<i>Strongyloides stercoralis</i>: a field-based survey of mothers and their preschool children using ELISA, Baermann and Koga plate methods reveals low endemicity in western Uganda

Stothard, J. Russell; Pleasant, Joyce; Oguttu, David; Adriko, Moses; Galimaka, R.; Ruggiana, Andrew; Kazibwe, Francis; Kabatereine, Narcis B.

doi:10.1017/s0022149x08971996

Cited by 32 publications

(29 citation statements)

References 34 publications

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“…Our study found that KAP culture was more sensitive than the Baermann method, which is consistent with reports from Cambodia [16], [35], rural Côte d′Ivoire [41], Brazil [42] and Honduras [43]. However, the opposite was observed in studies in south-central Côte d′Ivoire [44], Zanzibar [40], China [39] and Uganda [45]. This seems to indicate that neither method is superior.…”

Section: Discussionsupporting

confidence: 90%

High Prevalence and Spatial Distribution of Strongyloides stercoralis in Rural Cambodia

et al. 2014

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BackgroundThe threadworm, Strongyloides stercoralis, endemic in tropical and temperate climates, is a neglected tropical disease. Its diagnosis requires specific methods, and accurate information on its geographic distribution and global burden are lacking. We predicted prevalence, using Bayesian geostatistical modeling, and determined risk factors in northern Cambodia.MethodsFrom February to June 2010, we performed a cross-sectional study among 2,396 participants from 60 villages in Preah Vihear Province, northern Cambodia. Two stool specimens per participant were examined using Koga agar plate culture and the Baermann method for detecting S. stercoralis infection. Environmental data was linked to parasitological and questionnaire data by location. Bayesian mixed logistic models were used to explore the spatial correlation of S. stercoralis infection risk. Bayesian Kriging was employed to predict risk at non-surveyed locations.Principal FindingsOf the 2,396 participants, 44.7% were infected with S. stercoralis. Of 1,071 strongyloidiasis cases, 339 (31.6%) were among schoolchildren and 425 (39.7%) were found in individuals under 16 years. The incidence of S. stercoralis infection statistically increased with age. Infection among male participants was significantly higher than among females (OR: 1.7; 95% CI: 1.4–2.0; P<0.001). Participants who defecated in latrines were infected significantly less than those who did not (OR: 0.6; 95% CI: 0.4–0.8; P = 0.001). Strongyloidiasis cases would be reduced by 39% if all participants defecated in latrines. Incidence of S. stercoralis infections did not show a strong tendency toward spatial clustering in this province. The risk of infection significantly decreased with increasing rainfall and soil organic carbon content, and increased in areas with rice fields.Conclusions/SignificancePrevalence of S. stercoralis in rural Cambodia is very high and school-aged children and adults over 45 years were the most at risk for infection. Lack of access to adequate treatment for chronic uncomplicated strongyloidiasis is an urgent issue in Cambodia. We would expect to see similar prevalence rates elsewhere in Southeast Asia and other tropical resource poor countries.

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Section: Discussionsupporting

confidence: 90%

High Prevalence and Spatial Distribution of Strongyloides stercoralis in Rural Cambodia

et al. 2014

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“…Our study found the sensitivity of 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]. However, our findings are consistent with those reported in studies conducted in Cambodia [6], Brazil [16], rural Côte d’Ivoire [15] and Honduras [36].…”

Section: Discussioncontrasting

confidence: 56%

Prevalence and risk factors of Strongyloides stercoralis in Takeo Province, Cambodia

et al. 2014

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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.

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“…Other studies conducted in Uganda have found similar prevalences of hookworm infection (24 to 52%),[35–39] and Strongyloides (4 to 8%) [40–42] in adults with and without HIV. In persons with HIV in Nigeria, Senegal, and Ethiopia, Giardia prevalence has been observed at approximately 5%.…”

Section: Discussionmentioning

confidence: 60%

Hookworm infection is associated with decreased CD4+ T cell counts in HIV-infected adult Ugandans

et al. 2017

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Most studies evaluating epidemiologic relationships between helminths and HIV have been conducted in the pre-ART era, and evidence of the impact of helminth infections on HIV disease progression remains conflicting. Less is known about helminth infection and clinical outcomes in HIV-infected adults receiving antiretroviral therapy (ART). We sampled HIV-infected adults for eight gastrointestinal parasites and correlated parasitic infection with demographic predictors, and clinical and immunologic outcomes. Contrasting with previous studies, we measured parasitic infection with a quantitative, highly sensitive and specific polymerase chain reaction (PCR) method. This cohort study enrolled HIV-infected Ugandans from August-September 2013 in Mbale, Uganda and collected stool and blood samples at enrollment. Real-time PCR quantified stool: Ascaris lumbricoides, Ancylostoma duodenale, Necator americanus, Strongyloides stercoralis, Trichuris trichiura, Cryptosporidium spp., Entamoeba histolytica, and Giardia intestinalis infection. Generalized linear models assessed relationships between parasitic infection and clinical or demographic data. 35% of participants (71/202) tested positive for ≥1 helminth, mainly N. americanus (55/199, 28%), and 4.5% (9/202) were infected with ≥2 stool parasites. Participants with hookworm infection had lower average CD4+ cell counts (-94 cells/mcL, 95%CI: -141, -48 cells/mcL; p<0.001) after adjustment for sex, CD4+ nadir at clinic entry, and time on ART. The high prevalence of parasitic infection and correlation with decreased CD4+ concentrations highlight the need to re-examine the effects of invasive helminth co-infection in rural, HIV-infected populations in the era of widely available ART. Elucidating the relationship between hookworm infection and immune recovery could provide opportunities for health optimization, e.g. integrated deworming, in these vulnerable populations.

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Strongyloides stercoralis: a field-based survey of mothers and their preschool children using ELISA, Baermann and Koga plate methods reveals low endemicity in western Uganda

Cited by 32 publications

References 34 publications

High Prevalence and Spatial Distribution of Strongyloides stercoralis in Rural Cambodia

High Prevalence and Spatial Distribution of Strongyloides stercoralis in Rural Cambodia

Prevalence and risk factors of Strongyloides stercoralis in Takeo Province, Cambodia

Hookworm infection is associated with decreased CD4+ T cell counts in HIV-infected adult Ugandans

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