Modeling strongyloidiasis risk in the United States

Singer, Rachael; Sarkar, Sahotra

doi:10.1016/j.ijid.2020.09.002

Cited by 20 publications

(7 citation statements)

References 25 publications

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“…Our knowledge of the geographic distribution of Strongyloides species globally is limited, even in high-income country (HIC) settings. For example, recent modeling suggests far larger areas in the United States provide a suitable habitat for Strongyloides than previously described [ 36 ], consistent with previous reports of strongyloidiasis without travel to areas of higher endemicity [ 37 ]. A recent study performed in rural Alabama found a 7.3% prevalence of S. stercoralis using stool PCR analysis [ 38 ], which is higher than that of previous studies which used less sensitive stool microscopy detection methods [ 39 ].…”

Section: Risk Factors For Shs In Covid-19supporting

confidence: 85%

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: Risk Factors For Shs In Covid-19supporting

confidence: 85%

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

et al. 2023

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“…Strongyloidiasis is a worldwide helminthiasis that is highly prevalent in tropical or subtropical countries [ 37 ]. Additionally, endemic pockets have been recorded in more temperate areas, such as the Southeastern states of the USA [ 38 ] or Southern Europe [ 39 ]. Concerning France, the presence of autochthonous strongyloidiasis in the Midi-Pyrénées Region had been previously reported [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Epidemiological, Clinical and Laboratory Features of Strongyloidiasis in 69 Attendees at a French Outpatient Clinic

et al. 2023

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The present retrospective study analyzed the characteristics of strongyloidiasis in patients who were diagnosed at the Outpatient Clinic of the Department of Parasitology-Mycology, Toulouse, France. Sixty-nine file records were included in the study on the basis of a positive stool examination that used Baermann’s method. The prominent epidemiological findings were the presence of former immigrants from Italy or Portugal, veterans from the 1st Indochina war, and autochthonous cases. Almost 1/4 of the patients were asymptomatic. Manifestations of skin allergy were the main clinical feature. Blood eosinophilia was present in 76.8% of the patients, and serum total IgE was ≥150 kIU/L in 79.7%. Immunodiagnosis was achieved from 1990 to 2001 by indirect immunofluorescence (IFAT) that was then replaced with ELISA, both methods using Strongyloides ratti filariform larvae. ELISA was found to be similar to IFAT in terms of specificity but exhibited a greater sensitivity. Patients were primarily treated with albendazole or ivermectin beginning in 1993. Forty-eight patients attended the follow-up consultation. Kinetics of the clinical picture and blood eosinophilia were found to be the most convenient parameters to assess the efficacy of anthelmintic therapy. In conclusion, strongyloidiasis remains a neglected disease in Southwestern France. The resolution of clinical features along with the kinetics of eosinophilia appeared to be the most appropriate parameters to check during the posttreatment follow-up.

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“…For example, do not go barefoot when traveling in fields, and wash raw vegetables and fruit thoroughly. 20 Patients receiving long-term steroids should also take prophylactic medication (albendazole) every three months to prevent strongyloidiasis. 9 …”

Section: Discussionmentioning

confidence: 99%

Disseminated Strongyloidiasis Misdiagnosed as Guillain-Barré Syndrome: The Value of High-Throughput Genetic Sequencing of Pathogenic Microorganisms in Parasitic Infections

Song¹,

Li²,

Liu³

et al. 2022

IDR

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Background With the widespread use of steroids and immunosuppressants in mainland China, disseminated strongyloidiasis is becoming a severely underestimated tropical disease due to the lack of disease-specific manifestations and well-established diagnostic methods. Case Presentation Here, we report a 70-year-old woman who was diagnosed with Guillain-Barré syndrome due to autonomic disturbance, symmetrical bulbar palsy, and lower-motor-nerve damage in the extremities; her symptoms continued to worsen after hormone and immunoglobulin therapy. Later, parasitic larvae were found in the patient’s gastric fluid, and metagenomic Next Generation Sequencing (mNGS) detection of bronchoalveolar-lavage fluid also found a large number of Strongyloides roundworms . The patient was diagnosed with disseminated strongyloidiasis. The patient was given albendazole for anthelmintic treatment, but died two days after being transferred to the ICU due to the excessive strongyloidiasis burden. Conclusion This case highlights the combined application of mNGS and traditional testing in the clinical diagnosis of difficult and critical parasitic infections in immunocompromised patients. mNGS is a new, adjunct diagnostic method to rapidly screen for possible parasitic etiologies.

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Modeling strongyloidiasis risk in the United States

Cited by 20 publications

References 25 publications

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

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

Epidemiological, Clinical and Laboratory Features of Strongyloidiasis in 69 Attendees at a French Outpatient Clinic

Disseminated Strongyloidiasis Misdiagnosed as Guillain-Barré Syndrome: The Value of High-Throughput Genetic Sequencing of Pathogenic Microorganisms in Parasitic Infections

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