Strongyloides stercoralis en un hospital comarcal del Levante español: una enfermedad no solo importada

Pacheco-Tenza, María Isabel; Ruiz-Maciá, J.A.; Navarro-Cots, María; Gregori-Colomé, Joan; Cepeda-Rodrigo, José María; Llenas-García, Jara

doi:10.1016/j.eimc.2016.08.007

Cited by 10 publications

(8 citation statements)

References 14 publications

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“…An overall higher incidence rate in male gender is described, which is consistent with previous studies [15, 17, 21, 27]. This might be explained due to a gender biased; since some articles focus on screening high risk population (farmers or smokers with COPD), traditionally associated with gender roles.…”

Section: Discussionsupporting

confidence: 88%

Strongyloides stercoralis infection: A systematic review of endemic cases in Spain

et al. 2019

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BackgroundStrongyloides stercoralis infection, a neglected tropical disease, is widely distributed. Autochthonous cases have been described in Spain, probably infected long time ago. In recent years the number of diagnosed cases has increased due to the growing number of immigrants, travelers and refugees, but endemically acquired cases in Spain remains undetermined.MethodologyWe systematically searched the literature for references on endemic strongyloidiasis cases in Spain. The articles were required to describe Strongyloides stercoralis infection in at least one Spanish-born person without a history of travel to endemic areas and be published before 31st May 2018. Epidemiological data from patients was collected and described individually as well as risk factors to acquisition of the infection, diagnostic technique that lead to the diagnosis, presence of eosinophilia and clinical symptoms at diagnosis.FindingsThirty-six studies were included, describing a total of 1083 patients with an average age of 68.3 years diagnosed with endemic strongyloidiasis in Spain. The vast majority of the cases were described in the province of Valencia (n = 1049). Two hundred and eight of the 251 (82.9%) patients in whom gender was reported were male, and most of them had current or past dedication to agriculture. Seventy percent had some kind of comorbidity. A decreasing trend in the diagnosed cases per year is observed from the end of last decade. However, there are still nefigw diagnoses of autochthonous cases of strongyloidiasis in Spain every year.ConclusionsWith the data provided by this review it is likely that in Spain strongyloidiasis might have been underestimated. It is highly probable that the infection remains undiagnosed in many cases due to low clinical suspicion among Spanish population without recent travel history in which the contagion probably took place decades ago.

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Section: Discussionsupporting

confidence: 88%

Strongyloides stercoralis infection: A systematic review of endemic cases in Spain

et al. 2019

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“…Agricultural activities, whether for work or for leisure, were also associated with autochthonous cases. The sociodemographic characteristics of our autochthonous patients are similar to those described in previous studies in the Valencian region [ 13 , 20 ]. Moreover, a recent systematic review of autochthonous cases [ 21 ] of strongyloidiasis in Spain also reports a high percentage of men (82.9%), agricultural occupations, and a mean age of 68.3 years.…”

Section: Discussionsupporting

confidence: 74%

“…Vega Baja del Segura is a region located in southern Alicante, near the border with Murcia, where some isolated cases have been reported [ 19 ]. In a previous study, our group retrospectively reviewed the cases of autochthonous strongyloidiasis at the Vega Baja Hospital in Orihuela between January 1999 and March 2016, finding 10 autochthonous cases in that period [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Strongyloidiasis in Southern Alicante (Spain): Comparative Retrospective Study of Autochthonous and Imported Cases

et al. 2020

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Background: Strongyloidiasis is a parasitic disease with global prevalence. In Spain, autochthonous cases are concentrated in the Mediterranean basin. We aimed to analyze clinical and epidemiological characteristics of Strongyloides stercoralis infection in Vega Baja del Segura (Spain), comparing autochthonous versus imported cases. Methods: Observational retrospective study of all strongyloidiasis cases from January 2009 to January 2019. Cases were diagnosed by stool larvae visualization, positive culture, PCR, Strongyloides serology, and/or compatible histology. Results: We included 36 patients (21 men) with a mean age of 60.8 years ±17.6; 15 cases were autochthonous and 21 imported 80.9% from Latin America. Autochthonous cases were associated with older age (mean 71.3 vs. 53.3 years; p = 0.002), male sex (odds ratio (OR) 5.33; 95% confidence interval (CI) 1.15–24.68; p = 0.041), and agricultural activity (OR 13.5; 95% CI 2.4–73.7; p = 0.002). Fourteen were asymptomatic, three autochthonous cases presented with hyperinfection syndrome, and two patients died. There was no difference between autochthonous versus imported origin in eosinophilia at diagnosis (93.3% vs. 75%; p = 0.207), treatment received, or clinical response (85.7% vs. 88.9% cured; p = 1). Conclusion: In our region, imported strongyloidiasis coexists with autochthonous cases, which are mainly in older male farmers who are diagnosed at more advanced stages. Systematic screening programs are needed.

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“…Strongyloides stercoralis is an intestinal nematode that infects an estimated 30–100 million people worldwide [ 1 ]. It generally occurs in tropical and subtropical countries, but it might also be present in areas with temperate climate and moist soils [ 2 ], hence it has been reported in some areas of Spain [ 3 , 4 , 5 ]. However, strongyloidiasis is now increasingly emerging due to migration flows from high endemic areas and is a main risk factor for S. stercoralis infection [ 1 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical Features Associated with Strongyloidiasis in Migrants and the Potential Impact of Immunosuppression: A Case Control Study

Martínez-Pérez¹,

Soriano-Pérez²,

Salvador³

et al. 2020

Pathogens

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Strongyloides stercoralis is a widely distributed nematode more frequent in tropical areas and particularly severe in immunosuppressed patients. The aim of this study was to determine factors associated with strongyloidiasis in migrants living in a non-endemic area and to assess the response to treatment and follow-up in those diagnosed with the infection. We performed a multicenter case-control study with 158 cases and 294 controls matched 1:2 by a department service. Participants were recruited simultaneously at six hospitals or clinics in Spain. A paired-match analysis was then performed looking for associations and odds ratios in sociodemographic characteristics, pathological background, clinical presentation and analytical details. Cases outcomes after a six-month follow-up visit were also registered and their particularities described. Most cases and controls came from Latin America (63%–47%) or sub-Saharan Africa (26%–35%). The number of years residing in Spain (9.9 vs. 9.8, p = 0.9) and immunosuppression status (30% vs. 36.3%, p = 0.2) were also similar in both groups. Clinical symptoms such as diffuse abdominal pain (21% vs. 13%, p = 0.02), and epigastralgia (29% vs. 18%, p < 0.001); along with a higher eosinophil count (483 vs. 224 cells/mL in cases and controls, p < 0.001) and the mean total Immunoglobulin E (IgE) (354 U/L vs. 157.9 U/L; p < 0.001) were associated with having strongyloidiasis. Finally, 98.2% percent of the cases were treated with ivermectin in different schedules, and 94.5% met the cure criteria at least six months after their first consultation. Abdominal pain, epigastralgia, eosinophilia, increased levels of IgE and Latin American origin remain the main features associated with S. stercoralis infection, although this association is less evident in immunosuppressed patients. The appropriate follow-up time to evaluate treatment response based on serology titers should be extended beyond 6 months if the cure criteria are not achieved.

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Strongyloides stercoralis en un hospital comarcal del Levante español: una enfermedad no solo importada

Cited by 10 publications

References 14 publications

Strongyloides stercoralis infection: A systematic review of endemic cases in Spain

Strongyloides stercoralis infection: A systematic review of endemic cases in Spain

Strongyloidiasis in Southern Alicante (Spain): Comparative Retrospective Study of Autochthonous and Imported Cases

Clinical Features Associated with Strongyloidiasis in Migrants and the Potential Impact of Immunosuppression: A Case Control Study

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