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García-Aguilar JA, Alger J. Frequency of strongyloidiasis and associated factors: Analysis of 13 years of laboratory results in a tertiary referral hospital in Honduras, 2010-2022. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2023; 43:492-505. [PMID: 38109136 PMCID: PMC10776084 DOI: 10.7705/biomedica.7086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 12/13/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION The frequency of detected strongyloidiasis is affected by the selected laboratory method in the studied population. Considering that Honduras has few community-based studies, the analysis of the laboratory record data can provide information helping to understand this parasitosis. OBJECTIVE To estimate the frequency and to identify the factors associated with strongyloidiasis, analyzing the laboratory records of the Servicio de Parasitología at Hospital Escuela in Tegucigalpa (Honduras) between 2010 and 2022. MATERIALS AND METHODS We carried out a descriptive, cross-sectional, analytical study. The laboratory diagnosis consisted of stool samples' examination by direct smear and modified Baermann technique. We estimated frequencies and percentages. The statistical association was calculated with prevalence ratios and a 95% confidence interval. Software R, version 4.2.0, and epiR package, version 2.0.46, were used to perform the analysis. RESULTS The frequency of strongyloidiasis was 0.29% (112/38,085). It was higher with the modified Baermann technique (0.87%; 40/4,575) among male patients (0.44%; 70/15,758). Regarding the age, strongyloidiasis was higher in the 20-40 years old group (0.41%; 28/6,886) with direct smear and 41-61 years old (1.14%; 14/1,232) group with the modified Baermann technique. Among the factors associated with strongyloidiasis were age between 20 and 61 years old (PR=2.26, CI 95%=1.53-3.31), male patients (PR=2.34, CI 95%=1.60‑3.44), mucus (PR=1.86, CI 95%=1.22-2.83) and Charcot-Leyden crystals in stool (PR=8.47, CI 95%=5.14-13.96); watery stool (PR=2.39, CI 95%=1.55-3.68), and other helminthiases (PR=6.73, CI 95%=3.98-11.38). Associated factors to cases detected with the modified Baermann technique were outpatient consultation (PR=4.21, CI 95%=1.91-9.28) and formed stools (PR=3.99, CI 95%=1.94-8.19). CONCLUSIONS The modified Baermann technique increased the detection of strongyloidiasis almost four times. Most cases were distributed among male adults. The cases diagnosed exclusively with the modified Baermann technique have differences from those with observed larvae in the direct smear. It is necessary to develop community-based population studies.
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Affiliation(s)
- Jorge Alberto García-Aguilar
- Servicio de Parasitología, Departamento de Laboratorio Clínico, Hospital Escuela, Tegucigalpa, Honduras; Instituto de Enfermedades Infecciosas y Parasitología Antonio Vidal, Tegucigalpa, Honduras; Asociación Hondureña de Parasitología, Tegucigalpa, Honduras.
| | - Jackeline Alger
- Servicio de Parasitología, Departamento de Laboratorio Clínico, Hospital Escuela, Tegucigalpa, Honduras; Instituto de Enfermedades Infecciosas y Parasitología Antonio Vidal, Tegucigalpa, Honduras; Asociación Hondureña de Parasitología, Tegucigalpa, Honduras.
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Calvopina M, Cabezas-Moreno M, Cisneros-Vásquez E, Paredes-Betancourt I, Bastidas-Caldes C. Diversity and prevalence of gastrointestinal helminths of free-roaming dogs on coastal beaches in Ecuador: Potential for zoonotic transmission. VETERINARY PARASITOLOGY: REGIONAL STUDIES AND REPORTS 2023; 40:100859. [PMID: 37068862 DOI: 10.1016/j.vprsr.2023.100859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 03/28/2023]
Abstract
Free-roaming dogs are highly exposed to a range of zoonotic parasites, including helminths, which can be transmitted to humans, particularly in rural tropical settings of developing countries. To evidence the diversity and prevalence of gastrointestinal helminths in the stools of free-roaming dogs on the public Pacific coastal beaches of Ecuador, a cross-sectional study was conducted from August 2021 to August 2022. The sampling beaches are located along the tropical Pacific coastal region. Stools were collected from the ground in containers with 10% formalin and processed using the Ritchie method; eggs were identified under a microscope. A total of 573 stools were examined from 20 beaches; the overall prevalence was 157 (27.4%) for one or more helminths. Ten parasites were identified, nine of which are potentially zoonotic. Ancylostoma spp. was the most prevalent (19.4%), followed by Toxocara spp. (7.2%). Trichuris spp., Dipylidium caninum, Diphyllobothrium spp., Capillaria spp., Dicrocoelium spp., Heterobilharzia americana, Hymenolepis spp. and Spirocerca spp. were also observed. Five of them are reported for the first-time infecting dogs in Ecuador. Hence, we evidenced that Ecuadorian beaches are highly contaminated with the dogs' zoonotic gastrointestinal helminths, posing a great risk to public health. Differences in the presence and prevalence were found in samples of tropical humid and dry climate zones. Therefore, based on our findings, we encourage the implementation of broad antiparasitic treatment and prevention strategies to reduce the zoonotic risk.
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COVID-19-Associated Eosinopenia in a Patient With Chronic Eosinophilia Due to Chronic Strongyloidiasis. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2021; 29:e305-e306. [PMID: 34539164 PMCID: PMC8436813 DOI: 10.1097/ipc.0000000000000991] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Eosinopenia was frequently encountered in patients with coronavirus disease 2019 (COVID-19). We describe a case of a 59-year-old man who was treated with high-dose corticosteroids and anti-interleukin 1 receptor antagonist therapy because of severe acute respiratory distress syndrome due to a so-called cytokine storm in COVID-19. He had chronic eosinophilia for many years due to an unknown Strongyloides stercoralis infection, proven by serology and a positive polymerase chain reaction test on a stool sample. COVID-19 led to a complete resolution of eosinophilia, even before immunosuppressive treatment was started. Eosinophilia returned after recovery from COVID-19 and started to decline under treatment with ivermectin. Our case confirms previous reports of eosinopenia in COVID-19, as it appears even in patients with chronic eosinophilia. Presence of eosinophilia should prompt screening for strongyloidiasis in all patients eligible for immunosuppressive therapy because of the risk of Strongyloides hyperinfection syndrome, especially if this treatment is empirical.
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Ortiz-Martínez S, Ramos-Rincón JM, Vásquez-Chasnamote ME, Gamboa-Paredes ON, Arista-Flores KM, Espinoza-Venegas LA, de-Miguel-Balsa E, Pinedo-Cancino VV, Górgolas-Hernández-Mora M, Casapía-Morales M. Prevalence of strongyloidiasis in Peru: systematic review and meta-analysis. BMC Infect Dis 2021; 21:755. [PMID: 34348671 PMCID: PMC8336367 DOI: 10.1186/s12879-021-06441-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 07/16/2021] [Indexed: 11/23/2022] Open
Abstract
Background Strongyloidiasis is a disease of great public health significance, caused by the parasitic nematodes Strongyloides stercoralis, Strongyloides fuelleborni, and Strongyloides fuelleborni subsp. kellyi. This systematic review and meta-analysis aimed to assess the prevalence of Strongyloides stercoralis infection in Peru. Methods The review was based on a literature search in PubMed, SciELO and Google Scholar using the key words or root words “strongyl*” AND “Peru” on 15 July 2020. Eligible studies were published from 1 January 1981 to 15 July 2020 and written in English, Spanish, Italian, or French. Results We included 21 papers in the analysis. Studies were heterogeneous in terms of study population and diagnostic methods (e.g. Baermann technique, agar, Dancescu or charcoal cultures, serology, string capsule). Prevalence of S. stercoralis ranged from 0.3 to 45%. The pooled proportion of Strongyloides in the general population was 7.34% (95% CI 4.97 to 10.13%). Half the studies were designed to detect parasites in general. In studies designed to detect S. stercoralis, the most widely used diagnostic method was the Baermann technique. Conclusion Prevalence of S. stercoralis in Peru was high but varied by geographic area, techniques for stool examination, and participant characteristics.
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Affiliation(s)
- Sonia Ortiz-Martínez
- Medical Practice El Ballestero, Health Service of Castilla La Mancha, Albacete, Spain
| | - José-Manuel Ramos-Rincón
- Clinical Medicine Department, University Miguel Hernández of Elche, Ctra N-332, 03550 Sant Joan d'Alacant, Alicante, Spain. .,Internal Medicine Service, General University Hospital of Alicante-ISABIAL, Alicante, Spain.
| | | | | | | | | | - Eva de-Miguel-Balsa
- Clinical Medicine Department, University Miguel Hernández of Elche, Ctra N-332, 03550 Sant Joan d'Alacant, Alicante, Spain.,Intensive Care Unit, General University Hospital of Elche, Alicante, Spain
| | - Viviana-Vanessa Pinedo-Cancino
- Molecular Biology and Immunology Laboratory of the Specialized Unit of LIPNAA-CIRNA, National University of the Peruvian Amazon, Iquitos, Peru
| | - Miguel Górgolas-Hernández-Mora
- Infectious Disease Division, University Hospital Foundation Jiménez Díaz, Madrid, Spain.,Medicine Department, Autonomous University of Madrid, Madrid, Spain
| | - Martín Casapía-Morales
- Infectious Diseases and Tropical Medicine Service, Loreto Regional Hospital, Iquitos, Peru.,Medical Department, Amazon Rainforest Civil Association, Iquitos, Peru.,School of Medicine, National University of the Peruvian Amazon, Iquitos, Peru
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Lier AJ, Tuan JJ, Davis MW, Paulson N, McManus D, Campbell S, Peaper DR, Topal JE. Case Report: Disseminated Strongyloidiasis in a Patient with COVID-19. Am J Trop Med Hyg 2020; 103:1590-1592. [PMID: 32830642 PMCID: PMC7543803 DOI: 10.4269/ajtmh.20-0699] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The SARS-CoV-2 virus has emerged and rapidly evolved into a current global pandemic. Although bacterial and fungal coinfections have been associated with COVID-19, little is known about parasitic infection. We report a case of a COVID-19 patient who developed disseminated strongyloidiasis following treatment with high-dose corticosteroids and tocilizumab. Screening for Strongyloides infection should be pursued in individuals with COVID-19 who originate from endemic regions before initiating immunosuppressive therapy.
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Affiliation(s)
- Audun J Lier
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Jessica J Tuan
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Matthew W Davis
- Department of Pharmacy Services, Yale New Haven Hospital, New Haven, Connecticut
| | - Nathan Paulson
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Dayna McManus
- Department of Pharmacy Services, Yale New Haven Hospital, New Haven, Connecticut
| | - Sheldon Campbell
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - David R Peaper
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Jeffrey E Topal
- Department of Pharmacy Services, Yale New Haven Hospital, New Haven, Connecticut.,Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
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Asymptomatic Strongyloidiasis among Latin American Migrants in Spain: A Community-Based Approach. Pathogens 2020; 9:pathogens9060511. [PMID: 32599871 PMCID: PMC7350301 DOI: 10.3390/pathogens9060511] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/14/2020] [Accepted: 06/20/2020] [Indexed: 02/06/2023] Open
Abstract
Strongyloides stercoralis infection is frequently underdiagnosed since many infections remain asymptomatic. Aim: To estimate the prevalence and characteristics of asymptomatic S. stercoralis infection in Latin American migrants attending a community-based screening program for Chagas disease in Spain. Methodology: Three community-based Chagas disease screening campaigns were performed in Alicante (Spain) in 2016, 2017, and 2018. Serological testing for S. stercoralis infection was performed using a non-automatized IVD-ELISA detecting IgG (DRG Instruments GmbH, Marburg, Germany). Results: Of the 616 migrants from Central and South America who were screened, 601 were included in the study: 100 children and adolescents (<18 years of age) and 501 adults. Among the younger group, 6 participants tested positive (prevalence 6%, 95% confidence interval [CI] 2.5% to 13.1%), while 60 adults did so (prevalence 12%, 95% CI 9.3% to 15.3%). S. stercoralis infection was more common in men than in women (odds ratio adjusted [ORa] 2.28, 95% CI 1.289 to 4.03) and in those from Bolivia (ORa 2.03, 95% CI 1.15 to 3.59). Prevalence increased with age (ORa 1.02, 95% CI 0.99 to 1.05). In contrast, a university education had a protective effect (ORa 0.29, 95% CI 0.31 to 0.88). Forty-one (41/66; 62.1%) of the total cases of S. stercoralis infection were treated at the health care center. Positive stool samples were observed in 19.5% of the followed-up positive cases. Conclusion: Incorporating serological screening for S. stercoralis into community-based screening for Chagas disease is a useful intervention to detect asymptomatic S. stercoralis infection in Central and South American migrants and an opportunity to tackle neglected tropical diseases in a transversal way. The remaining challenge is to achieve patients’ adherence to the medical follow-up.
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Ortiz-Martínez S, Ramos-Rincón JM, Vásquez-Chasnamote ME, Alarcón-Baldeón JJ, Parraguez-de-la-Cruz J, Gamboa-Paredes ON, Schillyk-Guerra P, Espinoza-Venegas LA, Pinedo-Cancino VV, Perez-Tanoira R, Górgolas-Hernández-Mora M, Casapía-Morales M. A Cross-Sectional Study of Seroprevalence of Strongyloidiasis in Pregnant Women (Peruvian Amazon Basin). Pathogens 2020; 9:pathogens9050348. [PMID: 32375325 PMCID: PMC7281748 DOI: 10.3390/pathogens9050348] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 04/28/2020] [Accepted: 04/30/2020] [Indexed: 01/01/2023] Open
Abstract
Strongyloidiasis is a soil-transmitted helminthiasis with a high global prevalence. Objectives: We aimed to evaluate the prevalence of Strongyloides stercoralis infection and assess strongyloidiasis serology as a screening technique in the Peruvian Amazon. Material and Methods: We performed a cross-sectional study of strongyloidiasis in 300 pregnant women in Iquitos (Peru) from 1 May 2019 to 15 June 2019. Women were tested using serology (Strongyloides IgG IVD-ELISA kit) as an index test and the modified Baermann technique and/or charcoal fecal culture as the parasitological reference standard. Results: The reference tests showed S. stercoralis in the stool of 30 women (prevalence: 10%; 95% confidence interval [CI] 7.1% to 13.9%), while 101 women tested positive on the blood test (prevalence: 33.7%; 95% CI 28.6% to 39.4%). Fourteen of the 15 women (93.3%) with positive results according to the modified Baermann technique, and 14 of the 23 women (56.5%) with positive charcoal cultures also had positive serological results. Serology showed a sensitivity of 63.3% and a negative predictive value of 94.4%. Conclusion: In Iquitos, pregnant women have a high prevalence of S stercoralis. S. stercoralis ELISA could be an excellent tool for population-based screening, as it has a high negative predictive value that can help to rule out the presence of active infection.
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Affiliation(s)
- Sonia Ortiz-Martínez
- Consultorio El Ballestero, Servicio de Salud Castellano Manchego, 2614 Albacete, Spain;
| | - José-Manuel Ramos-Rincón
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, 03550 Alicante, Spain
- Servicio de Medicina Interna, Hospital General Universitario de Alicante, 03010 Alicante, Spain
- Correspondence:
| | | | - Jhonatan J. Alarcón-Baldeón
- Laboratorio Clínico. Asociación Civil Selva Amazónica, 16001 Iquitos, Peru; (J.J.A.-B.); (J.P.-d.-l.-C.); (P.S.-G.)
| | - Jorge Parraguez-de-la-Cruz
- Laboratorio Clínico. Asociación Civil Selva Amazónica, 16001 Iquitos, Peru; (J.J.A.-B.); (J.P.-d.-l.-C.); (P.S.-G.)
| | | | - Patricia Schillyk-Guerra
- Laboratorio Clínico. Asociación Civil Selva Amazónica, 16001 Iquitos, Peru; (J.J.A.-B.); (J.P.-d.-l.-C.); (P.S.-G.)
| | | | - Viviana-Vanessa Pinedo-Cancino
- Laboratorio de Biología Molecular e Inmunología, Unidad Especializada del LIPNAA-CIRNA, Universidad Nacional de la Amazonia Peruana, 16001 Iquitos, Peru;
| | - Ramón Perez-Tanoira
- Servicio de Microbiologia, Hospital Universitario Príncipe de Asturias, 28802 Alcalá de Henares, Spain;
| | - Miguel Górgolas-Hernández-Mora
- División de Enfermedades Infecciosas, Hospital Universitario Fundación Jiménez Díaz, 28040 Madrid, Spain;
- Departamento de Medicina, Universidad Autónoma de Madrid, 28029 Madrid, Spain
| | - Martin Casapía-Morales
- Servicio de Enfermedades Infecciosas y Medicina Tropical, Hospital Regional de Loreto, 16001 Iquitos, Peru;
- Departamento Médico, Asociación Cívica Selva Amazónica, 16001 Iquitos, Peru;
- Facultad de Medicina, Universidad Nacional de la Amazonia Peruana, 496 Iquitos, Peru
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