Asymptomatic Strongyloidiasis among Latin American Migrants in Spain: A Community-Based Approach

Abstract

Strongyloides stercoralis infection is frequently underdiagnosed since many infections remain asymptomatic. Aim: To estimate the prevalence and characteristics of asymptomatic S. stercoralis infection in Latin American migrants attending a community-based screening program for Chagas disease in Spain. Methodology: Three community-based Chagas disease screening campaigns were performed in Alicante (Spain) in 2016, 2017, and 2018. Serological testing for S. stercoralis infection was performed using a non-automatized IVD-ELISA detecting IgG (DRG Instruments GmbH, Marburg, Germany). Results: Of the 616 migrants from Central and South America who were screened, 601 were included in the study: 100 children and adolescents (<18 years of age) and 501 adults. Among the younger group, 6 participants tested positive (prevalence 6%, 95% confidence interval [CI] 2.5% to 13.1%), while 60 adults did so (prevalence 12%, 95% CI 9.3% to 15.3%). S. stercoralis infection was more common in men than in women (odds ratio adjusted [ORa] 2.28, 95% CI 1.289 to 4.03) and in those from Bolivia (ORa 2.03, 95% CI 1.15 to 3.59). Prevalence increased with age (ORa 1.02, 95% CI 0.99 to 1.05). In contrast, a university education had a protective effect (ORa 0.29, 95% CI 0.31 to 0.88). Forty-one (41/66; 62.1%) of the total cases of S. stercoralis infection were treated at the health care center. Positive stool samples were observed in 19.5% of the followed-up positive cases. Conclusion: Incorporating serological screening for S. stercoralis into community-based screening for Chagas disease is a useful intervention to detect asymptomatic S. stercoralis infection in Central and South American migrants and an opportunity to tackle neglected tropical diseases in a transversal way. The remaining challenge is to achieve patients’ adherence to the medical follow-up.

COVID-19 epidemic in the US—A gateway to screen for tuberculosis, HIV, viral hepatitides, Chagas disease, and other neglected tropical diseases among Hispanics

“…It is important to recognize health inequalities and barriers that migrants and other minority groups have to face to access the US healthcare systems and, subsequently, to be screened and treated. Several experts have pointed out the efficacy of transversal and community-based interventions to deal with NTDs and other diseases [ 22 , 23 ]. It is crucial to adapt the interventions to each collective enhancing the role of primary healthcare settings to overcome those barriers.…”

Community-based screening of Chagas disease among Latin American migrants in a non-endemic country: an observational study

“…This study is part of a larger research project, entitled "Diagnosis, treatment and follow-up of parasitic diseases (Chagas disease and strongyloidiasis) in the province of Alicante”. The results of the three community-based screening campaigns for strongyloidiasis have recently been reported [ 21 ].…”

Gastric Parasitic Infection: Thinking outside the Box

“…Usage and distribution for commercial purposes requires written permission. was a Dominican Republic native, and a recent study demonstrated a prevalence of 12% in Latin American migrants [7]. Second, in Silva et al [5], the patient, who was immunocompetent, had a suspicious gastric ulcer with upper gastrointestinal bleeding.…”

“…First, the case presented by Silva et al [5] seems to have an autochthonous origin, something that is now infrequent in the Iberian Peninsula. In contrast, the patient described by Alcázar et al [6]was a Dominican Republic native, and a recent study demonstrated a prevalence of 12% in Latin American migrants [7]. Second, in Silva et al [5], the patient, who was immunocompetent, had a suspicious gastric ulcer with upper gastrointestinal bleeding.…”