Prevalence and risk factors of acquiringStrongyloides stercoralisinfection among patients attending a tertiary hospital in Thailand

Abstract

Objectives: We aimed to determine the prevalence and risk factors for Strongyloides stercoralis infection in adult patients attending Siriraj Hospital, a tertiary hospital in Thailand. Methods: A case-control study was carried out between July 2008 and April 2010. Case and control were identified from 6022 patients for whom results of faecal examination were available. A case was a patient who had S. stercoralis larva detected from faecal examination. Control was randomly selected from patients without S. stercoralis larvae detected in three consecutive faecal examinations. The proportion of control to case was 2 : 1. Demographic and clinical data for the day of diagnosis and retrospectively up to 15 days preceding the date of faecal examination were reviewed from their medical records. Results: Overall, 149 (2.47%) patients had S. stercoralis larvae positive. There were 105 males (70.5%), with the mean (SD) age of 53.9 (17.2) years. A total of 300 controls were selected. Male gender (odds ratio (OR) 5 2.79, 95% confidence interval (CI) 1.78-4.27)), human immunodeficiency virus (HIV) infection (OR 5 3.23, 95% CI 1.43-7.29), and eosinophilia (OR 5 1.81, 95% CI 1.33-2.47) were found to be independent risk factors associated with S. stercoralis infection in this setting. Corticosteroid or other immunosuppressive treatment, and other concomitant illnesses were not associated with increased risk of S. stercoralis infection. Conclusion: In this setting, strongyloidiasis was seen more often in male patients with eosinophilia and with HIV infection. Prevention of fatal complication caused by S. stercoralis by regular faecal examination, or serology for early detection and treatment of undiagnosed S. stercoralis infection, is warranted in these high-risk patients.

Strongyloides stercoralis infection in human immunodeficiency virus‐infected patients and related risk factors: A systematic review and meta‐analysis

“…Hyperinfection occurs mostly in patients with an impaired cell mediated immune system (Grove, ; Huis, Sun, Hung, & Colebunders, ; Keiser & Nutman, ). Human immunodeficiency virus (HIV) infection, Human T‐cell leucemia virus type 1 (HTLV‐1) infection, alcoholism, low socioeconomic status, white race, male gender, corticosteroid therapy, hematologic malignancy and malnutrition have been reported as risk factors for strongyloidiasis (Davidson, Fletcher, & Chapman, ; Jongwutiwes, Waywa, Silpasakorn, Wanachiwanawin, & Suputtamongkol, ; Keiser & Nutman, ; Schär et al, ; Walzer et al, ).…”

The investigation of <i>Strongyloides stercoralis</i> seroprevalence in immunosupressed patients in Turkey

“…Jongwutiwes et al reported a case-control study for determining the prevalence and risk factors of S. stercoralis infection. They found that strongyloidiasis was seen more often in male patients with eosinophilia and with HIV infection (9). Despite the fact that prevalence rates of infection are higher in the individuals with HIV, some researchers report that hyperinfection syndrome is rarely seen in advanced HIV disease because of increased Th2 response which may protect against severe forms of strongyloidiasis (16)(17)(18)(19).…”

The Storm of Strongyloides stercoralis in Stool

“…The estimated prevalence of strongyloidiasis in India has been found to be 6.6% and 11.2% in community and hospital based surveys respectively [1]. Several studies have shown an increase in incidence of infection with Strongyloides stercoralis in HIV infected population but only a handful of cases with severe manifestations have been noted in these individuals [6,7]. This is largely because, there is loss of Th1 activity in HIV infection but Th2 activity is well preserved which provides protection against development of severe manifestations [8].…”