Abstract
Background Strongyloides stercoralis is a neglected soil-transmitted helminth species, and there is a lack of parasitologic and epidemiologic data pertaining to this parasite in China and elsewhere. We studied the local occurrence of S. stercoralis in a village in Yunnan province, China, and comparatively assessed the performance of different diagnostic methods.Methodology/Principal FindingsMultiple stool samples from a random population sample were subjected to the Kato-Katz method, an ether-concentration technique, the Koga agar plate method, and the Baermann technique. Among 180 participants who submitted at least 2 stool samples, we found a S. stercoralis prevalence of 11.7%. Males had a significantly higher prevalence than females (18.3% versus 6.1%, p = 0.011), and infections were absent in individuals <15 years of age. Infections were only detected by the Baermann (highest sensitivity) and the Koga agar plate method, but neither with the Kato-Katz nor an ether-concentration technique. The examination of 3 stool samples rather than a single one resulted in the detection of 62% and 100% more infections when employing the Koga agar plate and the Baermann technique, respectively. The use of a mathematical model revealed a ‘true’ S. stercoralis prevalence in the current setting of up to 16.3%.Conclusions/SignificanceWe conclude that S. stercoralis is endemic in the southern part of Yunnan province and that differential diagnosis and integrated control of intestinal helminth infections needs more pointed emphasis in rural China.
Highlights
Soil-transmitted helminthiases are caused by infections with intestinal nematodes, of which Ascaris lumbricoides, Trichuris trichiura and the hookworms (Ancylostoma duodenale and Necator americanus) are the most widespread species [1,2,3]
An estimated 30 million to 100 million people are infected with the parasitic worm Strongyloides stercoralis, the causative agent of strongyloidiasis, and yet this is a neglected tropical disease
The diagnosis of this parasite requires specialized techniques (e.g. Baermann and Koga agar plate method), but these are rarely employed in epidemiologic studies
Summary
Soil-transmitted helminthiases are caused by infections with intestinal nematodes, of which Ascaris lumbricoides, Trichuris trichiura and the hookworms (Ancylostoma duodenale and Necator americanus) are the most widespread species [1,2,3]. These soiltransmitted helminths affect over 1 billion people and cause a huge public-health burden; yet, soil-transmitted helminthiases are socalled neglected tropical diseases [4]. Strongyloides stercoralis is another and even more neglected soil-transmitted helminth, an estimated 30–100 million people are infected worldwide [2]. We studied the local occurrence of S. stercoralis in a village in Yunnan province, China, and comparatively assessed the performance of different diagnostic methods
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