Epidemiology of Strongyloides stercoralis infection in Bolivian patients at high risk of complications.
Journal
PLoS neglected tropical diseases
ISSN: 1935-2735
Titre abrégé: PLoS Negl Trop Dis
Pays: United States
ID NLM: 101291488
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
received:
31
07
2018
accepted:
26
11
2018
revised:
30
01
2019
pubmed:
18
1
2019
medline:
12
2
2019
entrez:
18
1
2019
Statut:
epublish
Résumé
Strongyloidiasis can be fatal in immunocompromised patients, but few epidemiological studies investigated the burden of this neglected tropical disease among these populations, particularly in low- and middle-income countries such as Bolivia. This study aimed to fill in this gap by estimating prevalence rate and risk factors associated with strongyloidiasis among patients at high risk of complications. A cross-sectional study was carried out in Santa Cruz (elevation 400 meters, tropical climate) and Cochabamba (elevation 2,500 meters, temperate climate), among patients with cancer, HIV infection and rheumatic or hematologic disease, using four coproparasitological techniques and one serological (ELISA) test. In total, 1,151 patients participated in this study, including individuals who were HIV-positive (30%) or with rheumatic (29%), oncologic (32%) or hematologic (9%) diseases. The serological and coproparasitological prevalence was 23.0% (95% confidence interval [CI], 20.7-25.5; n = 265/1151) and 7.6% (95% CI, 6.2-9.3; n = 88/1151), respectively, with an estimated actual prevalence of 20.2% (95% CI, 17.9-22.5). Positive serology and positive coproparasitology were associated with younger age and lower education levels. There was no significant difference in prevalence between Cochabamba and Santa Cruz as defined by coproparasitology (6.4% vs. 8.9%; p = 0.11) or serology (24.0% vs. 22.0%; p = 0.4). Among 64 patients in Cochabamba who had never travelled to the tropical lowlands, 5 (7.8%) had a positive coproparasitology. Strongyloidiasis is widely prevalent in Bolivia among vulnerable patients at increased risk of life-threatening complications. Transmission of the parasite occurs both in tropical lowlands and temperate elevation (≥ 2,500 m). Control strategies to prevent transmission and complications of this serious parasitic disease should be urgently reinforced.
Sections du résumé
BACKGROUND
Strongyloidiasis can be fatal in immunocompromised patients, but few epidemiological studies investigated the burden of this neglected tropical disease among these populations, particularly in low- and middle-income countries such as Bolivia. This study aimed to fill in this gap by estimating prevalence rate and risk factors associated with strongyloidiasis among patients at high risk of complications.
METHODS
A cross-sectional study was carried out in Santa Cruz (elevation 400 meters, tropical climate) and Cochabamba (elevation 2,500 meters, temperate climate), among patients with cancer, HIV infection and rheumatic or hematologic disease, using four coproparasitological techniques and one serological (ELISA) test.
RESULTS
In total, 1,151 patients participated in this study, including individuals who were HIV-positive (30%) or with rheumatic (29%), oncologic (32%) or hematologic (9%) diseases. The serological and coproparasitological prevalence was 23.0% (95% confidence interval [CI], 20.7-25.5; n = 265/1151) and 7.6% (95% CI, 6.2-9.3; n = 88/1151), respectively, with an estimated actual prevalence of 20.2% (95% CI, 17.9-22.5). Positive serology and positive coproparasitology were associated with younger age and lower education levels. There was no significant difference in prevalence between Cochabamba and Santa Cruz as defined by coproparasitology (6.4% vs. 8.9%; p = 0.11) or serology (24.0% vs. 22.0%; p = 0.4). Among 64 patients in Cochabamba who had never travelled to the tropical lowlands, 5 (7.8%) had a positive coproparasitology.
CONCLUSIONS
Strongyloidiasis is widely prevalent in Bolivia among vulnerable patients at increased risk of life-threatening complications. Transmission of the parasite occurs both in tropical lowlands and temperate elevation (≥ 2,500 m). Control strategies to prevent transmission and complications of this serious parasitic disease should be urgently reinforced.
Identifiants
pubmed: 30653489
doi: 10.1371/journal.pntd.0007028
pii: PNTD-D-18-01135
pmc: PMC6353209
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0007028Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Parassitologia. 1998 Dec;40(4):473-5
pubmed: 10645561
Mem Inst Oswaldo Cruz. 2002 Jan;97(1):119-21
pubmed: 11992161
Rev Soc Bras Med Trop. 2002 Nov-Dec;35(6):571-4
pubmed: 12612736
J Infect Dis. 2004 Dec 15;190(12):2175-80
pubmed: 15551217
Am J Trop Med Hyg. 2006 Jan;74(1):97-102
pubmed: 16407351
Scand J Infect Dis. 2008;40(2):154-8
pubmed: 17852953
Trans R Soc Trop Med Hyg. 2008 Apr;102(4):314-8
pubmed: 18321548
J Clin Invest. 2008 Apr;118(4):1311-21
pubmed: 18382743
Parasitol Res. 2009 Feb;104(3):553-7
pubmed: 18931858
Am J Trop Med Hyg. 1991 Oct;45(4):518-21
pubmed: 1951861
Parasitol Int. 2010 Mar;59(1):9-14
pubmed: 19892034
BMC Res Notes. 2010 Apr 01;3:90
pubmed: 20359359
Trop Geogr Med. 1990 Oct;42(4):312-23
pubmed: 2100072
Curr Infect Dis Rep. 2011 Feb;13(1):35-46
pubmed: 21308453
Parasitology. 2011 Sep;138(11):1331-40
pubmed: 21810305
Ann Trop Med Parasitol. 2011 Dec;105(8):617-23
pubmed: 22325821
Am J Trop Med Hyg. 2012 Apr;86(4):624-34
pubmed: 22492147
Trans R Soc Trop Med Hyg. 2012 Jun;106(6):333-9
pubmed: 22515992
Curr Opin Infect Dis. 2012 Aug;25(4):458-63
pubmed: 22691685
Parasitology. 2012 Sep;139(11):1513-20
pubmed: 22813776
Pathog Glob Health. 2012 Aug;106(4):249-51
pubmed: 23265427
PLoS Negl Trop Dis. 2013;7(2):e2035
pubmed: 23409200
PLoS Negl Trop Dis. 2013 May 09;7(5):e2214
pubmed: 23675546
BMC Res Notes. 2013 May 20;6:200
pubmed: 23688049
Trans R Soc Trop Med Hyg. 2013 Aug;107(8):465-70
pubmed: 23783760
Handb Clin Neurol. 2013;114:229-34
pubmed: 23829913
PLoS Negl Trop Dis. 2013 Jul 11;7(7):e2288
pubmed: 23875033
Case Rep Hematol. 2013;2013:860976
pubmed: 23936693
PLoS Negl Trop Dis. 2014 Jan 09;8(1):e2640
pubmed: 24427320
Parasit Vectors. 2014 May 12;7:221
pubmed: 24886763
Rev Esp Salud Publica. 2014 Oct;88(5):581-600
pubmed: 25327268
BMC Res Notes. 2015 Jan 24;8:17
pubmed: 25616876
Clin Microbiol Infect. 2015 Jun;21(6):543-52
pubmed: 25887711
Acta Trop. 2016 Feb;154:133-8
pubmed: 26592319
Rev Infect Dis. 1989 Sep-Oct;11(5):755-67
pubmed: 2682948
Am J Case Rep. 2017 Apr 03;18:339-346
pubmed: 28366929
Trop Med Int Health. 2017 Nov;22(11):1457-1462
pubmed: 28929562
PLoS Negl Trop Dis. 2017 Oct 23;11(10):e0005685
pubmed: 29059195