Current pharmacotherapeutic strategies for Strongyloidiasis and the complications in its treatment

Buonfrate, Dora; Rodari, Paola; Barda, Beatrice; Page, Wendy; Einsiedel, Lloyd; Watts, Matthew

doi:10.1080/14656566.2022.2114829

Cited by 17 publications

(20 citation statements)

References 91 publications

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“…Strongyloides seroprevalence surveys and their validation of screening algorithms could be incorporated into the protocols for COVID-19 therapeutic and vaccine trials in efficient and cost-effective ways (e.g., by using serum already collected to study the SARS-CoV-2 antibody responses for a vaccine clinical trial), which would also help to reduce the confounding of the immunologic and clinical outcomes of COVID-19 research by Strongyloides infection. Prospective clinical trials to establish safe and effective approaches for Strongyloides treatment in persons who cannot take oral medications are also needed, as well as in special populations such as pregnant women and young children where adequate safety and pharmacokinetic data is lacking [ 101 ]. There is also a critical need for improved Strongyloides diagnostic testing that can be implemented in resource-limited settings; if the PCR capacity has increased in some LMIC settings due to the need to test for SARS-CoV-2, this technical knowledge and equipment could perhaps be leveraged in the future to perform stool PCR-based screening for soil-transmitted helminths as well.…”

Section: Discussion Of the Challenges In Prevention Diagnosis And Man...mentioning

confidence: 99%

“…Approximately 2% of those with COVID-19 require admission to an intensive care unit, and in the setting of critical illness, there may be a difficulty in administering oral formulations of ivermectin due to malabsorption or shock [ 59 ]. Furthermore, the absorption and bioavailability of ivermectin is improved when taken with food, which is not feasible for many patients with respiratory failure due to COVID-19 who are receiving respiratory support [ 101 ]. Unfortunately, only oral formulations of ivermectin are licensed for human use, and while subcutaneous and rectal ivermectin have been used previously, the published evidence is merely anecdotal and the optimal dosing via these routes is unknown [ 97 , 100 , 101 ].…”

Section: Treatment Of Strongyloides In Covid-19mentioning

confidence: 99%

“…Furthermore, the absorption and bioavailability of ivermectin is improved when taken with food, which is not feasible for many patients with respiratory failure due to COVID-19 who are receiving respiratory support [ 101 ]. Unfortunately, only oral formulations of ivermectin are licensed for human use, and while subcutaneous and rectal ivermectin have been used previously, the published evidence is merely anecdotal and the optimal dosing via these routes is unknown [ 97 , 100 , 101 ].…”

Section: Treatment Of Strongyloides In Covid-19mentioning

confidence: 99%

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Strongyloides and COVID-19: Challenges and Opportunities for Future Research

et al. 2023

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Strongyloides stercoralis is a soil transmitted helminth endemic to tropical and subtropical areas that can persist for decades in immunocompetent human hosts as a chronic asymptomatic infection. The use of corticosteroids, a mainstay of treatment for patients hospitalized with severe coronavirus disease (COVID-19), can trigger a life-threatening Strongyloides hyperinfection syndrome and disseminated disease. We identified 22 previously published cases of strongyloidiasis occurring in individuals with COVID-19, with one death reported among the seven patients who had Strongyloides hyperinfection syndrome. A total of seventeen patients had previously received corticosteroids, and of the five with no prior corticosteroid use, one presented with hyperinfection syndrome. We identify the key challenges in the diagnosis and treatment of Strongyloides within the context of COVID-19, including our imprecise knowledge of the global distribution of Strongyloides, the overlapping symptoms and signs of COVID-19 and Strongyloides hyperinfection syndrome, the limited utility of eosinophilia as a clinical marker for strongyloidiasis in this setting, the lack of validated algorithms to screen for Strongyloides prior to corticosteroid use, and the paucity of treatment options for critically ill patients with COVID-19 who cannot take oral ivermectin. Future research should focus on improved diagnostic methods and population prevalence estimates, optimizing the approaches for Strongyloides screening in persons with COVID-19 (including clinical trial participants and strategies for resource-limited settings) and better defining the role of pre-emptive treatment.

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Section: Discussion Of the Challenges In Prevention Diagnosis And Man...mentioning

confidence: 99%

Section: Treatment Of Strongyloides In Covid-19mentioning

confidence: 99%

Section: Treatment Of Strongyloides In Covid-19mentioning

confidence: 99%

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Strongyloides and COVID-19: Challenges and Opportunities for Future Research

et al. 2023

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“…Although Albendazole has been extensively used in massive programs for the control of soil-transmitted helminths [ 56 ], this drug has been considered a second-line treatment for S . stercoralis infection [ 5 ]. Herein, indigenous persons may have refused, simulated intake,’ or discharged the anti-helminthics, which could have caused resistance over time, or reduced but not eradicated the chances of by S .…”

Section: Discussionmentioning

confidence: 99%

“…Strongyloidiasis is asymptomatic or oligosymptomatic in most infected individuals [ 4 ]. Dysregulation of cellular immune response, however, may trigger the reactivation of larvae and result in a life-threatening hyper-infection syndrome affecting multiple organ systems [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Seroprevalence and associated risk factors of strongyloidiasis in indigenous communities and healthcare professionals from Brazil

et al. 2023

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Strongyloides stercoralis, a pathogenic roundworm, is considered endemic in several tropical and subtropical areas worldwide. Indigenous populations have the highest soil-transmitted helminthiases-related mortality rates, but the prevalence and risk factors associated with S. stercoralis in Brazilian indigenous populations have not been established. Thus, the present study aimed to assess the seroprevalence and associated risk factors for S. stercoralis in indigenous communities and the healthcare professionals serving them in Brazil. Indigenous populations living in nine communities and healthcare professionals were tested for anti- S. stercoralis antibodies by ELISA. A questionnaire was used to assess socio-epidemiological information. Associated risk factors for seropositivity were tested by chi-square or Fisher’s exact tests, using bivariate analyses and multivariate logistic regression. Overall, 174/463 (37.6%; CI 95%: 33.3–42.1) indigenous persons and 77/147 (52.4%; 95% CI: 44.3–60.3) healthcare professionals were seropositive for anti- S. stercoralis antibodies. Seropositivity among the two groups was statistically significant (p = 0.0016; OR = 0.547; 95% CI: 0.376–0.796) and revealed that healthcare professionals were 1.83 times more likely to be seropositive. The multivariate analysis showed that being male or being adult were also risk factors, while having a septic tank as a sanitary facility represented a protective factor for S. stercoralis exposure in indigenous persons. None of the variables evaluated were associated with S. stercoralis exposure in the professional group. The study herein has reported a high seroprevalence to Strongyloides stercoralis in indigenous communities of Brazil and healthcare professionals, warning for potential public health concerns of strongyloidiasis in such populations.

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Pulmonary strongyloidiasis and hyperinfection in a Patient with idiopathic inflammatory myopathy：A case report

Fan,

Fu,

2024

Heliyon

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Current pharmacotherapeutic strategies for Strongyloidiasis and the complications in its treatment

Cited by 17 publications

References 91 publications

Strongyloides and COVID-19: Challenges and Opportunities for Future Research

Strongyloides and COVID-19: Challenges and Opportunities for Future Research

Seroprevalence and associated risk factors of strongyloidiasis in indigenous communities and healthcare professionals from Brazil

Pulmonary strongyloidiasis and hyperinfection in a Patient with idiopathic inflammatory myopathy：A case report

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