Abstract
BackgroundImported strongyloidiasis is increasingly being diagnosed in non-endemic areas. The aim of this study was to describe the epidemiological, clinical and microbiological characteristics of patients with imported strongyloidiasis in Spain.MethodologyThis is an observational retrospective study that included all patients diagnosed of strongyloidiasis registered in the +REDIVI Collaborative Network from 2009 to 2017. Demographic, epidemiological and clinical information was collected from the +REDIVI database, and extra information regarding microbiological techniques, treatment and follow-up was requested to participant centers.FindingsOverall, 1245 cases were included. Most of them were immigrants (66.9%), and South America was the most frequent area of origin. Detection of larvae in stool samples was observed in 21.9% of the patients, and serological tests allowed making the diagnosis in the rest of the cases. Eosinophilia was present in 82.2% of cases. Treatment with ivermectin (compared with albendazole) was the most strongly associated factor to achieve the cure (OR 2.34).ConclusionsGiven the long latency of the infection and the risk of developing a severe presentation, screening of S. stercoralis infection should be mandatory in patients coming from or had traveling to endemic areas, especially in those with immunosuppressant conditions.
Highlights
Strongyloidiasis is caused by the soil-transmitted nematode Strongyloides stercoralis [1]
Given the long latency of the infection and the risk of developing a severe presentation, screening of S. stercoralis infection should be mandatory in patients coming from or had traveling to endemic areas, especially in those with immunosuppressant conditions
Given the risk of developing a severe presentation, screening of S. stercoralis infection should be mandatory in patients coming from or had traveling to endemic areas, especially in those with immunosuppressant conditions
Summary
Strongyloidiasis is caused by the soil-transmitted nematode Strongyloides stercoralis [1]. It has been recently estimated that 370 million people are infected by the parasite; this prevalence is most probably underestimated, since the majority of the studies are focused on other soil-transmitted helminthes, and the microbiological techniques commonly used have low sensitivity for S. stercoralis [3, 4]. S. stercoralis infection is most often asymptomatic, but patients may present with gastrointestinal, cutaneous, and respiratory symptoms [2]. This parasite has the unique ability to persist in the human host for decades without the need of exogenous reinfection due to its autoinfection life cycle. The aim of this study was to describe the epidemiological, clinical and microbiological characteristics of patients with imported strongyloidiasis in Spain
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