Abstract

BackgroundStrongyloidiasis is prevalent in Southeast Asian regions along with other soil-transmitted helminthiases, but only limited present-day data was available for Myanmar.MethodsA prevalence survey for Strongyloides stercoralis infection was conducted among villagers in rural areas of three townships located in the Lower Myanmar during 2014–2016 by agar plate culture method in combination with specific identification by molecular assays. Risk factors associated with S. stercoralis infection were assessed by analyzing questionnaires obtained from study participants.ResultsStrongyloides stercoralis was identified in 40 out of 703 participants (5.7% overall prevalence). The highest prevalence (14.4%) was observed in Htantabin, while other two communities (Thabaung and Thanlyin) had much lower prevalence (2.2 and 2.5%, respectively). Infection was relatively rare (1.2%) in younger generations under 20 years compared to older generations (9.5%). Even in Htantabin, none of the female residents under age 40 (n = 33) had infection. In adult Htantabin residents, those who answered that they do not wear shoes regularly had an elevated risk of infection (odds ratio = 2.50, 95% confidence interval = 1.03–6.08).ConclusionsThis study showed that there is still an on-going transmission of strongyloidiasis in Lower Myanmar. It is highly desirable that the soil should be free of fecal contamination by improving the management of fecal waste. Meanwhile, health education to promote shoe-wearing would be beneficial to reduce the risk of transmission, especially for those who have frequent and intense contact with soil.

Highlights

  • Strongyloidiasis is prevalent in Southeast Asian regions along with other soil-transmitted helminthiases, but only limited present-day data was available for Myanmar

  • Infection is acquired via contaminated soil, similar to major soil-transmitted helminths (STHs), namely Ascaris lumbricoides, Necator americanus, Ancylostoma duodenale, and Trichuris trichiura, epidemiological information on S. stercoralis infection is scarce [2]

  • We described an epidemiological situation of strongyloidiasis in Lower Myanmar that was not included in our previous publication [9]

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Summary

Introduction

Strongyloidiasis is prevalent in Southeast Asian regions along with other soil-transmitted helminthiases, but only limited present-day data was available for Myanmar. Strongyloides stercoralis has been described as one of the most neglected soil-transmitted helminths (STHs) among the neglected tropical diseases (NTDs) [1]. Infection is acquired via contaminated soil, similar to major STHs, namely Ascaris lumbricoides, Necator americanus, Ancylostoma duodenale, and Trichuris trichiura, epidemiological information on S. stercoralis infection is scarce [2]. The primary route of infection of S. stercorailis is transdermal (infective larvae penetrate the skin), similar to hookworms (N. americanus, A. duodenale), but Strongyloidiasis has a cosmopolitan distribution. It was estimated that at least 370 million are infected worldwide [3]. It affects 10–40% of the population in many tropical and subtropical countries [4]. In resource-poor countries with ecological and socioeconomic settings conducive to the spread of S. stercoralis, infection rates can be high, up to 60% [4]

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