Diagnosis of human strongyloidiasis: Application in clinical practice

Costa, Idessânia Nazareth; Bosqui, Larissa Rodrigues; Corral, Marcelo Andreetta; Costa-Cruz, Júlia Maria; Gryschek, Ronaldo César Borges; Paula, Fabiana Martins de

doi:10.1016/j.actatropica.2021.106081

Cited by 8 publications

(9 citation statements)

References 123 publications

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“…Immunological techniques, such as enzyme-linked immunosorbent assay (ELISA), immunofluorescence antibody test (IFAT), and western blot, have been used as alternatives for S. stercoralis diagnosis and present certain advantages over parasitological methods [ 22 ]. Various studies have shown their high sensitivity, depending on the type of test employed [ 9 , 22 , 23 ]. Table 1 summarizes the sensitivity and specificity of the different immunological tests for the diagnosis of human strongyloidiasis.…”

Section: Techniques For Strongyloides Stercoralis ...mentioning

confidence: 99%

“…The sensitivity of five immunological tests (consisting of in-house assays and commercially available ELISA tests) was compared by Bisoffi et al (2014), and their results revealed that the sensitivity among the tests ranged from 75.4% to 93.9%, with the IFAT test being the most sensitive [ 24 ]. However, studies have also revealed cross-reactivity with other helminthic infections, such as filariasis and schistosomiasis, when crude antigens are used [ 5 , 22 , 25 ]. Also, immunological tests cannot distinguish between current and past infections of S. stercoralis , which can be a limiting factor in areas where strongyloidiasis is endemic [ 23 , 26 ].…”

Section: Techniques For Strongyloides Stercoralis ...mentioning

confidence: 99%

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From past to present: opportunities and trends in the molecular detection and diagnosis of Strongyloides stercoralis

Chan

Thaenkham

2023

Parasites Vectors

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Strongyloides stercoralis is a soil-transmitted helminth that is mainly found in the tropical and subtropical regions and affects approximately 600 million people globally. The medical importance of strongyloidiasis lies in its capacity to remain asymptomatic and chronically unnoticed until the host is immunocompromised. Additionally, in severe strongyloidiasis, hyperinfection syndrome and larva dissemination to various organs can occur. Parasitological techniques such as Baermann-Moraes and agar plate culture to detect larvae in stool samples are the current gold standard. However, the sensitivity might be inadequate, especially with reduced worm burden. Complementing parasitological techniques, immunological techniques including immunoblot and immunosorbent assays are employed, with higher sensitivity. However, cross-reactivity to other parasites may occur, hampering the assay’s specificity. Recently, advances in molecular techniques such as polymerase chain reaction and next-generation sequencing technology have provided the opportunity to detect parasite DNA in stool, blood, and environmental samples. Molecular techniques, known for their high sensitivity and specificity, have the potential to circumvent some of the challenges associated with chronicity and intermittent larval output for increased detection. Here, as S. stercoralis was recently included by the World Health Organization as another soil-transmitted helminth targeted for control from 2021 to 2030, we aimed to present a review of the current molecular techniques for detecting and diagnosing S. stercoralis in a bid to consolidate the molecular studies that have been performed. Upcoming molecular trends, especially next-generation sequencing technologies, are also discussed to increase the awareness of its potential for diagnosis and detection. Improved and novel detection methods can aid in making accurate and informed choices, especially in this era where infectious and non-infectious diseases are increasingly commonplace. Graphical Abstract

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Section: Techniques For Strongyloides Stercoralis ...mentioning

confidence: 99%

Section: Techniques For Strongyloides Stercoralis ...mentioning

confidence: 99%

From past to present: opportunities and trends in the molecular detection and diagnosis of Strongyloides stercoralis

Chan

Thaenkham

2023

Parasites Vectors

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“…Early diagnosis and prompt treatment are essential for a better prognosis (Guerreiro et al, 2018;Barreto et al, 2022). For the laboratory analysis, serology, parasitological examination of feces (stool O&P test), direct observation of the helminth and DNA research may be performed (Costa et al, 2021;Krasnovska et al, 2022). Faced with the clinical suspicion of a severe condition in immunosuppressed patients, negative serology is not considered as reliable, and the analyzes must be performed on two or more stool samples, in addition to molecular tests, when available (Costa et al, 2021).…”

Section: 2022mentioning

confidence: 99%

“…For the laboratory analysis, serology, parasitological examination of feces (stool O&P test), direct observation of the helminth and DNA research may be performed (Costa et al, 2021;Krasnovska et al, 2022). Faced with the clinical suspicion of a severe condition in immunosuppressed patients, negative serology is not considered as reliable, and the analyzes must be performed on two or more stool samples, in addition to molecular tests, when available (Costa et al, 2021). Finding eosinophilia is common, as in this report, and, in some cases, the histopathological examination of skin biopsy of periumbilical purpura may demonstrate parasites around the blood vessels, as well as signs absence of vasculitis (Krasnovska et al, 2022).…”

Section: 2022mentioning

confidence: 99%

Periumbilical purpuric rash as a clue to the diagnosis of strongyloidiasis and HTLV-1 infection

Tinelli Sant’ana,

Ximenes Fragoso,

Giuberti Junior

2023

Rev Patol Trop

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Strongyloidiasis is a parasitic disease caused by the nematode Strongyloides stercoralis, widely distributed in Brazil. In general, it manifests with nonspecific gastrointestinal symptoms. However, in severe cases, pulmonary, neurological and systemic manifestations may occur, culminating in high mortality rates. Exceptionally, there may be a single-appearing periumbilical purpuric eruption. The prognosis is related to the rapid diagnosis and to beginning of the therapy. The case of an elderly man, former alcoholic, with chronic abdominal pain, fever and unexplained weight loss, in addition to periumbilical purpura is reported on this study. The manifestation motivated a specific investigation in which resulted in the diagnosis of strongyloidiasis and infection by human T-lymphotropic virus 1 (HTLV-1). KEY WORDS: Strongyloidiasis; Strongyloides stercoralis; HTLV-1; Purpura

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“…Other tests that allow the diagnosis of strongyloidiasis are the detection of larvae by culture on an agar plate and the Baermann method, with sensitivity between 60 and 85%. However, these methods are laborious, with limited practical use in clinical laboratories (Costa et al 2021). The immunological diagnosis allows for ELISA detection of the patient’s antibodies against the parasite, but the available tests are not yet very specific, due to cross-reactions with other helminths (Machado et al 2008; Hailu et al 2022).…”

Section: Introductionmentioning

confidence: 99%

Comparison of different PCR amplification targets for molecular diagnosis of Strongyloides stercoralis

Marquet,

Mora,

Incani

et al. 2023

J. Helminthol.

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Molecular techniques are an alternative for the diagnosis of strongyloidiasis, produced by Strongyloides stercoralis. However, it is necessary to determine the best amplification target for the populations of this parasite present in a geographical area and standardize a polymerase chain reaction (PCR) protocol for its detection. The objectives of this work were the comparison of different PCR targets for molecular detection of S. stercoralis and the standardization of a PCR protocol for the selected target with the best diagnostic results. DNA extraction was performed from parasite larvae by saline precipitation. Three amplification targets of the genes encoding ribosomal RNA 18S (18S rDNA) and 5.8S (5.8S rDNA) and cytochrome oxidase 1 (COX1) of S. stercoralis were compared, and the PCR reaction conditions for the best target were standardized (concentration of reagents and template DNA, hybridization temperature, and number of cycles). The analytical sensitivity and specificity of the technique were determined. DNA extraction by saline precipitation made it possible to obtain DNA of high purity and integrity. The ideal target was the 5.8S rDNA, since the 18S rDNA yielded non-reproducible results and COX1 never amplified under any condition tested. The optimal conditions for the 5.8S rDNA-PCR were: 1.5 mM MgCl2, 100 μM dNTPs, 0.4 μM primers, and 0.75 U DNA polymerase, using 35 cycles and a hybridization temperature of 60 °C. The analytical sensitivity of the PCR was 1 attogram of DNA, and the specificity was 100%. Consequently, the 5.8S rDNA was shown to be highly sensitive and specific for the detection of S. stercoralis DNA.

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Diagnosis of human strongyloidiasis: Application in clinical practice

Cited by 8 publications

References 123 publications

From past to present: opportunities and trends in the molecular detection and diagnosis of Strongyloides stercoralis

From past to present: opportunities and trends in the molecular detection and diagnosis of Strongyloides stercoralis

Periumbilical purpuric rash as a clue to the diagnosis of strongyloidiasis and HTLV-1 infection

Comparison of different PCR amplification targets for molecular diagnosis of Strongyloides stercoralis

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