Abstract
BackgroundThe threadworm Strongyloides stercoralis, the most neglected helminth, affects an estimated 30-100 million people worldwide. Information on S. stercoralis infection is scarce in tropical and sub-tropical resource poor countries, including Cambodia. We determined S. stercoralis infection prevalence and risk factors for infection in the general population in Southern Cambodia.MethodsA cross-sectional study was carried out between January and April 2011 among 2,861 participants living in 60 villages of Takeo province, using Koga-agar plate culture, the Baermann technique and the Kato-Katz technique on a single stool sample.ResultsEight intestinal helminth species were diagnosed. Hookworm (31.4%) and S. stercoralis (21.0%) occurred most frequently. Prevalence of S. stercoralis infection increased with age. In all age groups a higher prevalence was found among males than among females (OR: 1.7; 95% CI: 1.4 – 2.0; P < 0.001). Participants who had a latrine at home were significantly less frequently infected with S. stercoralis than those who did not (OR: 0.7; 95% CI: 0.4 – 0.8; P = 0.003). Muscle pain (OR: 1.3; 95% CI: 1.0 – 1.6; P = 0.028) and urticaria (OR: 1.4; 95% CI: 1.1 – 1.8; P = 0.001) were significantly associated with S. stercoralis infection.ConclusionsS. stercoralis is highly prevalent among the general Cambodian population and should no longer be neglected. Access to adequate diagnosis and treatment is urgently needed.
Highlights
The threadworm Strongyloides stercoralis, the most neglected helminth, affects an estimated 30-100 million people worldwide
Of 601 S. stercoralis cases, 46.9% were co-infected with hookworms
Our study found the sensitivity of Koga-agar plate (KAP) culture to be higher than that of the Baermann method, contrary to previous reports from south-central Côte d’Ivoire [33], Zanzibar [34], Uganda [35] and China [14]
Summary
The threadworm Strongyloides stercoralis, the most neglected helminth, affects an estimated 30-100 million people worldwide. Information on S. stercoralis infection is scarce in tropical and sub-tropical resource poor countries, including Cambodia. We determined S. stercoralis infection prevalence and risk factors for infection in the general population in Southern Cambodia. Strongyloides stercoralis, a soil-transmitted nematode, is arguably the most neglected tropical disease [1], yet an estimated 30 – 100 million people are infected worldwide [2]. In resource poor countries, environmental conditions and poor hygiene behaviour favour transmission. For Cambodia, only a few reports are available, giving prevalences ranging from 2.6% to 24.4% [6,7,8,9,10].
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