The Health Effects of Strongyloidiasis on Pregnant Women and Children: A Systematic Literature Review

Abstract

Strongyloidiasis is a helminth infection that remains under-researched despite its ability to cause significant illness. Women and children may be at particular risk of health consequences from this parasite. This systematic literature review aims to examine research on the long-term health effects that strongyloidiasis has in pregnant women and children. We conducted a structured search using multiple databases to collect all primary studies discussing health effects of strongyloidiasis in the aforementioned groups. The review included 20 results: 16 primary studies and four case reports. The methodological quality of studies was substandard, and there was substantial heterogeneity to the statistical analysis and outcomes assessed in the literature. Statistically significant associations were found between strongyloidiasis and low birth weight, as well as wasting. No links were found between strongyloidiasis and anaemia. Due to testing methods used in the studies, the prevalence of Strongyloides stercoralis in these studies was probably under-estimated. Current research is suggestive that strongyloidiasis has long-term adverse health effects on the offspring of infected mothers and in chronically-infected children. Data analysis was hindered by both methodological and statistical flaws, and as such, reliable conclusions regarding the health impacts could not be formed.

Strongyloidiasis in northern Vietnam: epidemiology, clinical characteristics and molecular diagnosis of the causal agent

“…Clinical complications in organs other than the duodenum have also been described [8–10]. The health effects of strongyloidiasis on pregnant women should also be considered [11]. Autoinfection of the patients may lead to highly problematic, severe hyperinfections which are almost invariably fatal [12–18].…”

A Review on Strongyloidiasis in Pregnant Women

“…16 , 17 A recent systematic review found a mean prevalence of 12.3%, with a median of 6% and higher prevalence in rural areas. 18 Regional variation, pregnancy trimester, and diagnostic methods used may explain most of this variability. Also, the Venezuelan study excluded malnourished pregnant women.…”

“… 40 However, of five studies that searched for an association between Strongyloides and maternal anemia, only one found helminth infections to be a predictor of maternal anemia, but helminths were considered as a whole and no differential effect of Strongyloides could be found. 18 …”

“…Some reports have addressed the long-term impact on height and weight of Strongyloides infection in children, 18 , 41 showing decreased, although not always statistically significant, weight for height or weight for age Z -scores. However, from these reports it can be interpreted that malnutrition is a driving force behind the findings, but it cannot be concluded whether Strongyloides drives malnutrition or malnutrition facilitates Strongyloides infestation.…”

Control of Communicable Diseases in Human and in Animal Populations: 70th Anniversary of the Year of the Birth of Professor Rick Speare (2 August 1947–5 June 2016)

“…Different aspects of diagnosis of strongyloidiasis in hyperendemic regions in northern Australia are presented by Robertson et al [2]. Another review paper on strongyloidiasis focuses on the disease during pregnancy [3]. The authors describe the effects of strongyloidiasis, such as low birth weight and anemia, in children and pregnant women.…”