio Orza
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, 37024 Verona, Italy; (P.O.); (M.B.); (D.B.)
| | - Milena Bernardi
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, 37024 Verona, Italy; (P.O.); (M.B.); (D.B.)
| | - Fabio Fracchetti
- Microbion srl, San Giovanni Lupatoto, 37057 Verona, Italy; (F.F.); (I.C.); (P.D.M.)
| | - Ilenia Campedelli
- Microbion srl, San Giovanni Lupatoto, 37057 Verona, Italy; (F.F.); (I.C.); (P.D.M.)
| | - Patrick De Marta
- Microbion srl, San Giovanni Lupatoto, 37057 Verona, Italy; (F.F.); (I.C.); (P.D.M.)
| | - Alessandra Recchia
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Veterinary Section, University of Bari “Aldo Moro”, Valenzano, 70010 Bari, Italy; (A.R.); (P.P.)
| | - Paola Paradies
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Veterinary Section, University of Bari “Aldo Moro”, Valenzano, 70010 Bari, Italy; (A.R.); (P.P.)
| | - Dora Buonfrate
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, 37024 Verona, Italy; (P.O.); (M.B.); (D.B.)
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15
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Gardini G, Froeschl G, Puzzi PR, Gambino S, Erne EM. Dermatological Presentation of Strongyloides stercoralis Infection in Two Elderly Italian Inpatients. Pathogens 2024; 13:658. [PMID: 39204258 PMCID: PMC11357410 DOI: 10.3390/pathogens13080658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Revised: 08/02/2024] [Accepted: 08/04/2024] [Indexed: 09/03/2024] Open
Abstract
Persistent infections caused by Strongyloides stercoralis are probably underestimated in the elderly Italian population. This nematode is unique among helminths: it can last asymptomatically in the host for decades and may present with a broad range of clinical pictures upon reactivation. Misdiagnosis often occurs even when the clinical picture is suggestive. If undetected, this parasitosis can lead to serious consequences when hyperinfection occurs. Herein, we report two peculiar clinical cases of complicated strongyloidiasis with multiple skin lesions. The aim of our report is to lead clinicians to familiarize themselves with skin patterns and clinical features that can suggest a possible underlying strongyloidiasis.
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Affiliation(s)
- Giulia Gardini
- Department of Infectious Diseases, Provincial Hospital of Bolzano (SABES-ASDAA), Lehrkrankenhaus der Paracelsus Medizinischen Privatuniversität, 39100 Bolzano-Bozen, Italy (E.M.E.)
| | - Guenter Froeschl
- Division of Infectious Diseases and Tropical Medicine, University Hospital (LMU), 80802 Munich, Germany
| | - Petra Rosa Puzzi
- Department of Infectious Diseases, Provincial Hospital of Bolzano (SABES-ASDAA), Lehrkrankenhaus der Paracelsus Medizinischen Privatuniversität, 39100 Bolzano-Bozen, Italy (E.M.E.)
| | - Silvia Gambino
- Department of Infectious Diseases, Provincial Hospital of Bolzano (SABES-ASDAA), Lehrkrankenhaus der Paracelsus Medizinischen Privatuniversität, 39100 Bolzano-Bozen, Italy (E.M.E.)
| | - Elke Maria Erne
- Department of Infectious Diseases, Provincial Hospital of Bolzano (SABES-ASDAA), Lehrkrankenhaus der Paracelsus Medizinischen Privatuniversität, 39100 Bolzano-Bozen, Italy (E.M.E.)
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16
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Joo H, Maskery BA, Alpern JD, Weinberg M, Stauffer WM. Cost-effectiveness of treatment strategies for populations from strongyloidiasis high-risk areas globally who will initiate corticosteroid treatment in the USA. J Travel Med 2024; 31:taad054. [PMID: 37074145 PMCID: PMC10986739 DOI: 10.1093/jtm/taad054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 04/20/2023]
Abstract
BACKGROUND The risk of developing strongyloidiasis hyperinfection syndrome appears to be elevated among individuals who initiate corticosteroid treatment. Presumptive treatment or treatment after screening for populations from Strongyloides stercoralis-endemic areas has been suggested before initiating corticosteroids. However, potential clinical and economic impacts of preventative strategies have not been evaluated. METHODS Using a decision tree model for a hypothetical cohort of 1000 individuals from S. stercoralis-endemic areas globally initiating corticosteroid treatment, we evaluated the clinical and economic impacts of two interventions, 'Screen and Treat' (i.e. screening and ivermectin treatment after a positive test), and 'Presumptively Treat', compared to current practice (i.e. 'No Intervention'). We evaluated the cost-effectiveness (net cost per death averted) of each strategy using broad ranges of pre-intervention prevalence and hospitalization rates for chronic strongyloidiasis patients initiating corticosteroid treatment. RESULTS For the baseline parameter estimates, 'Presumptively Treat' was cost-effective (i.e. clinically superior with cost per death averted less than a threshold of $10.6 million per life) compared to 'No Intervention' ($532 000 per death averted) or 'Screen and Treat' ($39 000 per death averted). The two parameters contributing the most uncertainty to the analysis were the hospitalization rate for individuals with chronic strongyloidiasis who initiate corticosteroids (baseline 0.166%) and prevalence of chronic strongyloidiasis (baseline 17.3%) according to a series of one-way sensitivity analyses. For hospitalization rates ≥0.022%, 'Presumptively Treat' would remain cost-effective. Similarly, 'Presumptively Treat' remained preferred at prevalence rates of ≥4%; 'Screen and Treat' was preferred for prevalence between 2 and 4% and 'No Intervention' was preferred for prevalence <2%. CONCLUSIONS The findings support decision-making for interventions for populations from S. stercoralis-endemic areas before initiating corticosteroid treatment. Although some input parameters are highly uncertain and prevalence varies across endemic countries, 'Presumptively Treat' would likely be preferred across a range for many populations, given plausible parameters.
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Affiliation(s)
- Heesoo Joo
- Division of Global Migration and Quarantine, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Brian A. Maskery
- Division of Global Migration and Quarantine, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jonathan D. Alpern
- Infectious Disease Section, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA
- Department of Medicine, Infectious Diseases and International Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Michelle Weinberg
- Division of Global Migration and Quarantine, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - William M. Stauffer
- Division of Global Migration and Quarantine, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
- Department of Medicine, Infectious Diseases and International Medicine, University of Minnesota, Minneapolis, MN, USA
- Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, MN, USA
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17
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Yang R, Xu M, Zhang L, Liao Y, Liu Y, Deng X, Wang L. Human Strongyloides stercoralis infection. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2024:S1684-1182(24)00120-8. [PMID: 39142910 DOI: 10.1016/j.jmii.2024.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 06/14/2024] [Accepted: 07/15/2024] [Indexed: 08/16/2024]
Abstract
Strongyloides stercoralis is an important soil-transmitted helminth occurring world-wide and affecting 30-100 million people. Because many cases are asymptomatic and sensitive diagnostic methods are lacking, S. stercoralis infection is frequently underdiagnosed. The increasing incidence of autoimmune and wasting diseases and increased use of immunosuppressive agents, as well as the increased use of immunosuppressants and cytotoxic drugs, have increased S. stercoralis infection and their mortality. This review provides information about S. stercoralis epidemiology, life cycle, aetiology, pathology, comorbidities, immunology, vaccines, diagnosis, treatment, prevention, control and makes some recommendations for future prevention and control of this important parasite.
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Affiliation(s)
- Ruibing Yang
- Guangzhou Kingmed Center for Clinical Laboratory, Guangzhou, Guangdong 510320, China
| | - Meiyining Xu
- Department of Parasitology of Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - Lichao Zhang
- Guangdong Clinical Laboratory Center Guangdong Provincial People's Hospital, Guangzhou 510080, China
| | - Yao Liao
- Guangzhou Key Laboratory for Clinical Rapid Diagnosis and Early Warning of Infectious Diseases, KingMed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, Guangdong 510180, China
| | - Yuheng Liu
- Guangzhou Key Laboratory for Clinical Rapid Diagnosis and Early Warning of Infectious Diseases, KingMed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, Guangdong 510180, China
| | - Xiaoyan Deng
- Guangzhou Key Laboratory for Clinical Rapid Diagnosis and Early Warning of Infectious Diseases, KingMed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, Guangdong 510180, China.
| | - Lifu Wang
- Guangzhou Key Laboratory for Clinical Rapid Diagnosis and Early Warning of Infectious Diseases, KingMed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, Guangdong 510180, China.
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18
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Schweitzer L, Miko BA, Pereira MR. Infectious Disease Prophylaxis During and After Immunosuppressive Therapy. Kidney Int Rep 2024; 9:2337-2352. [PMID: 39156157 PMCID: PMC11328545 DOI: 10.1016/j.ekir.2024.04.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/17/2024] [Accepted: 04/19/2024] [Indexed: 08/20/2024] Open
Abstract
Immune-mediated renal diseases are a diverse group of disorders caused by antibody, complement, or cell-mediated autosensitization. Although these diseases predispose to infection on their own, a growing array of traditional and newer, more targeted immunosuppressant medications are used to treat these diseases. By understanding their mechanisms of action and the infections associated with suppression of each arm of the immune system, nephrologists can better anticipate these risks and effectively prevent and recognize opportunistic infections. Focusing specifically on nonkidney transplant recipients, this review discusses the infections that can be associated with each of the commonly used immunosuppressants by nephrologists and suggest interventions to prevent infectious complications in patients with immune-mediated renal disease.
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Affiliation(s)
- Lorne Schweitzer
- Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
- Columbia Center for Translational Immunology, Columbia University Irving Medical Center, New York, New York, USA
| | - Benjamin A. Miko
- Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Marcus R. Pereira
- Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
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19
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Busari IO, Elizondo-Luévano JH, Aiyelaagbe OO, Soetan KO, Babayemi OJ, Gorgojo-Galindo O, Muro A, Vicente B, López-Abán J. Anthelmintic activity of three selected ethnobotanical plant extracts against Strongyloides venezuelensis. Exp Parasitol 2024; 263-264:108801. [PMID: 39009180 DOI: 10.1016/j.exppara.2024.108801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 05/12/2024] [Accepted: 07/12/2024] [Indexed: 07/17/2024]
Abstract
The agropastoral farmers have employed Turraea vogelii(TVL),Senna podocarpa(SPL), and Jaundea pinnata (JPL) leaves for treating various diseases, including intestinal parasites in livestock and the human population in Nigeria. Gastrointestinal nematodes are highly significant to livestock production and people's health, and natural products are interesting as sources of new drugs. In this study, we evaluated the effectiveness of extracts derived from these plants in treating parasitic infections using third-stage infective larvae (L3) of Strongyloides venezuelensis. We obtained crude extracts using n-gexane (Hex), ethyl acetate (Ea), and methanol (Met). The extracts were analyzed for their phytochemical composition, and their ability to prevent hemolysis were tested. The mean concentrations of total phenols in SPL Hex, SPL Ea, and SPL Met were 92.3 ± 0.3, 103.0 ± 0.4, and 128.2 ± 0.5 mg/100 g, respectively. Total tannin concentrations for JPL Ea, SPL Ea, SPL Hex, and TVL Hex were 60.3 ± 0.1, 89.2 ± 0.2, 80.0 ± 0.1, and 66.6 ± 0.3 mg/100 g, respectively. The mean lethal concentration (LC50) at 72 h for JPL Ea 39 (26-61) μg/mL. SPL Ea was 39 (34-45) μg/mL, and TVL Hex 31 (26-36) μg/mL. The antiparasitic activities of the extracts against L3 were dose- and time-dependent. All the extracts were slightly hemolytic to the erythrocytes. In this study, the plant extract tested demonstrated significant anti-S. venezuelensis activity. These phytobotanical extracts could be used to create formulations for the potential treatment of helminthiasis in animals and humans.
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Affiliation(s)
- Ibukun O Busari
- Department of Animal Science, Faculty of Agriculture, University of Ibadan, Ibadan, Nigeria; Infectious and Tropical Diseases Group (e-INTRO), IBSAL-CIETUS (Biomedical Research Institute of Salamanca, Centre for Tropical Diseases at the University of Salamanca), Faculty of Pharmacy, University of Salamanca, Ldo, Mendez Nieto s/n, C.P. 37007, Salamanca, Spain.
| | - Joel H Elizondo-Luévano
- Infectious and Tropical Diseases Group (e-INTRO), IBSAL-CIETUS (Biomedical Research Institute of Salamanca, Centre for Tropical Diseases at the University of Salamanca), Faculty of Pharmacy, University of Salamanca, Ldo, Mendez Nieto s/n, C.P. 37007, Salamanca, Spain; Department of Chemistry, Faculty of Biological Sciences, Universidad Autónoma de Nuevo León (UANL), Av. Pedro de Alba s/n, San Nicolás de los Garza, C.P. 66455, Nuevo León, Mexico
| | - Olapeju O Aiyelaagbe
- Department of Chemistry, Faculty of Science, University of Ibadan, Ibadan, Nigeria
| | - Kehinde O Soetan
- Department of Veterinary Physiology and Biochemistry, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Nigeria
| | - Olaniyi J Babayemi
- Department of Animal Science, Faculty of Agriculture, University of Ibadan, Ibadan, Nigeria
| | - Oscar Gorgojo-Galindo
- Infectious and Tropical Diseases Group (e-INTRO), IBSAL-CIETUS (Biomedical Research Institute of Salamanca, Centre for Tropical Diseases at the University of Salamanca), Faculty of Pharmacy, University of Salamanca, Ldo, Mendez Nieto s/n, C.P. 37007, Salamanca, Spain
| | - Antonio Muro
- Infectious and Tropical Diseases Group (e-INTRO), IBSAL-CIETUS (Biomedical Research Institute of Salamanca, Centre for Tropical Diseases at the University of Salamanca), Faculty of Pharmacy, University of Salamanca, Ldo, Mendez Nieto s/n, C.P. 37007, Salamanca, Spain
| | - Belén Vicente
- Infectious and Tropical Diseases Group (e-INTRO), IBSAL-CIETUS (Biomedical Research Institute of Salamanca, Centre for Tropical Diseases at the University of Salamanca), Faculty of Pharmacy, University of Salamanca, Ldo, Mendez Nieto s/n, C.P. 37007, Salamanca, Spain
| | - Julio López-Abán
- Infectious and Tropical Diseases Group (e-INTRO), IBSAL-CIETUS (Biomedical Research Institute of Salamanca, Centre for Tropical Diseases at the University of Salamanca), Faculty of Pharmacy, University of Salamanca, Ldo, Mendez Nieto s/n, C.P. 37007, Salamanca, Spain.
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20
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Kirkwood N, Šlapeta J. Strongyloides stercoralis in two dogs from a household in temperate Australia. Aust Vet J 2024; 102:369-373. [PMID: 38506222 DOI: 10.1111/avj.13330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/08/2024] [Accepted: 03/04/2024] [Indexed: 03/21/2024]
Abstract
Strongyloides stercoralis is parasite affecting both humans and dogs and is most prevalent in tropical and subtropical areas of Australia. This case report describes two dogs from a household in Sydney, New South Wales, one with chronic gastrointestinal signs and the other who was asymptomatic who were subsequently diagnosed with S. stercoralis. Diagnosis can be challenging in humans and dogs due to intermittent shedding and low worm burdens and in this case the symptomatic dog had Strongyloides spp. rhabitiform larvae detected on a direct faecal smear and PCR, the asymptomatic dog on PCR only. Obtained sequences from the symptomatic dog confirmed the presence of the S. stercoralis clade affecting both dogs and humans. Infection does not respond to commonly used deworming drugs for dogs. Treatment in both cases was undertaken using off-label doses of ivermectin and follow-up PCR testing was negative. This case report should increase practitioner awareness of this parasite as present and transmissible in temperate areas of Australia.
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Affiliation(s)
- N Kirkwood
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Sydney, New South Wales, Australia
| | - J Šlapeta
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Sydney, New South Wales, Australia
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21
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Omidian M, Mostafavi-Pour Z, Asadi M, Sharifdini M, Nezafat N, Pouryousef A, Savardashtaki A, Taheri-Anganeh M, Mikaeili F, Sarkari B. Design and expression of a chimeric recombinant antigen (SsIR-Ss1a) for the serodiagnosis of human strongyloidiasis: Evaluation of performance, sensitivity, and specificity. PLoS Negl Trop Dis 2024; 18:e0012320. [PMID: 39008519 PMCID: PMC11271862 DOI: 10.1371/journal.pntd.0012320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 07/25/2024] [Accepted: 06/26/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND The sensitivity of parasitological and molecular methods is unsatisfactory for the diagnosis of strongyloidiasis, and serological techniques are remaining as the most effective diagnostic approach. The present study aimed to design and produce a chimeric recombinant antigen from Strongyloides stercoralis immunoreactive antigen (SsIR) and Ss1a antigens, using immune-informatics approaches, and evaluated its diagnostic performance in an ELISA system for the diagnosis of human strongyloidiasis. METHODOLOGY/PRINCIPAL FINDINGS The coding sequences for SsIR and Ss1a were selected from GenBank and were gene-optimized. Using bioinformatics analysis, the regions with the highest antigenicity that did not overlap with other parasite antigens were selected. The chimeric recombinant antigen SsIR- Ss1a, was constructed. The solubility and physicochemical properties of the designed construct were analyzed and its tertiary structures were built and evaluated. The construct was expressed into the pET-23a (+) expression vector and the optimized DNA sequences of SsIR-Ss1a (873 bp) were cloned into competent E. coli DH5α cells. Diagnostic performances of the produced recombinant antigen, along with a commercial kit were evaluated in an indirect ELISA system, using a panel of sera from strongyloidiasis patients and controls. The physicochemical and bioinformatics evaluations revealed that the designed chimeric construct is soluble, has a molecular with of 35 KDa, and is antigenic. Western blotting confirmed the immunoreactivity of the produced chimeric recombinant antigen with the sera of strongyloidiasis patients. The sensitivity and specificity of the indirect ELISA system, using the produced SsIR-Ss1a chimeric antigen, were found to be 93.94% (95% CI, 0.803 to 0.989) and 97.22% (95% CI, 0.921 to 0.992) respectively. CONCLUSIONS/SIGNIFICANCE The preliminary findings of this study suggest that the produced SsIR-Ss1a chimeric antigen shows promise in the diagnosis of human strongyloidiasis. However, these results are based on a limited panel of samples, and further research with a larger sample size is necessary to confirm its accuracy. The construct has potential as an antigen in the ELISA system for the serological diagnosis of this neglected parasitic infection, but additional validation is required.
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Affiliation(s)
- Mostafa Omidian
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zohreh Mostafavi-Pour
- Recombinant Proteins Laboratory, Department of Biochemistry, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Asadi
- Department of Medical Biotechnology, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences Shiraz, Iran
| | - Meysam Sharifdini
- Department of Medical Parasitology and Mycology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Navid Nezafat
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Pouryousef
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Savardashtaki
- Department of Medical Biotechnology, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences Shiraz, Iran
| | - Mortaza Taheri-Anganeh
- Cellular and Molecular Research Center, Cellular and Molecular Medicine Research Institute, Urmia University of Medical Sciences, Urmia, Iran
| | - Fattaneh Mikaeili
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Bahador Sarkari
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Basic Sciences in Infectious Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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22
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Alam AM, Ozdemir C, Reza N. Strongyloides stercoralis infection in the UK: A systematic review and meta-analysis of published cases. Clin Med (Lond) 2024; 24:100227. [PMID: 39009349 PMCID: PMC11342261 DOI: 10.1016/j.clinme.2024.100227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 06/10/2024] [Accepted: 06/29/2024] [Indexed: 07/17/2024]
Abstract
Strongyloidiasis is a helminth infection where symptoms vary, and asymptomatic presentation is common. Chronic strongyloidiasis can cause a high mortality 'hyper-infection' in immunocompromised states. Understanding at risk populations and symptomology can guide screening and early treatment to reduce hyper-infection risk. A systematic review of studies describing patients in the UK with strongyloidiasis pooled a total of 1,308 patients. Weighted pooled prevalence (WPP) of asymptomatic cases was 27.7% (95% CI 17.1-39.5%, I2 = 92%, p < 0.01). At-risk populations included migrants, returning travellers and armed forces personnel. The most common symptoms reported were abdominal pain (WPP 32.1% (95% CI 20.5-44.8%), I2 = 93%, p < 0.01), rashes (WPP 38.4% (95% CI 13.1-67.7%), I2 = 99%, p < 0.01) and diarrhoea (WPP 12.6% (95% CI 6.7-19.9%), I2=70%, p = 0.03). Symptomatology varied with cohort characteristics. Although asymptomatic presentation is common, patients may present with abdominal pain, diarrhoea or rashes. A low threshold for screening symptomatic individuals in at-risk groups is required.
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Affiliation(s)
- Ali M Alam
- Newham Hospital, Barts Health NHS Trust, London, UK
| | - Cansu Ozdemir
- GKT School of Medical Education, King's College London, London, UK
| | - Nada Reza
- Antimicrobial Pharmacodynamics and Therapeutics Group, Institute of Systems, Molecular and Integrative Biology, William Henry Duncan Building, 6 West Derby Street, University of Liverpool, Liverpool L7 8TX, UK.
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23
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Choi JDW, Kulkarni R, Shanmugalingam A, Kwik C, Sandaradura I, Renthawa J, Watts MR, Toh JWT. An Unusual Case of Lethal Strongyloides stercoralis-Associated Chronic Fulminant Colitis in an Immunocompetent Patient. Case Rep Infect Dis 2024; 2024:4223529. [PMID: 38966249 PMCID: PMC11223904 DOI: 10.1155/2024/4223529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 05/28/2024] [Accepted: 06/10/2024] [Indexed: 07/06/2024] Open
Abstract
A 70-year-old immunocompetent Lebanese male presented with 3-month history of watery diarrhoea and abdominal pain after recently arriving to Australia from Lebanon. He had a colectomy for an iatrogenic bowel perforation associated with a colonoscopy in Lebanon several months prior. His computed tomography (CT) scan demonstrated pancolitis. Stool culture and polymerase chain reaction (PCR) were positive for Strongyloides stercoralis. Despite Strongyloides treatment and total parenteral nutrition, his pancolitis unexpectedly persisted despite negative stool cultures, and the patient failed to progress over several weeks with worsening abdominal pain. A colectomy was considered. However, due to his recent myocardial infarct requiring cardiac stenting, his anticoagulant and antiplatelets could not be ceased for at least 3 months without significant cardiac risk. After hospitalisation for several weeks in Australia, he was discharged against medical advice and flew back to Lebanon, where he presented with worsening pain and underwent a subtotal colectomy. Unfortunately, he developed multiorgan failure and died 3 weeks following his colectomy. Strongyloides-related pancolitis is a rare condition in immunocompetent adults that has the potential to persist and be lethal, despite microbiological antiparasitic eradication.
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Affiliation(s)
- Joseph Do Woong Choi
- Department of Colorectal SurgeryWestmead Hospital, Corner Hawkesbury Road and Darcy Roads, Westmead, New South Wales, Australia
- Faculty of Medicine and HealthThe University of Sydney, Sydney, NSW, Australia
| | - Rukmini Kulkarni
- Department of Colorectal SurgeryWestmead Hospital, Corner Hawkesbury Road and Darcy Roads, Westmead, New South Wales, Australia
| | - Aswin Shanmugalingam
- Department of Colorectal SurgeryWestmead Hospital, Corner Hawkesbury Road and Darcy Roads, Westmead, New South Wales, Australia
| | - Charlotte Kwik
- Department of Colorectal SurgeryWestmead Hospital, Corner Hawkesbury Road and Darcy Roads, Westmead, New South Wales, Australia
| | - Indy Sandaradura
- Centre for Infectious Diseases and MicrobiologyInstitute of Clinical Pathology and Medical ResearchNew South Wales Health Pathology and Sydney Institute for Infectious DiseasesWestmead HospitalUniversity of Sydney, Sydney, New South Wales, Australia
| | - Jasveen Renthawa
- Department of Tissue Pathology an Diagnostic OncologyInstitute of Clinical Pathology and Medical ResearchWestmead HospitalUniversity of Sydney, Sydney, New South Wales, Australia
| | - Matthew R. Watts
- Faculty of Medicine and HealthThe University of Sydney, Sydney, NSW, Australia
- Centre for Infectious Diseases and MicrobiologyInstitute of Clinical Pathology and Medical ResearchNew South Wales Health Pathology and Sydney Institute for Infectious DiseasesWestmead HospitalUniversity of Sydney, Sydney, New South Wales, Australia
| | - James Wei Tatt Toh
- Department of Colorectal SurgeryWestmead Hospital, Corner Hawkesbury Road and Darcy Roads, Westmead, New South Wales, Australia
- Faculty of Medicine and HealthThe University of Sydney, Sydney, NSW, Australia
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24
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Sengthong C, Pinlaor S, Yingklang M, Haonon O, Jantawong C, Pinlaor P, Sithithaworn P, Hongsrichan N. High Efficacy of Ivermectin for Strongyloidiasis Treatment. Am J Trop Med Hyg 2024; 110:951-952. [PMID: 38579698 PMCID: PMC11066358 DOI: 10.4269/ajtmh.23-0645] [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: 09/14/2023] [Accepted: 01/17/2024] [Indexed: 04/07/2024] Open
Abstract
Infection with Strongyloides stercoralis is often asymptomatic but can be life-threatening in immunocompromised patients, which can be prevented by ivermectin (IVM) treatment. The efficacy of IVM has been reported to have lessened over time in some regions as a consequence of prolonged use and mass treatment campaigns. Ivermectin has been used in Thailand for more than a decade; therefore, we investigated the efficacy of a single dose (200 µg/kg) of IVM against in asymptomatic strongyloidiasis in northeastern Thailand. Fecal samples were collected before and 2 weeks after treatment and were analyzed for the presence of Strongyloides using a modified agar plate culture and the formalin-ethyl acetate concentration technique. Our results showed that single-dose IVM treatment successfully eliminated S. stercoralis infection in asymptomatic individuals in the endemic area with a 100% cure rate, indicating the high efficacy of IVM treatment in strongyloidiasis in northeast Thailand.
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Affiliation(s)
| | - Somchai Pinlaor
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in The Northeast of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Manachai Yingklang
- Department of Fundamentals of Public Health, Faculty of Public Health, Burapha University, Chonburi, Thailand
| | - Ornuma Haonon
- Cellular and Molecular Immunology Research Unit, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Chanakan Jantawong
- Department of Medical Technology, Faculty of Allied Health Science, Nakhonratchasima College, Nakhon Ratchasima, Thailand
| | - Porntip Pinlaor
- Chronic Kidney Disease Prevention in The Northeast of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Centre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Paiboon Sithithaworn
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Nuttanan Hongsrichan
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in The Northeast of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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25
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Lee YH. A case of disseminated strongyloidiasis diagnosed by worms in the urinary sediment. PARASITES, HOSTS AND DISEASES 2024; 62:238-242. [PMID: 38835264 PMCID: PMC11150928 DOI: 10.3347/phd.23124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 03/13/2024] [Indexed: 06/06/2024]
Abstract
Strongyloidiasis is a chronic infection caused by the intestinal nematode parasite Strongyloides stercoralis and is characterized by a diverse spectrum of nonspecific clinical manifestations. This report describe a case of disseminated strongyloidiasis with urination difficulty, generalized weakness, and chronic alcoholism diagnosed through the presence of worms in the urinary sediment. A 53-year-old man was hospitalized for severe abdominal distension and urinary difficulties that started 7-10 days prior. The patient also presented with generalized weakness that had persisted for 3 years, passed loose stools without diarrhea, and complained of dyspnea. In the emergency room, approximately 7 L of urine was collected, in which several free-living female adult and rhabditiform larvae of S. stercoralis, identified through their morphological characteristics and size measurements, were detected via microscopic examination. Rhabditiform larvae of S. stercoralis were also found in the patient's stool. During hospitalization, the patient received treatment for strongyloidiasis, chronic alcoholism, peripheral neurosis, neurogenic bladder, and megaloblastic anemia, and was subsequently discharged with improved generalized conditions. Overall, this report presents a rare case of disseminated strongyloidiasis in which worms were detected in the urinary sediment of a patient with urination difficulties and generalized weakness combined with chronic alcoholism, neurogenic bladder, and megaloblastic anemia.
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Affiliation(s)
- Young-Ha Lee
- Department of Infection Biology and Department of Medical Science, Chungnam National University College of Medicine, Daejeon 35015,
Korea
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26
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Chessell C, Rabuszko L, Richardson D, Llewellyn C. Factors associated with the sexual transmission of Strongyloides stercoralis in men who have sex with men: A systematic review. J Eur Acad Dermatol Venereol 2024; 38:673-679. [PMID: 38013501 DOI: 10.1111/jdv.19664] [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: 03/13/2023] [Accepted: 10/09/2023] [Indexed: 11/29/2023]
Abstract
Strongyloides stercoralis is a parasitic worm with a complex life cycle and can cause significant morbidity, including a proctocolitis and life-threatening hyperinfection syndrome. Limited reports from non-endemic areas, including in men who have sex with men (MSM), suggest sexual transmission of S. stercoralis. In this systematic review of the published literature, we aimed to explore the associated factors of S. stercoralis in MSM. We systematically searched three bibliographical databases (MEDLINE, CINAHL and EMBASE) up to November 2022. We used a two-stage process to assess eligibility: the primary author conducted an initial screen of abstracts, and then three authors conducted independent full manuscripts to determine the final eligible manuscripts. We only included manuscripts written in English that contained data on specific factors associated with sexual transmission in MSM. We used the STROBE checklist to assess the risk of bias and synthesized the narrative data using the SWiM method. Seven manuscripts were eligible for this review (four case reports, one case series, one cross-sectional study and one experimental study), which included 22 individuals from Europe and the Americas. From these studies, S. stercoralis in MSM was associated with living with HIV (including having a low CD4 count and not using antiretrovirals), having a concomitant sexually transmitted infection (Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum and hepatitis C) and a concomitant (sexually transmitted) protozoal infection (Entamoeba histolytica, Giardia lamblia), travel to the S. stercoralis endemic area, multiple sexual partners from endemic areas, oro-anal sexual contact and chemsex. Although limited by the number of cases in the literature, we have highlighted some possible biological and behavioural risk factors associated with the sexual transmission of S. stercoralis in MSM that could be used to both target future research and S. stercoralis public health control interventions.
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Affiliation(s)
- Callum Chessell
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Lucy Rabuszko
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Daniel Richardson
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
- Department of Sexual Health and HIV, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - Carrie Llewellyn
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
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27
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Chinen T, Kameyama M, Minami K. Successful Prompt Diagnosis of Strongyloidiasis in an Outpatient Setting at Amami Oshima Island in Japan: A Case Report. Cureus 2024; 16:e58851. [PMID: 38784335 PMCID: PMC11112541 DOI: 10.7759/cureus.58851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2024] [Indexed: 05/25/2024] Open
Abstract
Strongyloidiasis is a parasitic infection caused by the nematode Strongyloides stercoralis that presents with a variety of nonspecific symptoms. Diagnosis is challenging unless physicians suspect this disease and perform sensitivity tests. We report a case of strongyloidiasis with protein-losing gastroenteropathy-like symptoms in a 92-year-old Japanese female with lower extremity edema and hypoalbuminemia. In this case, the patient refused invasive tests for a complete examination; however, an agar plate culture of a stool sample was used to diagnose strongyloidiasis. The patient was treated with ivermectin during the second visit. One month later, leg edema and hypoproteinemia improved. When the cause of the symptoms is unclear, physicians should be aware of the possibility of strongyloidiasis in a person residing in a tropical or subtropical environment, where human feces are used as fertilizer and individuals frequently go barefoot in agricultural settings.
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Affiliation(s)
- Takashi Chinen
- Department of Clinical Oncology, Jichi Medical University, Shimotsuke, JPN
| | - Manabu Kameyama
- Division of General Internal Medicine, Kagoshima Oshima Prefectural Hospital, Amami, JPN
| | - Kensuke Minami
- Department of Infection Control, Jichi Medical University, Shimotsuke, JPN
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28
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Banerjee N, Gang SS, Castelletto ML, Ruiz F, Hallem EA. Carbon dioxide shapes parasite-host interactions in a human-infective nematode. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.28.587273. [PMID: 38585813 PMCID: PMC10996684 DOI: 10.1101/2024.03.28.587273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Skin-penetrating nematodes infect nearly one billion people worldwide. The developmentally arrested infective larvae (iL3s) seek out hosts, invade hosts via skin penetration, and resume development inside the host in a process called activation. Activated infective larvae (iL3as) traverse the host body, ending up as parasitic adults in the small intestine. Skin-penetrating nematodes respond to many chemosensory cues, but how chemosensation contributes to host seeking, intra-host development, and intra-host navigation - three crucial steps of the parasite-host interaction - remains poorly understood. Here, we investigate the role of carbon dioxide (CO2) in promoting parasite-host interactions in the human-infective threadworm Strongyloides stercoralis. We show that S. stercoralis exhibits life-stage-specific preferences for CO2: iL3s are repelled, non-infective larvae and adults are neutral, and iL3as are attracted. CO2 repulsion in iL3s may prime them for host seeking by stimulating dispersal from host feces, while CO2 attraction in iL3as may direct worms toward high-CO2 areas of the body such as the lungs and intestine. We also identify sensory neurons that detect CO2; these neurons are depolarized by CO2 in iL3s and iL3as. In addition, we demonstrate that the receptor guanylate cyclase Ss-GCY-9 is expressed specifically in CO2-sensing neurons and is required for CO2-evoked behavior. Ss-GCY-9 also promotes activation, indicating that a single receptor can mediate both behavioral and physiological responses to CO2. Our results illuminate chemosensory mechanisms that shape the interaction between parasitic nematodes and their human hosts and may aid in the design of novel anthelmintics that target the CO2-sensing pathway.
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Affiliation(s)
- Navonil Banerjee
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, Los Angeles, CA 90095
| | - Spencer S. Gang
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, Los Angeles, CA 90095
| | - Michelle L. Castelletto
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, Los Angeles, CA 90095
| | - Felicitas Ruiz
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, Los Angeles, CA 90095
| | - Elissa A. Hallem
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, Los Angeles, CA 90095
- Molecular Biology Institute, University of California, Los Angeles, Los Angeles, CA 90095
- Lead contact
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29
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Ceccarelli G, Goracci L, Carotti A, Paccoia F, Passeri D, Cipolloni M, Di Bona S, Cruciani G, Pellicciari R, Gioiello A. Discovery and Structure-Activity Relationships of Novel ssDAF-12 Receptor Modulators. J Med Chem 2024; 67:4150-4169. [PMID: 38417155 DOI: 10.1021/acs.jmedchem.3c02421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
The nuclear receptor ssDAF-12 has been recognized as the key molecular player regulating the life cycle of the nematode parasite Strongyloides stercoralis. ssDAF-12 ligands permit the receptor to function as an on/off switch modulating infection, making it vulnerable to therapeutic intervention. In this study, we report the design and synthesis of a set of novel dafachronic acid derivatives, which were used to outline the first structure-activity relationship targeting the ssDAF-12 receptor and to unveil hidden properties shared by the molecular shape of steroidal ligands that are relevant to the receptor binding and modulation. Moreover, biological results led to the discovery of sulfonamide 3 as a submicromolar ssDAF-12 agonist endowed with a high receptor selectivity, no toxicity, and improved properties, as well as to the identification of unprecedented ssDAF-12 antagonists that can be exploited in the search for novel chemical tools and alternative therapeutic approaches for treating parasitism such as Strongyloidiasis.
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Affiliation(s)
- Giada Ceccarelli
- Department of Pharmaceutical Sciences, University of Perugia, Via del Liceo 1, 06123 Perugia, Italy
| | - Laura Goracci
- Department of Chemistry, Biology and Biotechnology, University of Perugia, Via dell' Elce di Sotto 8, 06123 Perugia, Italy
| | - Andrea Carotti
- Department of Pharmaceutical Sciences, University of Perugia, Via del Liceo 1, 06123 Perugia, Italy
| | - Federico Paccoia
- Department of Pharmaceutical Sciences, University of Perugia, Via del Liceo 1, 06123 Perugia, Italy
| | | | | | - Stefano Di Bona
- Department of Chemistry, Biology and Biotechnology, University of Perugia, Via dell' Elce di Sotto 8, 06123 Perugia, Italy
| | - Gabriele Cruciani
- Department of Chemistry, Biology and Biotechnology, University of Perugia, Via dell' Elce di Sotto 8, 06123 Perugia, Italy
| | | | - Antimo Gioiello
- Department of Pharmaceutical Sciences, University of Perugia, Via del Liceo 1, 06123 Perugia, Italy
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30
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Cutfield T, Motuhifonua SK, Blakiston M, Bhally H, Duffy E, Lane R, Otte E, Swager T, Taylor AM, Playle V. Strongyloidiasis in Auckland: A ten-year retrospective study of diagnosis, treatment and outcomes of a predominantly Polynesian and Fijian migrant cohort. PLoS Negl Trop Dis 2024; 18:e0012045. [PMID: 38547314 PMCID: PMC11003684 DOI: 10.1371/journal.pntd.0012045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 04/09/2024] [Accepted: 03/05/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Strongyloides stercoralis is not endemic in Aotearoa New Zealand (AoNZ). However, approximately one third of Auckland residents are born in endemic countries. This study aimed to describe the epidemiology and management of strongyloidiasis in Auckland, with a focus on migrants from Pacific Island Countries and Territories. METHODS This study retrospectively reviewed clinical, laboratory and pharmacy records data for all people diagnosed with strongyloidiasis in the Auckland region between July 2012 and June 2022. People with negative Strongyloides serology were included to estimate seropositivity rate by country of birth. FINDINGS Over ten years, 691 people were diagnosed with strongyloidiasis. Most diagnoses were made by serology alone (622, 90%). The median age was 63 years (range 15-92), 500 (72%) were male, and the majority were born in Polynesia (350, 51%), Fiji (130, 19%) or were of Pasifika ethnicity (an additional 7%). Twelve participants (1.7%) had severe strongyloidiasis at diagnosis. The total proportion treated with ivermectin was only 70% (484/691), with no differences between immunocompromised and immunocompetent participants, nor by ethnicity. The outcome of treatment (based on a combination of serology and/or eosinophilia and/or stool microscopy) could only be determined in 50% of the treated cohort. One participant failed treatment with ivermectin, experiencing recurrent strongyloidiasis, and another participant died in association with severe strongyloidiasis. The rate of 'positive' Strongyloides serology was highest among participants born in Samoa (48%), Fiji (39%), and Southeast Asian countries (34%). INTERPRETATION Strongyloidiasis was common and under-treated in Auckland during the study period. Clinicians should have a low threshold for considering strongyloidiasis in migrants from endemic countries, including Polynesia and Fiji.
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Affiliation(s)
- Tim Cutfield
- Department of Infectious Diseases, Te Whatu Ora Counties Manukau, Auckland, New Zealand
| | - Soana Karuna Motuhifonua
- Faculty of Medical and Health Sciences, The University of Auckland, Park Road, Grafton, Auckland, New Zealand
| | - Matthew Blakiston
- Department of Microbiology, Labtests Auckland, Mount Wellington, Auckland, New Zealand
| | - Hasan Bhally
- Department of Infectious Diseases, Te Whatu Ora Waitematā, Takapuna, Auckland, New Zealand
| | - Eamon Duffy
- Faculty of Medical and Health Sciences, The University of Auckland, Park Road, Grafton, Auckland, New Zealand
- Department of Infectious Diseases, Te Whatu Ora Te Toka Tumai Auckland, Grafton, Auckland, New Zealand
| | - Rebekah Lane
- Department of Infectious Diseases, Te Whatu Ora Te Toka Tumai Auckland, Grafton, Auckland, New Zealand
| | - Erik Otte
- Department of Microbiology, Canterbury Health Laboratories, Hagley Avenue, Christchurch Central City, Christchurch, New Zealand
| | - Terri Swager
- LabPLUS Auckland, Auckland City Hospital, Grafton, Auckland
| | - Amanda Maree Taylor
- Faculty of Medical and Health Sciences, The University of Auckland, Park Road, Grafton, Auckland, New Zealand
| | - Veronica Playle
- Department of Infectious Diseases, Te Whatu Ora Counties Manukau, Auckland, New Zealand
- Faculty of Medical and Health Sciences, The University of Auckland, Park Road, Grafton, Auckland, New Zealand
- LabPLUS Auckland, Auckland City Hospital, Grafton, Auckland
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Salvador F, Treviño B, Sulleiro E, Bosch-Nicolau P, Aznar ML, Goterris L, Espinosa-Pereiro J, Pou D, Sánchez-Montalvá A, Oliveira I, Martínez-Campreciós J, Serre-Delcor N, Sao-Avilés A, Molina I. Epidemiological and clinical trends of imported strongyloidiasis in a referral international health unit, Barcelona, Spain: A 12-year period experience. Travel Med Infect Dis 2024; 58:102690. [PMID: 38246513 DOI: 10.1016/j.tmaid.2024.102690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 12/20/2023] [Accepted: 01/15/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Imported strongyloidiasis in non-endemic countries has increasingly been diagnosed. The aim of the present study is to describe the main epidemiological and clinical characteristics of patients with imported strongyloidiasis attended in a referral International Health Unit and to detect trend changes over a 12-year period. METHODS This is an observational retrospective study including all imported strongyloidiasis cases seen at the International Health Unit Vall d'Hebron-Drassanes (Barcelona, Spain) from January 2009 to December 2020. Epidemiological and clinical characteristics from included patients were collected. RESULTS Overall, 865 cases of imported strongyloidiasis were diagnosed, of whom 472 (54.6 %) were men and mean age was 38.7 (SD 13.4) years. Most cases were diagnosed in migrants (830, 96 %). The distribution of the geographic origin was: Latin America (561, 67.6 %), Sub-Saharan Africa (148, 17.8 %), Asia (113, 13.6 %), North Africa (5, 0.6 %), Eastern Europe (2, 0.2 %), and North America (1, 0.1 %). The main reasons for consultation at the Unit were screening of health status (371, 42.9 %), laboratory test alteration (367, 42.4 %), gastrointestinal symptoms (56, 6.5 %), cutaneous symptoms (26, 3 %), and other clinical symptoms (45, 5.2 %). An increase in the number of cases was observed in the last years of the study period. CONCLUSIONS Imported strongyloidiasis has increasingly been diagnosed in our referral unit, mostly due to screening strategies implementation. Most of the patients were young migrants coming from Latin America, with no symptoms at the time of diagnosis. The optimization of screening strategies will increase the detection and treatment of cases, reducing potential complications.
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Affiliation(s)
- Fernando Salvador
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.
| | - Begoña Treviño
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Elena Sulleiro
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain; Microbiology Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Pau Bosch-Nicolau
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Ma Luisa Aznar
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Lidia Goterris
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain; Microbiology Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Juan Espinosa-Pereiro
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Diana Pou
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Adrián Sánchez-Montalvá
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Inés Oliveira
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Joan Martínez-Campreciós
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Núria Serre-Delcor
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Augusto Sao-Avilés
- Information Systems Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Israel Molina
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
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32
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Wong MTJ, Anuar NS, Noordin R, Tye GJ. Generation of IgG antibodies against Strongyloides stercoralis in mice via immunization with recombinant antigens A133 and Ss-IR. Acta Trop 2024; 251:107122. [PMID: 38246399 DOI: 10.1016/j.actatropica.2024.107122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/16/2023] [Accepted: 01/13/2024] [Indexed: 01/23/2024]
Abstract
Strongyloidiasis, caused by the nematode Strongyloides stercoralis, remains a threat to global public health, and a vaccine would be useful to control the disease, especially in developing countries. This study aimed to evaluate the efficacy of recombinant proteins, A133 and Ss-IR, as potential vaccine candidates against strongyloidiasis by investigating the humoral and cellular immune responses in immunized mice. Respective antigens were adjuvanted with Complete Freund's Adjuvant (prime) and Incomplete Freund's Adjuvant (boost) and administered intraperitoneally (prime) and subcutaneously (boost) to female BALB/c mice. For antigen-only doses, only antigens were injected without adjuvants. Altogether, 1 prime dose, 4 booster doses, and 2 antigen-only doses were administered successively. ELISAs were conducted to assess the antibody responses, along with flow cytometry and cytokine ELISA to elucidate the cellular immune responses. Results showed that A133 and Ss-IR induced the production of IgG1 and IgG2a, with A133 generating more robust IgG2a responses than Ss-IR. Flow cytometry findings indicated that effector CD8+T-cells and memory B-cells activity were upregulated significantly for A133 only, whereas cytokine ELISA demonstrated that a Th1/Th2/Th17 mixed cell responses were triggered upon vaccination with either antigen. This preliminary study illustrated the good potential of recombinant A133 and Ss-IR as vaccine candidates against S. stercoralis. It provided information on the probable immune mechanism involved in host defence and the elicitation of protection against S. stercoralis.
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Affiliation(s)
- Matthew Tze Jian Wong
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Pulau Pinang, Malaysia
| | - Nor Suhada Anuar
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Pulau Pinang, Malaysia
| | - Rahmah Noordin
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Pulau Pinang, Malaysia; Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Gee Jun Tye
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Pulau Pinang, Malaysia.
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33
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Castelletto ML, Akimori D, Patel R, Schroeder NE, Hallem EA. Introduction to Strongyloides stercoralis Anatomy. J Nematol 2024; 56:20240019. [PMID: 38855080 PMCID: PMC11162604 DOI: 10.2478/jofnem-2024-0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Indexed: 06/11/2024] Open
Abstract
Strongyloides stercoralis, commonly known as the human threadworm, is a skin-penetrating gastrointestinal parasitic nematode that infects hundreds of millions of people worldwide. Like other Strongyloides species, S. stercoralis is capable of cycling through a single free-living generation. Although S. stercoralis and the free-living nematode Caenorhabditis elegans are evolutionarily distant, the free-living adults of S. stercoralis are similar enough in size and morphology to C. elegans adults that techniques for generating transgenics and knockouts in C. elegans have been successfully adapted for use in S. stercoralis. High-quality genomic and transcriptomic data are also available for S. stercoralis. Thus, one can use a burgeoning array of functional genomic tools in S. stercoralis to probe questions about parasitic nematode development, physiology, and behavior. Knowledge gained from S. stercoralis will inform studies of other parasitic nematodes such as hookworms that are not yet amenable to genetic manipulation. This review describes the basic anatomy of S. stercoralis.
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Affiliation(s)
- Michelle L. Castelletto
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, Los Angeles, CA, 90095
| | - Damia Akimori
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, Los Angeles, CA, 90095
- Molecular Biology Interdepartmental Ph.D. Program, University of California, Los Angeles, Los Angeles, CA, 90095
| | - Ruhi Patel
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, Los Angeles, CA, 90095
| | - Nathan E. Schroeder
- Department of Crop Sciences, University of Illinois at Urbana-Champaign, Urbana, IL61801
| | - Elissa A. Hallem
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, Los Angeles, CA, 90095
- Molecular Biology Institute, University of California, Los Angeles, Los Angeles, CA, 90095
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Prato M, Tamarozzi F, Tais S, Rizzi E, Mazzi C, Buonfrate D. Evaluation of the SsIR/NIE recombinant antigen ELISA for the follow up of patients infected by Strongyloides stercoralis: a diagnostic study. Parasitology 2024; 151:295-299. [PMID: 38185819 PMCID: PMC11007275 DOI: 10.1017/s0031182024000027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/06/2023] [Accepted: 12/19/2023] [Indexed: 01/09/2024]
Abstract
Some serology assays demonstrated useful for post-treatment monitoring of Strongyloides stercoralis infection. Serology frequently has low specificity, which might be improved by the use of recombinant antigens. The Strongy Detect ELISA is based on 2 recombinant antigens (SsIR and NIE) and proved good accuracy. Aim of this study was to evaluate the performance of this test for the post-treatment monitoring of strongyloidiasis. We tested 38 paired sera, with matched fecal tests results, stored in our biobank and originating from a randomized controlled trial. At baseline, all patients tested positive for at least 1 fecal assay among PCR, direct stool microscopy and agar plate culture. Patients were re-tested with both serology and fecal assays 12 months after treatment. Primary outcome was the relative reduction in optical density (OD) between baseline and follow up. We observed that about 95% samples showed a reduction between pre and post-treatment OD, with a median relative reduction of 93.9% (IQR 77.3%–98.1%). In conclusion, the test proved reliable for post-treatment monitoring. However, some technical issues, including that the threshold for positivity has not be predefined, and that a substantial number of samples showed overflow signals, need to be fixed to permit use in routine practice.
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Affiliation(s)
- Marco Prato
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Negrar di Valpolicella, Italy
| | - Francesca Tamarozzi
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Negrar di Valpolicella, Italy
| | - Stefano Tais
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Negrar di Valpolicella, Italy
| | - Eleonora Rizzi
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Negrar di Valpolicella, Italy
| | - Cristina Mazzi
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Negrar di Valpolicella, Italy
| | - Dora Buonfrate
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Negrar di Valpolicella, Italy
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Le B, Clarke NE, Legrand N, Nery SV. Effectiveness of ivermectin mass drug administration in the control of soil-transmitted helminth infections in endemic populations: a systematic review and meta-analysis. Infect Dis Poverty 2024; 13:16. [PMID: 38369483 PMCID: PMC10874526 DOI: 10.1186/s40249-024-01185-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/01/2024] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND Current soil-transmitted helminth (STH) control guidelines endorse the use of albendazole or mebendazole for school-based targeted preventive chemotherapy (PC), yet their reduced efficacy against Strongyloides stercoralis and Trichuris trichiura presents significant limitations. Emerging evidence indicates that community-wide PC [or mass drug administration (MDA)] using ivermectin, commonly used in other neglected tropical disease (NTD) control programs, may play an important role in controlling these parasites. We conducted a systematic review and meta-analysis to evaluate the effectiveness of ivermectin PC in reducing STH prevalence in endemic populations. METHODS We searched Pubmed, EMBASE, and Web of Science on February 14, 2023, for studies that investigated the effectiveness of ivermectin PC, either alone or in combination with other anthelmintic drugs, on STH infections, and provided a measure of STH prevalence before and after PC. We calculated pooled prevalence reductions for each STH using random-effects meta-analyses. Our protocol is available on PROSPERO (registration number CRD42023401219). RESULTS A total of 21 were eligible for the systematic review, of which 15 were eligible for meta-analysis. All studies delivered ivermectin through MDA. The pooled prevalence reduction of S. stercoralis following MDA with ivermectin alone was 84.49% (95% CI 54.96-94.66) across five studies and 81.37% (95% CI 61.62-90.96) across seven studies with or without albendazole. The prevalence reduction of T. trichiura was 49.93% (95% CI 18.23-69.34) across five studies with ivermectin alone, and 89.40% (95% CI 73.66-95.73) across three studies with the addition of albendazole. There was high heterogeneity for all syntheses (I2 > 65%). CONCLUSIONS This study underscores the key role of ivermectin-based MDA in addressing limitations in current global STH guidelines in terms of limited efficacy against S. stercoralis and T. trichiura. Based on these findings, revising international STH guidelines to include ivermectin is a promising option to progress the control and eventual elimination of STHs and other NTDs.
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Affiliation(s)
- Brandon Le
- The Kirby Institute, University of New South Wales, Level 6, Wallace Wurth Building, Sydney, NSW, 2052, Australia.
| | - Naomi E Clarke
- The Kirby Institute, University of New South Wales, Level 6, Wallace Wurth Building, Sydney, NSW, 2052, Australia
| | - Nicolas Legrand
- The Kirby Institute, University of New South Wales, Level 6, Wallace Wurth Building, Sydney, NSW, 2052, Australia
| | - Susana Vaz Nery
- The Kirby Institute, University of New South Wales, Level 6, Wallace Wurth Building, Sydney, NSW, 2052, Australia
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36
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Wongphutorn P, Noordin R, Anuar NS, Worasith C, Kopolrat KY, Homwong C, Tippayawat P, Techasen A, Pitaksakurat O, Sithithaworn J, Eamudomkarn C, Sithithaworn P. Examination of Diagnostic Performance of New IgG4 Rapid Test Compared with IgG- and IgG4-ELISAs to Investigate Epidemiology of Strongyloidiasis in Northeast Thailand. Am J Trop Med Hyg 2024; 110:254-262. [PMID: 38190756 PMCID: PMC10859814 DOI: 10.4269/ajtmh.23-0518] [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: 08/06/2023] [Accepted: 10/16/2023] [Indexed: 01/10/2024] Open
Abstract
Strongyloidiasis, caused by Strongyloides stercoralis, is a neglected tropical disease with a global distribution. The infection can be fatal in immunocompromised individuals, and accurate diagnosis leading to timely treatment can save lives. Serodiagnosis is a sensitive method for diagnosis and is recommended for screening high-risk individuals. A point-of-care rapid test will facilitate the screening activities, especially in low-resource settings. This study aims to apply a new IgG4 immunochromatographic test using S. stercoralis recombinant antigen (SsRapid® cassette test) and to compare it with in-house IgG and IgG4 enzyme-linked immunosorbent assays (IgG- and IgG4-ELISAs) using native Strongyloides ratti antigen to investigate the epidemiology of strongyloidiasis in northeast Thailand. A total of 300 people participated, with 136 males and 164 females of a similar mean age. The reference tests were fecal examinations using the formalin-ethyl acetate concentration technique and an agar plate culture technique. The prevalence of S. stercoralis determined by SsRapid (81.7%) was significantly higher than that by fecal examinations (43.3%) or by antibody detection by IgG-ELISA (53.0%) or IgG4-ELISA (44.0%). The diagnostic sensitivities of SsRapid, IgG-ELISA, and IgG4-ELISA were found to be 93.9%, 77.7%, and 63.1%, respectively. The rate of positive tests by the SsRapid was significantly correlated to the levels of Strongyloides-specific IgG4 and IgG antibodies. By all diagnostic methods, male participants had a significantly higher prevalence of strongyloidiasis than females. Age was significantly associated with the concentration of specific serum IgG but not with the SsRapid grading score. In conclusion, SsRapid was shown to be a sensitive and valuable diagnostic test for the epidemiology study of strongyloidiasis.
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Affiliation(s)
| | - Rahmah Noordin
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, Penang, Malaysia
| | - Nor Suhada Anuar
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, Penang, Malaysia
| | - Chanika Worasith
- Department of Adult Nursing, Faculty of Nursing, Khon Kaen University, Khon Kaen, Thailand
| | - Kulthida Y. Kopolrat
- Faculty of Public Health, Kasetsart University Chalermphrakiat Sakon Nakhon Province Campus, Sakon Nakhon, Thailand
| | - Chutima Homwong
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
| | | | - Anchalee Techasen
- Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Opal Pitaksakurat
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | - Chatanun Eamudomkarn
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Paiboon Sithithaworn
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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Sprecher VP, Hofmann D, Savathdy V, Xayavong P, Norkhankhame C, Huy R, Khieu V, Sayasone S, Hattendorf J, Keiser J. Efficacy and safety of moxidectin compared with ivermectin against Strongyloides stercoralis infection in adults in Laos and Cambodia: a randomised, double-blind, non-inferiority, phase 2b/3 trial. THE LANCET. INFECTIOUS DISEASES 2024; 24:196-205. [PMID: 37949090 DOI: 10.1016/s1473-3099(23)00507-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/02/2023] [Accepted: 08/02/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Infection with the soil-transmitted helminth Strongyloides stercoralis affects up to 600 million people globally, most of whom live in rural areas with poor sanitation. If untreated, infection leads to long-lasting morbidity and might even be life-threatening. Moxidectin might be a promising alternative to ivermectin, the only currently recommended single-dose treatment. We aimed to assess whether moxidectin is non-inferior in terms of efficacy and safety compared with ivermectin. METHODS In this randomised, double-blind, parallel-group, non-inferiority, phase 2b/3 trial in communities in Laos and Cambodia, adults aged 18-65 years were screened for the presence of S stercoralis larvae in their stool via sextuplicate quantitative Baermann assays. Using computer-generated group allocation (block randomisation stratified by infection intensity), parasitologically (two or more positive Baermann assays) and clinically eligible participants were randomly assigned (1:1) to receive single oral doses of either moxidectin (8 mg) and ivermectin-matched placebo, or ivermectin (200 μg/kg bodyweight) and moxidectin-matched placebo. The primary endpoint was cure rate assessed at 14-21 days after treatment, using the available-case population analysed according to intention-to-treat principles. Moxidectin was considered non-inferior to ivermectin if the lower limit of the two-sided 95% CI of the difference was greater than the non-inferiority margin of -10 percentage points. Safety endpoints were assessed before treatment, and at 2-3 h, 24 h, and 14-21 days after treatment. This trial is registered at ClinicalTrials.gov, NCT04056325 and NCT04848688. FINDINGS Between Dec 6, 2020, and May 21, 2022, 4291 participants were screened, 726 of whom were enrolled and randomly assigned to moxidectin (n=363) or ivermectin (n=363). For the participants with primary outcome data, we observed a cure rate of 93·6% (95% CI 90·5 to 96·0; 324 of 346 participants) in the moxidectin group and 95·7% (93·0 to 97·6; 335 of 350 participants) in the ivermectin group, resulting in a between-group difference of -2·1 percentage points (95% CI -5·5 to 1·3). The most common adverse events were abdominal pain (32 [9%] of 363 with moxidectin vs 34 [9%] of 363 with ivermectin) and headache (25 [7%] vs 30 [8%]), which were predominantly mild and transient. INTERPRETATION Moxidectin was non-inferior to ivermectin in terms of efficacy in the treatment of strongyloidiasis. Additionally, both drugs had a similar safety profile. The fixed dose and lower cost of moxidectin compared with ivermectin make it a valuable alternative for people with strongyloidiasis. FUNDING Swiss National Science Foundation.
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Affiliation(s)
- Viviane P Sprecher
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Daniela Hofmann
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
| | | | | | | | - Rekol Huy
- National Centre for Parasitology, Entomology and Malaria Control, Ministry of Health, Phnom Penh, Cambodia
| | - Virak Khieu
- National Centre for Parasitology, Entomology and Malaria Control, Ministry of Health, Phnom Penh, Cambodia
| | | | - Jan Hattendorf
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Jennifer Keiser
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland.
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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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Rodrigues JGM, Miranda GS, Camelo GMA, Rodrigues VF, Silva JKAO, Gouveia CBG, Porto WJN, Wanderley FS, Geiger SM, Negrão-Corrêa DA. Modifications to the parasitological technique of Rugai increase the diagnostic sensitivity for strongyloidiasis. Parasitol Res 2024; 123:101. [PMID: 38233532 DOI: 10.1007/s00436-023-08111-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 12/29/2023] [Indexed: 01/19/2024]
Abstract
Strongyloidiasis is a neglected tropical disease caused mainly by Strongyloides stercoralis, a nematode that can persist for decades in the human host with a very low parasitic burden and without specific symptoms. Hence, it is difficult to diagnose and control. Larval concentration and culture methods with fecal samples show higher sensitivity for the diagnosis of Strongyloides-infected individuals; however, these techniques are not routinely used, primarily due to the challenges associated with processing a substantial volume of fecal samples. In the current study, we comparatively evaluated the sensitivity and applicability of modifications made to the Rugai parasitological method for the diagnosis of strongyloidiasis in fecal samples of experimentally infected rats and in 68 individuals from an urban community close to Maceió, Brazil. The presence and quantity of parasite larvae in the feces were comparatively evaluated using different parasitological techniques. In the experimental model, we demonstrated that the modified Rugai technique (RMOD) allowed for significantly higher recovery of larvae than the original Rugai technique (RO). Moreover, the sediment was cleaner and easier to evaluate using optical microscopy. Compared to other parasitological techniques, such as agar-plate culture (A-PC) and spontaneous sedimentation (SS), the RMOD technique showed higher sensitivity in the detection of larvae in all infected groups and presented comparatively better performance, especially in rats with a low parasite burden. In the human population, among the 68 stool samples evaluated, Strongyloides larvae were detected in the feces of six individuals with an estimated prevalence of 8.82%. However, the performance of each parasitological method was remarkably different. SS identified Strongyloides larvae in only two individuals and A-PC in three, whereas RMOD was able to identify six infected individuals, resulting in sensitivities of 33.3%, 50%, and 100%, respectively. In conclusion, the modifications introduced to the Rugai technique resulted in improved sensitivity for the detection of Strongyloides spp. infections, especially in stool samples with a low parasite burden, in comparison with other routinely used parasitological techniques.
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Affiliation(s)
- João Gustavo Mendes Rodrigues
- Institute of Biological Sciences, Department of Parasitology, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Guilherme Silva Miranda
- Institute of Biological Sciences, Department of Parasitology, Federal University of Minas Gerais, Belo Horizonte, Brazil
- Department of Biology, Federal Institute of Education, Science and Technology of Maranhão, São Raimundo das Mangabeiras, Brazil
| | - Genil Mororó Araújo Camelo
- Institute of Biological Sciences, Department of Parasitology, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Vanessa Fernandes Rodrigues
- Institute of Biological Sciences, Department of Parasitology, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | - Caio Brandão Goes Gouveia
- Institute of Biological Sciences, Department of Parasitology, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | - Flaviana Santos Wanderley
- Laboratory of Parasitic Infectious Diseases, State University of Health Sciences of Alagoas, Maceió, Brazil
| | - Stefan Michael Geiger
- Institute of Biological Sciences, Department of Parasitology, Federal University of Minas Gerais, Belo Horizonte, Brazil
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40
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Beiromvand M, Ashiri A, de Ree V, Harbecke D, Rödelsperger C, Streit A, Rafiei A. Strongyloides stercoralis genotyping in a human population in southwestern Iran. Parasit Vectors 2024; 17:21. [PMID: 38229164 DOI: 10.1186/s13071-023-06103-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 12/17/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Strongyloidiasis is a neglected tropical disease (NTD) that is caused mainly by Strongyloides stercoralis, with an estimated 600 million people infected worldwide, and in fewer cases by Strongyloides fuelleborni fuelleborni and Strongyloides fuelleborni kellyi. A number of studies have been conducted on the genetic diversity of S. stercoralis in East and Southeast Asia; however, there is very limited corresponding information from West Asian countries, including Iran. METHODS For Strongyloides worms collected from patients in southwestern Iran, the hypervariable regions I (HVR-I) and IV (HVR-IV) of the nuclear 18S ribosomal DNA (rDNA) locus (SSU) and a fragment of the subunit 1 mitochondrial cytochrome c oxidase gene (cox-1) were sequenced. For a subset of the worms, whole-genome sequencing data were generated. RESULTS The cox-1 sequences of 136 worms isolated from 23 patients indicated that all isolates were S. stercoralis. Among the cox-1 sequences, 33 polymorphic sites and 13 haplotypes were found. The phylogenetic analysis demonstrated that some sequences clustered fairly closely with sequences from humans and dogs from other parts of the world, while others formed a separate, Iran-specific group. Among 64 S. stercoralis analyzed, we found three of the previously described SSU HVR-I haplotypes, with haplotype II being the most frequent haplotype. In contrast to Southeast Asia, where S. stercoralis heterozygous for different haplotypes at the HVR-I locus are rare, we found 20 worms to be heterozygous for two different HVR-I haplotypes, 18 of which fell into the Iran-specific cox-1 cluster. SSU-heterozygous worms also showed elevated heterozygosity at the whole-genome level. CONCLUSIONS We conclude that the S. stercoralis population from the Khuzestan province shares much of the genetic diversity with the population in Southeast Asia, but there is an indication of additional genetic input. There appears to be some population structure with different subpopulations, which however do interbreed at least occasionally.
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Affiliation(s)
- Molouk Beiromvand
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
- Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Alireza Ashiri
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Veroni de Ree
- Department of Integrative Evolutionary Biology, Max Planck Institute for Biology Tübingen, Tübingen, Baden‑Württemberg, Germany
| | - Dorothee Harbecke
- Department of Integrative Evolutionary Biology, Max Planck Institute for Biology Tübingen, Tübingen, Baden‑Württemberg, Germany
| | - Christian Rödelsperger
- Department of Integrative Evolutionary Biology, Max Planck Institute for Biology Tübingen, Tübingen, Baden‑Württemberg, Germany
| | - Adrian Streit
- Department of Integrative Evolutionary Biology, Max Planck Institute for Biology Tübingen, Tübingen, Baden‑Württemberg, Germany.
| | - Abdollah Rafiei
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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41
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Breloer M, Linnemann L. Strongyloides ratti infection in mice: immune response and immune modulation. Philos Trans R Soc Lond B Biol Sci 2024; 379:20220440. [PMID: 38008111 PMCID: PMC10676808 DOI: 10.1098/rstb.2022.0440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/09/2023] [Indexed: 11/28/2023] Open
Abstract
Strongyloides ratti is a natural parasite of wild rats and most laboratory mouse strains are also fully permissive. The infection can be divided into three distinct phases: the tissue migration of the infective third stage larvae during the first two days, the early intestinal establishment of S. ratti parasites molting to adults on days three to six and the later intestinal parasitic phase until the end of infection. Immunocompetent mice terminate the S. ratti infection after one month and are semi-resistant to a second infection. Employing the powerful tools of mouse immunology has facilitated a detailed analysis of the initiation, execution and regulation of the immune response to S. ratti. Here we review the information collected to date on the protective immune response to migrating S. ratti larvae in tissues and to adult parasites in the intestine. We show that depending on the phase of infection, a site-specific portfolio of immune effector mechanisms is required for infection control. In addition, we summarize the strategies employed by S. ratti to evade the immune system and survive long enough in its host to replicate despite an effective immune response. Selected murine studies using the closely related Strongyloides venezuelensis will be discussed. This article is part of the Theo Murphy meeting issue 'Strongyloides: omics to worm-free populations'.
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Affiliation(s)
- Minka Breloer
- Section of Molecular Biology and Immunology, Bernhard Nocht Institute for Tropical Medicine, Hamburg 20359, Germany
- Department of Biology, University of Hamburg, Hamburg 20156, Germany
| | - Lara Linnemann
- Section of Molecular Biology and Immunology, Bernhard Nocht Institute for Tropical Medicine, Hamburg 20359, Germany
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42
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Nosková E, Sambucci KM, Petrželková KJ, Červená B, Modrý D, Pafčo B. Strongyloides in non-human primates: significance for public health control. Philos Trans R Soc Lond B Biol Sci 2024; 379:20230006. [PMID: 38008123 PMCID: PMC10676817 DOI: 10.1098/rstb.2023.0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/18/2023] [Indexed: 11/28/2023] Open
Abstract
Primates are an important source of infectious disease in humans. Strongyloidiasis affects an estimated 600 million people worldwide, with a global distribution and hotspots of infection in tropical and subtropical regions. Recently added to the list of neglected tropical diseases, global attention has been demanded in the drive for its control. Through a literature review of Strongyloides in humans and non-human primates (NHP), we analysed the most common identification methods and gaps in knowledge about this nematode genus. The rise of molecular-based methods for Strongyloides detection is evident in both humans and NHP and provides an opportunity to analyse all data available from primates. Dogs were also included as an important host species of Strongyloides and a potential bridge host between humans and NHP. This review highlights the lack of molecular data across all hosts-humans, NHP and dogs-with the latter highly underrepresented in the database. Despite the cosmopolitan nature of Strongyloides, there are still large gaps in our knowledge for certain species when considering transmission and pathogenicity. We suggest that a unified approach to Strongyloides detection be taken, with an optimized, repeatable molecular-based method to improve our understanding of this parasitic infection. This article is part of the Theo Murphy meeting issue 'Strongyloides: omics to worm-free populations'.
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Affiliation(s)
- Eva Nosková
- Institute of Vertebrate Biology, Czech Academy of Sciences, 603 00 Brno, Czech Republic
- Department of Botany and Zoology, Faculty of Science, Masaryk University, 625 00 Brno, Czech Republic
| | - Kelly M. Sambucci
- Institute of Vertebrate Biology, Czech Academy of Sciences, 603 00 Brno, Czech Republic
- Department of Anthropology, Faculty of Science, Masaryk University, 611 37 Brno, Czech Republic
| | - Klára J. Petrželková
- Institute of Vertebrate Biology, Czech Academy of Sciences, 603 00 Brno, Czech Republic
- Institute of Parasitology, Biology Centre, Czech Academy of Sciences, 370 05 České Budějovice, Czech Republic
| | - Barbora Červená
- Institute of Vertebrate Biology, Czech Academy of Sciences, 603 00 Brno, Czech Republic
| | - David Modrý
- Department of Botany and Zoology, Faculty of Science, Masaryk University, 625 00 Brno, Czech Republic
- Institute of Parasitology, Biology Centre, Czech Academy of Sciences, 370 05 České Budějovice, Czech Republic
- Department of Veterinary Sciences, Faculty of Agrobiology, Food and Natural Resources, Czech University of Life Sciences Prague, 165 00 Prague, Czech Republic
| | - Barbora Pafčo
- Institute of Vertebrate Biology, Czech Academy of Sciences, 603 00 Brno, Czech Republic
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Fan W, Fu Q, Yu Y. Pulmonary strongyloidiasis and hyperinfection in a Patient with idiopathic inflammatory myopathy:A case report. Heliyon 2024; 10:e23484. [PMID: 38148807 PMCID: PMC10750171 DOI: 10.1016/j.heliyon.2023.e23484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 12/03/2023] [Accepted: 12/05/2023] [Indexed: 12/28/2023] Open
Abstract
Pulmonary strongyloidiasis is a rare infection in patients with autoimmune diseases, and immunosuppression can lead to the development of hyperinfection syndrome with a high mortality rate. We present a case of a 78-year-old male with previous idiopathic inflammatory myopathy (IIM) with interstitial lung disease. He developed hyperinfection syndrome and respiratory failure, and diagnostic metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) confirmed the presence of Strongyloides stercoralis. After treatment with ivermectin, the patient's symptoms improved. Therefore, adequate screening and prophylactic treatment are needed for people at risk of immunosuppression, which can reduce the occurrence of the devastating S. stercoralis hyperinfection syndrome. It also highlights mNGS as a highly accurate test for the detection of difficult to atypical pathogens.
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Affiliation(s)
- Wei Fan
- Department of Rheumatology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiong Fu
- Department of Rheumatology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuetian Yu
- Department of Critical Care Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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44
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Buonfrate D, Hunt VL, Odermatt P, Streit A. Strongyloides: omics to worm-free populations. Philos Trans R Soc Lond B Biol Sci 2024; 379:20220448. [PMID: 38008116 PMCID: PMC10676809 DOI: 10.1098/rstb.2022.0448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 10/20/2023] [Indexed: 11/28/2023] Open
Abstract
This article is part of the Theo Murphy meeting issue 'Strongyloides: omics to worm-free populations'.
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Affiliation(s)
- Dora Buonfrate
- IRCCS Sacro Cuore Don Calabria hospital, Negrar, Verona 37024, Italy
| | - Vicky L. Hunt
- Department of Life Sciences, University of Bath, Bath BA2 7AY, UK
| | - Peter Odermatt
- Epidemiology and Public Health, Swiss Tropical and Public Health Insitute, Allschwil, Basel 4123, Switherland
| | - Adrian Streit
- Max Planck Institute for Biology Tübingen, Tübingen, Baden-Württemberg 72076, Germany
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45
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Ross K. Locally acquired strongyloidiasis in remote Australia: why are there still cases? Philos Trans R Soc Lond B Biol Sci 2024; 379:20220435. [PMID: 38008121 PMCID: PMC10676813 DOI: 10.1098/rstb.2022.0435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 03/20/2023] [Indexed: 11/28/2023] Open
Abstract
In Australia, strongyloidiasis primarily affects returned travellers, Vietnam veterans and refugees or asylum seekers, and First Nations people. Non-overseas acquired cases are seen almost exclusively in Australian First Nations remote communities. Australian First Nations communities have one of the highest rates of strongyloidiasis in the world. Our work has shown that strongyloidiasis is a disease of poverty. Acknowledging this is important-we need to shift the lens to socioeconomic factors, particularly environmental health hardware such as working toilets and sewerage systems, showers and laundries, and effective wastewater and rubbish removal. The rates of strongyloidiasis in First Nations communities is a result of decades of inadequate, poorly constructed and/or poorly maintained housing, and poor environmental health hardware (hereafter hardware). The solution lies in adequate funding, resulting in well designed and maintained housing and appropriate hardware. Governments need to allow First Nations communities themselves to take the lead role in funding allocation, and design, construction and maintenance of their housing and hardware. This will ensure housing and hardware fulfils cultural and physical needs and desires, and protects health. Improving housing and hardware will also improve other health outcomes. This article is part of the Theo Murphy meeting issue 'Strongyloides: omics to worm-free populations'.
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Affiliation(s)
- Kirstin Ross
- Environmental Health, Flinders University, GPO Box 2100, Adelaide, South Australia 5001, Australia
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46
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Tiberti N, Manfredi M, Piubelli C, Buonfrate D. Progresses and challenges in Strongyloides spp. proteomics. Philos Trans R Soc Lond B Biol Sci 2024; 379:20220447. [PMID: 38008115 PMCID: PMC10676815 DOI: 10.1098/rstb.2022.0447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 08/09/2023] [Indexed: 11/28/2023] Open
Abstract
The availability of high-quality data of helminth genomes provided over the past two decades has supported and accelerated large-scale 'omics studies and, consequently, the achievement of a more in-depth molecular characterization of a number of pathogens. This has also involved Strongyloides spp. and since their genome was made available transcriptomics has been rather frequently applied to investigate gene expression regulation across their life cycle. Strongyloides proteomics characterization has instead been somehow neglected, with only a few reports performing high-throughput or targeted analyses associated with protein identification by tandem mass spectrometry. Such investigations are however necessary in order to discern important aspects associated with human strongyloidiasis, including understanding parasite biology and the mechanisms of host-parasite interaction, but also to identify novel diagnostic and therapeutic targets. In this review article, we will give an overview of the published proteomics studies investigating strongyloidiasis at different levels, spanning from the characterization of the somatic proteome and excretory/secretory products of different parasite stages to the investigation of potentially immunogenic proteins. Moreover, in the effort to try to start filling the current gap in host-proteomics, we will also present the first serum proteomics analysis in patients suffering from human strongyloidiasis. This article is part of the Theo Murphy meeting issue 'Strongyloides: omics to worm-free populations'.
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Affiliation(s)
- Natalia Tiberti
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Negrar di Valpolicella (Verona), Italy
| | - Marcello Manfredi
- Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy
| | - Chiara Piubelli
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Negrar di Valpolicella (Verona), Italy
| | - Dora Buonfrate
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Negrar di Valpolicella (Verona), Italy
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47
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McClure CR, Patel R, Hallem EA. Invade or die: behaviours and biochemical mechanisms that drive skin penetration in Strongyloides and other skin-penetrating nematodes. Philos Trans R Soc Lond B Biol Sci 2024; 379:20220434. [PMID: 38008119 PMCID: PMC10676818 DOI: 10.1098/rstb.2022.0434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 04/05/2023] [Indexed: 11/28/2023] Open
Abstract
Skin-penetrating nematodes, including the human threadworm Strongyloides stercoralis and hookworms in the genera Necator and Ancylostoma, are gastrointestinal parasites that are a major cause of neglected tropical disease in low-resource settings worldwide. These parasites infect hosts as soil-dwelling infective larvae that navigate towards hosts using host-emitted sensory cues such as odorants and body heat. Upon host contact, they invade the host by penetrating through the skin. The process of skin penetration is critical for successful parasitism but remains poorly understood and understudied. Here, we review current knowledge of skin-penetration behaviour and its underlying mechanisms in the human parasite S. stercoralis, the closely related rat parasite Strongyloides ratti, and other skin-penetrating nematodes such as hookworms. We also highlight important directions for future investigations into this underexplored process and discuss how recent advances in molecular genetic and genomic tools for Strongyloides species will enable mechanistic investigations of skin penetration and other essential parasitic behaviours in future studies. This article is part of the Theo Murphy meeting issue 'Strongyloides: omics to worm-free populations'.
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Affiliation(s)
- Courtney R. McClure
- Molecular Toxicology Interdepartmental PhD Program, University of California, Los Angeles, CA 90095, USA
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, CA 90095, USA
| | - Ruhi Patel
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, CA 90095, USA
| | - Elissa A. Hallem
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, CA 90095, USA
- Molecular Biology Institute, University of California, Los Angeles, CA 90095, USA
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48
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Collyer BS, Anderson R. The transmission dynamics of Strongyloides stercoralis and the impact of mass drug administration. Philos Trans R Soc Lond B Biol Sci 2024; 379:20220442. [PMID: 38008114 PMCID: PMC10676814 DOI: 10.1098/rstb.2022.0442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/30/2023] [Indexed: 11/28/2023] Open
Abstract
The epidemiology of Strongyloides stercoralis is briefly reviewed with an emphasis on cross section and longitudinal studies of infection prevalence stratified by age, performance of different diagnostic tools, mass drug administration (MDA) impact and estimates of key population parameters within the complex life cycle of the parasite that determine transmission intensity and response to control measures. The paucity of studies is highlighted, and gaps in current knowledge identified about the population biology of this very prevalent infection in tropical and sub-tropical regions around the world. A stochastic individual based stochastic model is described in part to highlight gaps in knowledge. The impact of repeated MDA is simulated to illustrate some aspects of transmission dynamics of this helminth infection. Specifically, the impact and bounce back times in either the intervals between treatment rounds, or post the cessation of treatment, depend critically on the magnitude of two distinct components of the basic reproductive number R0. The absence of data on these key components is highlighted, as is the value of studies of longitudinal cohorts of people in regions of endemic infection post rounds of MDA to record how infection levels bounce back post treatment at individual and population levels of study. This article is part of the Theo Murphy meeting issue 'Strongyloides: omics to worm-free populations'.
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Affiliation(s)
- Benjamin S. Collyer
- Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, Praed Street, London W2 1PG, UK
| | - Roy Anderson
- Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, Praed Street, London W2 1PG, UK
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Al-Jawabreh R, Anderson R, Atkinson LE, Bickford-Smith J, Bradbury RS, Breloer M, Bryant AS, Buonfrate D, Cadd LC, Crooks B, Deiana M, Grant W, Hallem E, Hedtke SM, Hunt V, Khieu V, Kikuchi T, Kounosu A, Lastik D, van Lieshout L, Liu Y, McSorley HJ, McVeigh P, Mousley A, Murcott B, Nevin WD, Nosková E, Pomari E, Reynolds K, Ross K, Streit A, Suleiman M, Tiberti N, Viney M. Strongyloides questions-a research agenda for the future. Philos Trans R Soc Lond B Biol Sci 2024; 379:20230004. [PMID: 38008122 PMCID: PMC10676812 DOI: 10.1098/rstb.2023.0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/29/2023] [Indexed: 11/28/2023] Open
Abstract
The Strongyloides genus of parasitic nematodes have a fascinating life cycle and biology, but are also important pathogens of people and a World Health Organization-defined neglected tropical disease. Here, a community of Strongyloides researchers have posed thirteen major questions about Strongyloides biology and infection that sets a Strongyloides research agenda for the future. This article is part of the Theo Murphy meeting issue 'Strongyloides: omics to worm-free populations'.
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Affiliation(s)
| | - Roy Anderson
- Department of Infectious Disease Epidemiology, Imperial College London, London SW7 2BX, UK
| | - Louise E. Atkinson
- School of Biological Sciences, Queen's University Belfast, Belfast BT9 5DL, UK
| | | | | | - Minka Breloer
- Bernhard Nocht Institute for Tropical Medicine, Hamburg 20359, Germany
| | - Astra S. Bryant
- Department of Physiology and Biophysics, University of Washington, Seattle 98195, USA
| | - Dora Buonfrate
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona 37024, Italy
| | - Luke C. Cadd
- School of Biological Sciences, Queen's University Belfast, Belfast BT9 5DL, UK
| | - Bethany Crooks
- School of Biological Sciences, Queen's University Belfast, Belfast BT9 5DL, UK
| | - Michela Deiana
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona 37024, Italy
| | - Warwick Grant
- Department of Environment and Genetics, La Trobe University, Bundoora, Victoria 3083, Australia
| | - Elissa Hallem
- Department of Microbiology, Immunology, and Molecular Genetics, Molecular Biology Institute, University of California Los Angeles, Los Angeles 90095, USA
| | - Shannon M. Hedtke
- Department of Environment and Genetics, La Trobe University, Bundoora, Victoria 3083, Australia
| | - Vicky Hunt
- Life Sciences Department, University of Bath, Bath BA2 7AY, UK
| | - Virak Khieu
- National Centre for Parasitology, Entomology and Malaria Control, Cambodia Ministry of Health, Cambodia
| | - Taisei Kikuchi
- Department of Integrated Biosciences, Graduate School of Frontier Sciences, The University of Tokyo, Kashiwa 277-8652, Japan
| | - Asuka Kounosu
- Division of Parasitology, Department of Infectious Diseases, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan
| | - Dominika Lastik
- Life Sciences Department, University of Bath, Bath BA2 7AY, UK
| | - Lisette van Lieshout
- Leiden University Center for Infectious Diseases, Leiden University Medical Center, 2300 RC Leiden, The Netherlands
| | - Yuchen Liu
- Department of Evolution, Ecology & Behaviour, University of Liverpool, Liverpool L69 7ZB, UK
| | - Henry J. McSorley
- Division of Cell Signalling and Immunology, School of Life Sciences, University of Dundee, Dundee DD1 5EH, UK
| | - Paul McVeigh
- School of Biological Sciences, Queen's University Belfast, Belfast BT9 5DL, UK
| | - Angela Mousley
- School of Biological Sciences, Queen's University Belfast, Belfast BT9 5DL, UK
| | - Ben Murcott
- Life Sciences Department, University of Bath, Bath BA2 7AY, UK
| | - William David Nevin
- Department of Infectious Diseases, Imperial College London, London SW7 2BX, UK
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Eva Nosková
- Department of Botany and Zoology, Faculty of Science, Masaryk University, 611 37 Brno, Czech Republic
- Institute of Vertebrate Biology, Czech Academy of Sciences, 603 65 Brno, Czech Republic
| | - Elena Pomari
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona 37024, Italy
| | - Kieran Reynolds
- Life Sciences Department, University of Bath, Bath BA2 7AY, UK
| | - Kirstin Ross
- Environmental Health, College of Science and Engineering, Flinders University, South Australia 5042, Australia
| | - Adrian Streit
- Department of Integrative Evolutionary Biology, Max Planck Institute for Biology Tübingen, Tübingen 72076, Germany
| | - Mona Suleiman
- Life Sciences Department, University of Bath, Bath BA2 7AY, UK
| | - Natalia Tiberti
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona 37024, Italy
| | - Mark Viney
- Department of Evolution, Ecology & Behaviour, University of Liverpool, Liverpool L69 7ZB, UK
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Bradbury RS, Streit A. Is strongyloidiasis a zoonosis from dogs? Philos Trans R Soc Lond B Biol Sci 2024; 379:20220445. [PMID: 38008118 PMCID: PMC10676807 DOI: 10.1098/rstb.2022.0445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/29/2023] [Indexed: 11/28/2023] Open
Abstract
Strongyloides stercoralis infection remains a major veterinary and public health challenge globally. This chronic and potentially lifelong disease has fatal outcomes in immunosuppressed people and dogs. Currently, the role of dogs in the transmission cycle of human strongyloidiasis remains enigmatic. While zoonotic transmission to humans from companion animals has been proposed, this has not been confirmed. Modern molecular methods have allowed greater opportunity to explore the genotypes of S. stercoralis in dogs and humans. Work thus far has demonstrated that at least two distinct lineages exist, one apparently confined to canine hosts and one found in canine, feline, human and non-human primate hosts. Although genotyping of dog and human isolates from the same village has demonstrated identical genotypes in both species, coprophagia of human waste by dogs confounds interpretation. It remains unclear if dogs act as a zoonotic reservoir for human infection, or vice versa, or if this occurs only in some regions of the world and not in others. These questions must be answered before effective control strategies for strongyloidiasis can be instituted. This review explores the evidence for and against cross-species transmission of S. stercoralis between dogs and humans and summarizes future directions for research in this area. This article is part of the Theo Murphy meeting Issue 'Strongyloides: omics to worm-free populations'.
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Affiliation(s)
- Richard S. Bradbury
- School of Health and Life Sciences, Federation University, Melbourne, Victoria 3806, Australia
| | - Adrian Streit
- Department for Integrative Evolutionary Biology, Max Planck Institute for Biology Tübingen, Tübingen, 72076, Germany
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