Strongyloides stercoralis, Eosinophilia, and Type 2 Diabetes Mellitus: The Predictive Value of Eosinophilia in the Diagnosis of S stercoralis Infection in an Endemic Community

Hays, Russell; Thompson, Fintan; Esterman, Adrian; McDermott, Robyn

doi:10.1093/ofid/ofw029

Cited by 17 publications

(14 citation statements)

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“…5 These findings suggest that in contrast to previous studies, the FNQ region has a low prevalence of strongyloidiasis; however, the possibility of S. stercoralis being endemic to remote areas cannot be ruled out given the small sample size obtained. This corroborates the now substantial evidence discouraging the use of a raised eosinophil count as a screening tool for S. stercoralis and should serve as a reminder to clinicians that serology should be performed if strongyloidiasis is suspected.…”

Section: Paltridge Et Alcontrasting

confidence: 86%

“…1 Strongyloidiasis is of particular concern to immunosuppressed patients, in which the parasite can proliferate rapidly (hyperinfection syndrome), with a mortality of 70%-100%. 5 These findings suggest that in contrast to previous studies, the FNQ region has a low prevalence of strongyloidiasis; however, the possibility of S. stercoralis being endemic to remote areas cannot be ruled out given the small sample size obtained. 2 In a 2015 reported case from New York, a Haitian woman died and her foetus was stillborn.…”

contrasting

confidence: 86%

“…This corroborates the now substantial evidence discouraging the use of a raised eosinophil count as a screening tool for S. stercoralis and should serve as a reminder to clinicians that serology should be performed if strongyloidiasis is suspected. 5 These findings suggest that in contrast to previous studies, the FNQ region has a low prevalence of strongyloidiasis; however, the possibility of S. stercoralis being endemic to remote areas cannot be ruled out given the small sample size obtained. Our findings highlight the significant heterogeneity to prevalence data of S. stercoralis across Australia and reinforce the need for further research in possible endemic locations.…”

contrasting

confidence: 86%

“…5 Without reliable, up-to-date prevalence studies clinicians are unable to appropriately screen and treat at-risk patients. Little is known about the current burden of strongyloidiasis, as studies typically show inconsistent prevalence data from single towns, which due to their unique socioeconomic circumstances cannot be generalized to the whole region.…”

Section: Introductionmentioning

confidence: 99%

“…Two studies in rural Queensland found prevalences of 4% and 12%, respectively, 3,4 while a study in the Kimberley found 36%. 5 Without reliable, up-to-date prevalence studies clinicians are unable to appropriately screen and treat at-risk patients.…”

Section: Introductionmentioning

confidence: 99%

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Low prevalence of strongyloidiasis in Far North Queensland pregnant women

Paltridge

Traves

Costa

et al. 2019

Australian J Rural Health

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INTRODUCTIONStrongyloidiasis is a neglected tropical disease caused by the parasite Strongyloides stercoralis that remains consistently under-researched despite an estimated worldwide prevalence of 370 million people. 1 Strongyloidiasis is of particular concern to immunosuppressed patients, in which the parasite can proliferate rapidly (hyperinfection syndrome), with a mortality of 70%-100%. 1 Pregnant women are potentially at risk of hyperinfection syndrome, due to the combined effects of immunosuppression during pregnancy and the prescription of corticosteroids, which are routinely administered if a preterm birth is suspected. 2 In a 2015 reported case from New York, a Haitian woman died and her foetus was stillborn. 2 Moreover, the offspring of chronically infected mothers are at risk of low birthweight.Cairns is the largest city in tropical Far North Queensland (FNQ), in a region in which strongyloidiasis is suspected to be hyper-endemic. Little is known about the current burden of strongyloidiasis, as studies typically show inconsistent prevalence data from single towns, which due to their unique socioeconomic circumstances cannot be generalized to the whole region. Two studies in rural Queensland found prevalences of 4% and 12%, respectively, 3,4 while a study in the Kimberley found 36%. 5 Without reliable, up-to-date prevalence studies clinicians are unable to appropriately screen and treat at-risk patients.We performed a prospective cohort study examining the prevalence and clinical burden of strongyloidiasis in pregnant women in FNQ. From January to July 2018, all women able to provide informed consent were invited to participate at antenatal clinics at Cairns Hospital, irrespective of age, ethnicity or medical co-morbidities. Consented women had S. stercoralis serology added to their routine prenatal blood tests and were then followed until the end of their pregnancy. Cairns Hospital is the main health service performing deliveries for FNQ including the Torres Strait, making this site a suitable location to collect an accurate sample and accurately describe Strongyloides' prevalence. The study received ethical approval from the FNQ Human Research Ethics Committee (Reference Number HREC/17/QCH/25-1125).Eighty-seven women were approached for involvement with one woman declining, leaving 86 women who consented for involvement in this study (Table 1). Compliance with the testing protocol was challenging: amongst the 86 consented participants, only 60 then went on to complete testing for S. stercoralis. In contrast to our hypothesis, a very low prevalence rate of 3.3% (two patients, 95% CI, 0.8%-12.5%) was recorded amongst the cohort. Both were Aboriginal or Torres Strait Island Australians and one had type two diabetes mellitus, one from the greater Cairns region and one from a remote community. No child complications were observed, and the seropositive participants were treated. | 439 PALTRIDGE ET AL.Neither of the two participants who were positive for S. stercoralis had eosinophilia. This corroborates th...

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Section: Paltridge Et Alcontrasting

confidence: 86%

contrasting

confidence: 86%

contrasting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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