Strongyloidiasis-Related Deaths in the United States, 1991–2006

Abstract

Abstract. The objective of this study was to 1) assess the incidence of strongyloidiasis in the United States, 2) evaluate demographic and regional associations, and 3) identify comorbid conditions as risk factors for death. A population-based case-control study was performed by using mortality data during 1991-2006. We identified 347 strongyloidiasis deaths (0.79 per 10 million deaths, 14-29 deaths per year), which decreased slightly over time. Deaths occurred primarily among older (median age = 66.0 years), white (57.6%) and Hispanic (22.2%) men (69.2%), residing in the Southeastern United States (49.3%). Associated health conditions included chronic obstructive pulmonary disease (28.7%, odds ratio [OR] = 4.0, 95% confidence interval [CI] = 3.0-5.4) and infection with human immunodeficiency virus (12.5%, OR = 4.6, 95% CI = 2.7-7.9). Strongyloidiasis deaths in the second half of the study period (1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006) were less likely to be associated with chronic obstructive pulmonary disease (19.4%, OR = 1.2, 95% CI = 0.7-1.9), but continued to be associated with human immunodeficiency virus infection (12.9%, OR = 2.8, 95% CI = 1.3-6.0). Early detection and treatment of at-risk patients with latent strongyloidiasis infections is needed to reduce strongyloidiasis mortality.

Extracellular traps are associated with human and mouse neutrophil and macrophage mediated killing of larval Strongyloides stercoralis

“…Strongyloides stercoralis , a parasitic nematode of humans, primates and canines, infects an estimated 60–100 million people worldwide [21,22]. The protective innate and adaptive immune response to this parasite has been studied in mice [23].…”

Prevalence of Strongyloides stercoralis Antibodies among a Rural Appalachian Population—Kentucky, 2013

“…8 S. stercoralis infection occurs through exposure to stoolcontaminated soil by either ingesting or skin contact with soil containing larvae. Risk for transmission increases if infected persons use outdoor toilets, which may have inadequate sewage disposal and fecal management, thus transmitting infection to others through exposure to contaminated soil during work or play.…”

Advocating for both Environmental and Clinical Approaches to Control Human Strongyloidiasis

“…The complicated S. stercoralis life-cycle, insensitivity of detection methods and social factors challenge strongyloidiasis identification, diagnosis and treatment [3,13]. If not diagnosed in time it can lead to fatal outcomes [1,14], and given that we see high disease rates in population sub-groups, strongyloidiasis is not only a personal but a public health issue [2,15]. …”