Abstract
Strongyloides stercoralis is a parasitic nematode found in humans, with a higher prevalence in tropical and sub-tropical regions worldwide. If untreated, the infection can progress to disseminated strongyloidiasis, a critical illness which may be fatal. To provide clinical guidance on the prevention, assessment and management of disseminated strongyloidiasis. A literature review was conducted to evaluate the current evidence and to identify any systematic reviews, case reports, guidelines and peer reviewed and non-peer reviewed medical literature. The Committee to Advise on Tropical Medicine and Travel (CATMAT) assembled a working group to develop this statement, which was then critically reviewed and approved by all CATMAT members. CATMAT recommends that screening for strongyloidiasis should be considered for individuals with epidemiologic risk and/or co-morbidities that place them at risk for Strongyloides hyperinfection and dissemination. Those at highest risk of hyperinfection and dissemination are individuals born in a Strongyloides-endemic area who undergo iatrogenic immunosuppression or have intercurrent human T-lymphotropic virus (HTLV-1) infection. Diagnosis of strongyloidiasis is based on serologic testing and/or examination of stools and other clinical specimens for larvae. Referral to a tropical medicine specialist with expertise in the management of strongyloidiasis is recommended for suspected and confirmed cases. A diagnosis and treatment algorithm for strongyloidiasis has been developed as a reference tool. Strongyloidiasis is relatively widespread in the global migrant population and screening for the disease should be based on an individual risk assessment. A practical tool for the clinician to use in the prevention, assessment and management of disseminated strongyloidiasis in Canada is now available.
Highlights
Strongyloidiasis is a disease caused by a nematode, which is present mainly in tropical and sub-tropical regions, and in temperate climates
Strongyloidiasis is relatively widespread in the global migrant population and screening for the disease should be based on an individual risk assessment
A practical tool for the clinician to use in the prevention, assessment and management of disseminated strongyloidiasis in Canada is available
Summary
This statement was created after CATMAT identified a need to inform Canadian clinicians about disseminated strongyloidiasis. It has been our collective clinical experience, that strongyloidiasis is widespread in the global migrant population and screening should be based on a risk assessment, taking into account the risk of exposure to Strongyloides, the risk of disseminated disease and the presenting clinical syndrome (including asymptomatic persons who are planned to undergo iatrogenic immune suppression) This is supported by a case series in Toronto that documented ten cases of disseminated strongyloidiasis over a seven-month period, all of which occurred in immigrants to Canada, originating from Southeast Asia, the Caribbean, South America or Italy [11]. Albendazole 400 mg po BID until cessation of larval shedding and clinical improvement
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
