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Abstract
BackgroundStrongyloidiasis is a health problem in Vietnam, but appropriate information is still limited. The aim of this study was to determine the prevalence, geographical distribution, epidemiological aspects, symptoms and other health indicators of Strongyloides stercoralis infections in patients from 27 provinces of northern Vietnam attending the Hanoi Medical University Hospital during 2016 and 2017.MethodsBlood samples of 2000 patients were analyzed for S. stercoralis infection with an IgG ELISA test. Seroprevalence was analyzed by gender, age group, locality of origin (rural or urban areas) and symptoms. Stools from the seropositive patients were examined for the detection of worms which were subsequently used for species identification by morphology and rDNA ITS1 sequencing.ResultsA seroprevalence of 20% was detected, showing an increasing prevalence from young to older age groups but without significant gender difference. Seroprevalence was higher in rural areas than in urban areas, both in general and individually in all provinces without exception, and lower in the mountainous areas than in the large valley lowlands. The follow-up of the 400 patients showed eosinophilia in 100% of cases, diarrhoea in 64.5%, digestion difficulties in 58.0%, stomachache in 45.5%, stomach and duodenal ulcers in 44.5%, itching in 28.0% and fever in 9.5%. The prevalence of symptoms and signs were also higher in older age groups than in younger age groups. Worms were detected in stools of 10.5% of the patients. Sequencing of a 501-bp nuclear ribosomal DNA ITS1 fragment allowed for the verification of infection by Strongyloides stercoralis.ConclusionsTo our knowledge, this study is the largest survey of human strongyloidiasis in Vietnam so far and the first molecular identification of this nematode species in this country. Long-term chronicity may probably be usual in infected subjects, mainly in the older age groups.
Highlights
Strongyloidiasis is a health problem in Vietnam, but appropriate information is still limited
Epidemiological aspects From 2000 adult patients comprising 1022 females and 978 males who visited Hanoi Medical University Hospital, a total of 400 patients tested positive by the enzyme-linked immunosorbent assay (ELISA) test of S. stercoralis antigen, furnishing a seroprevalence of S. stercoralis of 20%
Strongyloides stercoralis infection showed to be higher in rural areas than in urban areas (311/1390 = 22.37% and 89/610 = 14.59%; P < 0.05), both in general and individually in all provinces without exception (Table 2)
Summary
Strongyloidiasis is a health problem in Vietnam, but appropriate information is still limited. Strongyloidiasis is a helminthic disease included among the group of soil-transmitted diseases (STDs), still not included within the neglected tropical diseases list (NTDs) [1] It is caused by small-sized, soil-transmitted nematodes whose females and larval stages infect humans, dogs and cats [2,3,4]. Right upper abdominal pain, diarrhoea, irregular fever and cough. These symptoms become aggravated in autoinfection including mucous, bloody diarrhoea, anaemia, edema and ascites [7]
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